Tax Invoice/Bill of Supply/Cash Memo
(Original for Recipient)
Sold By : Billing Address :
COCOBLU RETAIL LIMITED Sandeep Minj
* Sacred heart collage Satya Nilayam, No: 201, kalki
SHOP NO. 110A, VARDHAMAN MALL SECTOR Krishnamurthy road thiruvanmiyur
19 CHENNAI, TAMIL NADU, 600041
FARIDABAD, HARYANA, 121002 IN
IN State/UT Code: 33
PAN No: AAJCC8517E Shipping Address :
GST Registration No: 06AAJCC8517E1ZP Sandeep Minj
Sandeep Minj
Sacred heart collage Satya Nilayam, No: 201, kalki
Ship From : Krishnamurthy road thiruvanmiyur
NITHYA FOOTWEAR PRIVATE LIMITED - CHENNAI, TAMIL NADU, 600041
Hariyana - CB IN
PLOT NO-153,PHASE-4, Kanha Polyfab, Sector State/UT Code: 33
57, Kundli Industrial Area Place of supply: TAMIL NADU
KUNDLI INDUSTRIAL AREA, HARYANA, 131028 Place of delivery: TAMIL NADU
IN
Order Number: 402-4049207-0373123 Invoice Number : GQIZ-2454
Order Date: 23.02.2026 Invoice Details : HR-GQIZ-1271137075-2526
Invoice Date : 23.02.2026
Sl. Unit Net Tax Tax Tax Total
Description Discount Qty
No Price Amount Rate Type Amount Amount
1 HOPPA- BILLY Men Slider Lightweight Classic Clogs I
HOPP Tech R-eva Material I Lightweight I Superior Bounce I
Stylish & Anti-Skid I Waterproof I Recyclable & eco-Friendly | ₹522.86 ₹0.00 1 ₹522.86 5% IGST ₹26.14 ₹549.00
B0DXQ5G9S6 ( B0DXQ5G9S6 )
HSN:64029990
Shipping Charges ₹38.10 -₹38.10 ₹0.00 5% IGST ₹0.00 ₹0.00
TOTAL: ₹26.14 ₹549.00
Amount in Words:
Five Hundred Forty-nine only
For COCOBLU RETAIL LIMITED:
Authorized Signatory
Whether tax is payable under reverse charge - No
Payment Transaction ID: Date & Time: 23/02/2026, 11:47:14 Invoice Value: Mode of Payment:
i93r3yqERXhenBmY2cxumsU6y5HhlkR20qs hrs 549.00 UPI
*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)
Customers desirous of availing input GST credit are requested to create a Business account and purchase on [Link]/business from Business eligible offers
Please note that this invoice is not a demand for payment
Page 1 of 1
Tax Invoice/Bill of Supply/Cash Memo
(Original for Recipient)
Signature valid
Digitally signed by DS AMAZON SELLER SERVICES PRIVATE LIMITED 6
Date: 2026.02.23 06:22:48 UTC
Reason: Invoice
Sold By : Billing Address :
Amazon Seller Services Private Limited Sandeep Minj
* Sacred heart collage Satya Nilayam, No: 201, kalki
Sattva Horizon, Survey No 6/1 and 7/1, Vinayak Krishnamurthy road thiruvanmiyur
Nagar, Kattigenahalli CHENNAI, TAMIL NADU, 600041
Venkatala Village, Yelahanka Hobli IN
Bangalore, Karnataka – 560064 State/UT Code: 33
India
Shipping Address :
PAN No: AAICA3918J Sandeep Minj
GST Registration No: 29AAICA3918J1ZE Sandeep Minj
CIN No: U51900KA2010PTC053234 Sacred heart collage Satya Nilayam, No: 201, kalki
Krishnamurthy road thiruvanmiyur
CHENNAI, TAMIL NADU, 600041
Ship From : IN
NITHYA FOOTWEAR PRIVATE LIMITED - State/UT Code: 33
Hariyana - CB Place of supply: TAMIL NADU
Amazon Seller Services Private Limited Place of delivery: TAMIL NADU
Sattva Horizon, Survey No 6/1 and 7/1, Vinayak
Nagar, Kattigenahalli
Venkatala Village, Yelahanka Hobli
Bangalore, Karnataka – 560064
India
Order Number: 402-4049207-0373123 Invoice Number : MKT-486680807
Order Date: 23.02.2026 Invoice Details : HR-GQIZ-1044-2526
Invoice Date : 23.02.2026
Sl. No Description Unit Price Qty Net Amount Tax Rate Tax Type Tax Amount Total Amount
1 Marketplace Fees ₹4.24 ₹4.24 18% IGST ₹0.76 ₹5.00
TOTAL: ₹0.76 ₹5.00
Amount in Words:
Five only
For Amazon Seller Services Private Limited:
Authorized Signatory
(1) Service Accounting Code: 998319
Whether tax is payable under reverse charge - No
Payment Transaction ID: Date & Time: 23/02/2026, 11:47:14 Invoice Value: Mode of Payment:
i93r3yqERXhenBmY2cxumsU6y5HhlkR20qs hrs 5.00 UPI
Please note that this invoice is not a demand for payment
Regd Office: Amazon Seller Services Private Limited
Sattva Horizon, Survey No 6/1 and 7/1, Vinayak Nagar, Kattigenahalli
Venkatala Village, Yelahanka Hobli,Bengaluru
Telephone: +91 89 33420300
Fax: +91 80 30625685
Email: customer-service@[Link]
[Link] - Amazon Seller Services Private Limited
*ASSPL-Amazon Seller Services Pvt. Ltd., ARIPL-Amazon Retail India Pvt. Ltd. (only where Amazon Retail India Pvt. Ltd. fulfillment center is co-located)
Customers desirous of availing input GST credit are requested to create a Business account and purchase on [Link]/business from Business eligible offers
Page 1 of 1