Black Monthly Statement

Kolli V D S Siva Samrat Total Amount Payable: Due Date:

Registered Email: ₹2,143.03 16 Nov 2025
savasamrat@[Link]
Registered Telephone Number (RTN):
8890224743

Your Plan: Pay via

Airtel Custom Plan
Airtel Thanks App
Airtel Black ID Number of connections
10101026421150 5 [Link]/pay

Statement Date Statement Period Scan and pay via any UPI apps
6 Nov 2025 5 Oct 2025 - 4 Nov 2025 Powered by

Last bill amount Payment made Credits This Month's Charges Total Amount Amount after
due date (16 Nov)

₹2,473.66 - ₹2,473.66 - ₹0.00 + ₹2,143.03 = ₹2,143.03 ₹2,479.03

This Month's Summary (Amounts in ₹)

Services Connections Plan/Pack Charges Other Charges Total

Airtel Custom Plan - 10101026421150 5 1961.29 0.00 1,961.29

Plan Discount - - - 145.16

Revised Charges - - - 1,816.13

Taxes - - - 326.90

This month's charges 2,143.03

TOTAL ₹2,143.03

Total: Two Thousand One Hundred Forty Three Rupees And Three Paise Only

Changes This Month

Services Details

Plan Change

Wi-Fi : 026524906283_wifi New connection added to the Black plan on 22 Oct 2025

**All the charges are on pro rata basis.

Detailed breakup of these charges can be found on respective invoice pages.

Bills & Payments Summary

Month Previous Dues (A) Payments (B) Credits (C) This Month's Charges (D) Total Amount (A+B+C+D)

Nov'25 2,473.66 -2,473.66 0.00 2,143.03 2,143.03

Oct'25 1,473.82 -1,473.82 0.00 1,473.82 1,473.82

Sep'25 1,555.31 -1,555.31 0.00 1,473.82 1,473.82

Aug'25 204.30 -187.50 0.00 1,538.51 1,555.31

All above values are inclusive of tax

FIXEDLINE AND Wi-Fi SERVICES
Original Copy for Recipient provided by Bharti Airtel Limited- Tax Invoice
Fixedline number : 02654066106 / Wi-Fi ID : 026524906283_wifi

Billing Address

V D S Siva Samrat kolli

OMQ -28 officers enclave Air force stati,Vadodara,Air Force Rd
Yashoda Colo ny Himmat Nagar Makarpura,Air Force Station HF2624I002705968 20029933272
Makarpura,Vadodara,Gujarat,3900 14 Ship To State Code : 24 Place of Supply : Gujarat
Vadodara, 390014
Gujarat
Email id : sivasamrat@[Link]
PhoneNo:8890224743

Account

Account No 20029933272 Bill NO HF2624I002705968

Bill Period 17 Oct 2025 to 04 Nov 2025 Bill Date 06 Nov 2025
Due date 16 Nov 2025
Credit limit 2500.00
Security deposit 0.00

Amount after due

Last bill amount Payment made Credits This month's charges Total Amount
date(16Nov)

` 999.84 - ` 999.84 - ` 0.00 + ` 669.21 = ` 669.21 ` 787.21

This Month's Charges Charges( ` )

Rental Charges 567.13

Taxes 102.08

Total Amount ` 669.21

Total:Six Hundred Sixty Nine Rupees and Twenty One Paise Only

Detailed breakup of these charges can be found on next page

Send payment to
[Link]@mairtel

For Bharti Airtel Limited

Scan & pay via any UPI Apps

Vasim Unissa S, Powered by

Head - Experience Operations (VP)

Page 1 of 2
 Relationship No : 20029933272

YOUR CHARGES IN DETAIL

Rentals
Description From date To date Rental Discount Net charges Total(`)
Plan Details
567.13
Scheme Charges @ ` 999 17/10/2025 04/11/2025 612.29 45.16 567.13

Tax Details
CGST SGST/UTGST
HSN Taxable Value Total Tax Total(`)
Rate Amount Rate Amount
998412 567.13 9% 51.04 9% 51.04 102.08 102.08

This month's charges 669.21

Payments and refunds-details

Description Date Amount Total(`)
payment via airtel pay (payu) 22-Oct-2025 -999.84 -999.84

Bill Plan Details : 999 Wi-Fi. 100Mbps

Rental: ` 999 Quota: Unlimited *Speed: 100 Mbps
Tariff Details
Local STD Intra Circle STD Inter Circle ISD
Voice - Call Rates
(Rs/sec) (Rs/sec) (Rs/sec) (Rs/sec)
to airtel fixedline .00/60 Sec .00/60 Sec .00/60 Sec
to other fixedline .00/60 Sec .00/60 Sec .00/60 Sec for country
to airtel mobile .00/60 Sec .00/60 Sec .00/60 Sec
specific rates
to other mobile .00/60 Sec .00/60 Sec .00/60 Sec
to fixedline CUG .00/60 Sec .00/60 Sec .00/60 Sec visit [Link]
to WLL .00/60 Sec .00/60 Sec .00/60 Sec
*Post consumption of Unlimited quota, the speed would be revised to 2 Mbps as per Fair Usage Policy | For information on other plans, visit [Link]/broadband

Payment Modes - Pay online using debit/credit card, netbanking on My Airtel App, [Link], eWallets, UPI, visit an Airtel Store to pay using cash/cheque/credit/
debit cards or activate Auto pay options from bank account (NACH) or Credit card account (SI)
Contact Information - For Queries: Call 121 (toll free for Airtel), 079-44444121(for Non-Airtel number, call charges apply) | Complaints: Call 198 (toll free for
Airtel), 079-44444198(for Non-Airtel number, call charges apply) | NDNC Registration: Call 1909 (Activation time: 7 days) | Complaint/SR Status: [Link]/
help. | Appellate Desk: Mr. Ashish Agrawal, 079-40020143; [Link]@[Link]; address: Bharti Airtel Limited, Zodiac Square, 2nd Floor, SG Road, Opp
Gurudwara, Ahmedabad 380 054
Call 1930 for cyber-crime fraud reporting.
Corporate Coordinator Contact Information - For queries and complaints: Call 1800102002 | Email: Esupport@[Link]
Charges - Itemized bill: Rs. 50/Bill | Duplicate Bill: Rs. 50/Bill (Last 2 months free) | Cheque / SI / ECS Decline: Rs. 200 | Late payment charges shall be Rs. 100 for
bill value between Rs. 300 and Rs. 5,000; and for bill value above Rs. 5,000, a charge of 2% of the amount, capped at a maximum of Rs. 750 will be applied. As per
the Government directive, effective 1-July-17, 18% GST is applicable on Late Fee Charges. No charge is levied for any service without your explicit consent.
Address change - Visit the nearest Airtel Store with new address proof. For store details, visit [Link]/store
Other Information - Tariff Plan: No increase in any line item (except ISD) for first 6months effective enrolment date. T&C apply | No fee is charged for migrating to
any plan | Disconnection: For permanent disconnection, security deposit will be refunded within 60days. Else, interest will be paid @10%p.a. | Call pulses will be
rounded off | Billing disagreements should be reported within 2months of bill receipt. Post this period no claim shall be entertained. | Whether tax is payable on
Reverse Charge Basis - "NO". The Airtel Wi-Fi router is Airtel's property & may be reclaimed if the customer discontinues Airtel's Wi-Fi services.
Registered Office : Bharti Airtel Limited, Plot No. 16, Udyog Vihar, Phase IV, Gurugram - 122015, Haryana, India. Tel: +91-124-4248655, e-mail: 121@[Link],
website: [Link]
Corporate Identity Number : L74899HR1995PLC095967 Bharti Airtel Ltd, 2nd Floor, Zodiac Square, Opp. Gurudwara, [Link], Bodakdev, Ahmedabad, Gujrat -
380054
Ship To State Code : 24 GST registration no : 24AAACB2894G1ZT under Category TELECOMMUNICATION SERVICE PAN : AAACB2894G
HSN : 998412 Fixed Telephony Service , 998433 On-line video content , 996812 Courier Services , 997317 Leasing or rental services concerning
telecommunications equipment with or without operator , 9983 Support services , 998716 Maintenance and repair services of telecommunication equipment and
apparatus , 999799 Other Services n.e.c

Page 2 of 2
MOBILE SERVICES
Original Copy for Recipient provided by Bharti Airtel Limited- Tax Invoice
1388998040

Billing Address

Mr Kolli . V D S Siva Samrat

O M Q 16/2 Officers Enclave M B Road Delhi,New Delhi
South Delhi 110062
Delhi MF2607I007721335 1388998040
Email: sivasamrat@[Link]
PhoneNo: 8890224743 Ship To State Code : 07 Place of Supply : Delhi

Account

Account No 1388998040 Bill NO MF2607I007721335

Bill Period 05 Oct 2025-04 Nov 2025 Adjustment 0.00
Bill Date 06 Nov 2025
Due date 24 Nov 2025
Credit limit 10000
Security deposit 0.0

Amount after due

Last bill amount Payment made Credits This Month's Charges Total Amount
date(24Nov)

` 1060.82 - ` 1060.82 - ` 0.00 + ` 1060.82 = ` 1060.82 ` 1178.82

This Month's Charges Charges (` )

Rental Charges 899.00

Taxes 161.82

Total Amount ` 1060.82

Total:One Thousand Sixty Rupees and Eighty Two Paise Only

Detailed breakup of these charges can be found on next page

Send payment to
[Link]@mairtel

For Bharti Airtel Limited

Scan & pay via any UPI Apps

Vasim Unissa S, Powered by

Head - Experience Operations (VP)

Page 1 of 5
 Relationship number 1388998040

SUMMARY OF THIS MONTH CHARGES

Account summary
Account no. Airtel number Monthly rentals Usage One time charges Total
1388998040 8890224743 899.00 0.00 0.00 899.00
1-2533583129007 7568504743 0.00 0.00 0.00 0.00
1-3370440852013 7042437008 0.00 0.00 0.00 0.00
Total 899.00 0.00 0.00 899.00

Tax Details
CGST SGST/UTGST
HSN Taxable Value Total Tax Total(`)
Rate Amount Rate Amount
998413 899.00 9% 80.91 9% 80.91 161.82 161.82

This month's charges 1060.82

Payment Details
Description Date Total Total(`)
Payment via Airtel Pay (PayU) 16-Oct-2025 -1060.82 -1060.82

Payment Modes - Pay online using debit/credit card, netbanking on My Airtel App, [Link], eWallets, UPI, visit an Airtel Store to pay using
cash/cheque/credit/debit cards or activate Auto pay options from bank account (NACH) or Credit card account (SI)
Contact Information - For Queries: Call 121(tollfree) | Complaints: Call 198(tollfree) | Email: 121@[Link] | NDNC
Registration: Call 1909 (Activation time: 7days) | Complaint / SR Status: [Link]/airtelpresence . Appellate Desk: Mr. Ankur
Singh ;9958444865;[Link]@[Link] ;Bharti Airtel Limited, Plot No. 16, Udyog Vihar, Phase - IV, Gurgaon - 122015
Call 1930 for cyber-crime fraud reporting.
Charges - Cheque / SI / ECS Decline: Rs. 200 | Late payment charges shall be Rs. 100 for bill value between Rs. 300 and Rs. 5,000; and for
bill value above Rs. 5,000, a charge of 2% of the amount, capped at a maximum of Rs. 750 will be applied. No charge is levied for any service
without your explicit consent.
Address change - Visit the nearest Airtel Store with new address [Link] store details, visit [Link]/store
Other Information - Tariff Plan: No increase in any line item (except ISD) for first 6months effective enrolment date. T&C apply | No fee is
charged for migrating to any plan | Disconnection: For permanent disconnection, security deposit will be refunded within 60days. Else, interest
will be paid @10%p.a. | Call pulses will be rounded off | Billing disagreements should be reported within 2months of bill receipt. Post this period
no claim shall be entertained. | The credit limit is not applicable on usage done in international roaming. | As per the Government directive,
effective 1-July-17, existing service tax of 15% has been replaced with 18% GST. |Whether tax is payable on Reverse Charge Basis - "NO".
Registered Office : Bharti Airtel Limited, Plot No. 16, Udyog Vihar, Phase IV, Gurugram - 122015, Haryana, India. Tel: +91-124-4248655, e-mail:
121@[Link], website: [Link]
Corporate Identity Number: L74899HR1995PLC095967 Bharti Airtel Ltd, 1, Bharti Crescent, Nelson Mandela Road, Vasant Kunj, Phase
II,Delhi, Delhi- 110070
State Code: 07 GST registration no.: 07AAACB2894G1ZP under Category TELECOMMUNICATION SERVICE PAN: AAACB2894G
HSN: 998599 Other support services 998433 On-line video content 996812 Courier Services 997317 Leasing or rental services concerning
telecommunications equipment with or without operator 998413 Mobile Telecommunication Service 9983 Support services 998716
Maintenance and repair services of telecommunication equipment and apparatus 999799 Other Services n.e.c

Page 2 of 5
 Relationship number 1388998040
Airtel mobile number 8890224743
YOUR CHARGES IN DETAIL - 8890224743

Monthly rentals
Description From date To date Rental Discount Amount Total(`)
Plan Name
899.00
infinity family 999 plan_pkg_51038 05/10/2025 04/11/2025 999.00 100.00 899.00

This month's charges 899.00

Tariff after plan benefits

Call rates Local( ` ) STD(` ) SMS rates Local( ` ) National( ` )
to airtel mobile 00/min 00/min local/national 0.1/msg 0.1/msg

to other mobile 00/min 00/min national roaming 0.25/msg 0.38/msg

international 5/msg 5/msg
to landline 00/min 00/min
to airtel cug 00/min 00/min
video call 00/sec 00/sec Data conversion : 1MB =1,024KB ; 1GB=1,024MB/1,048,576KB
For Roaming, ISD and other plans/tariff, visit [Link]
16-feb-2019

Page 3 of 5
 Relationship number 1-2533583129007
Airtel mobile number 7568504743
YOUR CHARGES IN DETAIL - 7568504743

Monthly rentals
Total(`)
Description From date To date Rental Discount Amount
0.00

This month's charges 0.00

Tariff after plan benefits

Call rates Local( ` ) STD(` ) SMS rates Local( ` ) National( ` )
to airtel mobile 00/min 00/min local/national 0.1/msg 0.1/msg

to other mobile 00/min 00/min national roaming 0.25/msg 0.38/msg

international 5/msg 5/msg
to landline 00/min 00/min
to airtel cug 00/min 00/min
video call 00/sec 00/sec Data conversion : 1MB =1,024KB ; 1GB=1,024MB/1,048,576KB
For Roaming, ISD and other plans/tariff, visit [Link]

Page 4 of 5
 Relationship number 1-3370440852013
Airtel mobile number 7042437008
YOUR CHARGES IN DETAIL - 7042437008

This month's charges 0.00

Tariff after plan benefits

Call rates Local( ` ) STD(` ) SMS rates Local( ` ) National( ` )
to airtel mobile 00/min 00/min local/national 0.1/msg 0.1/msg

to other mobile 00/min 00/min national roaming 0.25/msg 0.38/msg

international 5/msg 5/msg
to landline 00/min 00/min
to airtel cug 00/min 00/min
video call 00/sec 00/sec Data conversion : 1MB =1,024KB ; 1GB=1,024MB/1,048,576KB
For Roaming, ISD and other plans/tariff, visit [Link]

Page 5 of 5
DTH MONTHLY STATEMENT
Kolli Samrat DTH Account ID: 3061001356
OMQ/28 , Air Force Station Makarpura Total Amount:
Number of connections: 2
. ₹ 413.00
Vadodara, Gujarat 390014 Statement Date: 06 Nov 2025
Due Date:
Statement Period: 05 Oct 2025 to 04 Nov 2025
Phone number: 8890224743 16 Nov 2025

Last Bill Last Credit Charges for this Month Total Amount Amount after due date
Amount (A) Payments (B) (C) (D) (A-B-C+D) (16 Nov)

₹ 413.00 - ₹ 413.00 - ₹ 0.00 + ₹ 413.00 = ₹ 413.00 ₹ 513.00

This Month's Summary

Services Charges Tax Net Charges

1. Airtel Black Plan (Including NCF) ₹ 350.00 ₹ 63.00 ₹ 413.00

Total Charges ₹ 350.00 ₹ 63.00 ₹ 413.00

Previous Dues ₹ 0.00

Payable Amount ₹ 413.00

Total: Four Hundred Thirteen Rupees Only

TAX INVOICE • 3061001356
Original copy for recipient provided by Bharti Telemedia Ltd.

Billing Details

Kolli Samrat
OMQ/28 , Air Force Station Makarpura Bill Number DP2624I000938041
.
Vadodara, Gujarat 390014 Bill Period 05 Oct 2025 to 04 Nov 2025

Contact Number 8890224743 Bill Date 06 Nov 2025

Due Date 16 Nov 2025

Place of Supply Gujarat

State Code 24

Security Deposit ₹ 0.00

Monthly Rental

DTH ID Description Duration Monthly Discount Net Charges

Charges

3061001356-001 Black Telugu Ultimate Plus HD 05 Oct - 04 Nov ₹ 349.00 ₹ 349.00

3061001356-001 NCF PRNT 833 05 Oct - 04 Nov ₹ 1.00 ₹ 1.00

Taxable Value – HSN/SAC 998466 (A) ₹ 350.00 ₹ 0.00 ₹ 350.00

State GST @9% (B) ₹ 31.50

Central GST @9% (C) ₹ 31.50

Charges for Bill period (A+B+C) ₹ 413.00

Scan & pay via any UPI Apps

Powered by

For Bharti Telemedia Limited

Ravi Negi, DGM

TAX INVOICE • 3061001356
Original copy for recipient provided by Bharti Telemedia Ltd.

Payments

Description Date Amount

Payment via Airtel Pay (PayU) 16 Oct 2025 -₹ 413.00

Total Payments ₹ -413.00

Payment Modes: Pay online using debit/credit card, netbanking on My Airtel App, [Link] eWallets, UPI, visit an Airtel Store to pay
using cash/cheque/credit/ debit cards or activate Auto pay options from bank account (NACH) or Credit card account (SI)
Contact Information: For Queries: Call 121 (toll free for Airtel), 0522-4444121(for Non-Airtel number, call charges apply) | Complaints: Call 198
(toll free for Airtel), 0522-4444198(for Non-Airtel number, call charges apply). For Nodal desk details: 079-40037114; [Link]@[Link];
address: Bharti Telemedia Ltd., 4th Floor, Zodiac Square, Opp. Gurudwara, Thaltej, Ahmedabad - 380054.. Complaint / SR Status:
[Link]
Call 1930 for cyber-crime fraud reporting
Other Information: Tariff Plan: Charges for the plan would depend on the price of the bouquet and ala-carte channels that customer has adopted
for. NCF would apply as per the government regulations. T&C apply | No fee is charged for migrating to any plan | For permanent disconnection,
security deposit will be refunded within 60days. Else, interest will be paid @10%p.a.| Billing disagreements should be reported within 2months
of bill receipt. Post this period no claim shall be entertained. As per the Government directive, effective 1-July-17, existing service tax of 15% has
been replaced with 18% GST. Whether tax is payable on Reverse Charge Basis - "NO".
Registered Office: Bharti Telemedia Ltd. Airtel Centre, Plot No. 16, Udyog Vihar, Phase IV, Gurugram – 122015, Haryana, India Tel: +91-124-
4222222 Fax: +91-124- 4243252, e-mail: 121@[Link], website: [Link]
Corporate Identity Number: U92200HR2006PLC130723 State Code: 24 GST registration no.: 24AADCB0147R1ZL Under Category
TELECOMMUNICATION SERVICE 2nd Floor, Zodiac Square, Opp. Gurudwara, [Link], Bodakdev, Ahmedabad, Gujrat - 380054 PAN:
AADCB0147R HSN: 998466 Home programme distribution services