vat return (1st) qtr)
TRANSCRIPT
LIST OF SALE OF GOODS IN THE COURSE OF INTERESTATE TRADE AND COMMERCE FOR THE QUARTER ENDED
Name and TIN of the VAT dealer furnishing the list
Name and style of businessD D M M Y
3 0 0 6 2 0 1TIN 0 6 0 7 1 8 2 8 3 1 8 Economic activity code
Name and address of the Purchaser TIN Sale/Invoice No./ Date Description of goods Quantity / Weight Value of Goods Value of Goods
1 2 3 4 5 6 7 8
1
28310167509
Pine Apple Syrup
100 Kg
24,600.00 24,600.00
2
27110410052
Alphanso Mango Pulp
148.80 Kg
10,713.60 10,713.60
3
23629010554
Strawberry Fruit Preparation
175 Kg
35,875.00 35,875.00
4
33591121863 64 Bottles
16,750.00 16,750.00
5
08720600732
Apple Flavour, Apple Flavour,
80 Kg
390,000.00 390,000.00
6
24571600064
Mango Concentrate, Strawberry Concentrate
431 Kg
177,440.00 177,440.00
7
CST No. 20254430 Banana Strawberry Crush, 24 Bottle
7,059.00 7,059.00
FORM LS-2(See VAT-R1
Orana India Pvt. Ltd GP-28, 3rd Floor,
Sector-18, Gurgaon Haryana, PIN 122015
Sr.
No.
Sold against declaration
of form "C"
Sold without
declaration in
form "C"
Heritage Foods (India) Ltd., 001: Head Office 6-3-541/C, Panjagutta, Hyderabad
- 500082
OIN/INV/2011/I097
dated 05/04/2011
Schreiber Dynamix Dairies Ltd. , E-94, M.I.D.C, Bhigwan Road, Baramati - 413133,
Pune - Maharashtra
OIN/INV/2011/I098
dated 05/04/2011
AVM Foods Spacialities, 396, Cleark Colony, Indore - 452011, Madhya Pradesh
OIN/INV/2011/I099
dated 05/04/2011
Anp Associate,#25 Gajapathy Street, Ground Floor, Shnoy Nagar, Chennai - 600030
OIN/INV/2011/I100
dated 06/04/2011
Pinnacolada Syrup, Strawberry Green Tea Syrup, Lychee Green Tea Syrup, Cherry Crush, Strawberry Crush,Forest Fruit Crush, Kiwi Crush, Muskmelon Crush, Pink Guava Crush
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I101
dated 07/04/2011
M/s Mother Dairy , A unit of Gujrat Co-operative, Plot no - 35, Near Indira Bridge
OIN/INV/2011/I102
dated 11/04/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I103
dated 12/04/2011
8
CST No. 20254430
Black Currant Crush
240 Bottle
69,048.00 69,048.00
9
9537 DTD 15.10.2005
Black Currant Syrup
138 Bottle
49,693.80 49,693.80
29910870135 60 Bottle
17,610.00 17,610.00
10
Black Currant Crush,Kiwi Crush
264 Bottle
75,912.00 75,912.00
11
Banana Strawberry Crush, Peach Crush
48 Bottle
14,588.00 14,588.00
12
29270836246
Peach Green Tea Syrup
55 Kg
9,471.00 9,471.00
13
29270836246
Lychee Green Tea Syrup
31.20 Kg
5414.00 5,414.00
14
29910870135 60 Bottle
17,610.00 17,610.00
15
29910870135
Banana Strawberry Crush, Black Currant crush
36 Bottle
11,580.00 11,580.00
16
27410138869C 180 Bottles
47,100.00 47,100.00
17
33591121863 114 Bottle
30,180.00 30,180.00
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I104
dated 12/04/2011
Devyani Food Industries Pvt. Ltd. Plot no - 1-21, EPIP Phase - 2, Village Thana, Baddi,
Tehsil - Nalagarh, Dist, Solan
OIN/INV/2011/I105
dated 12/04/2011
Future Value retail Ltd. Big Bazzar, Bangalore Central - 3, Soul Space Sprit, bangalore Outer
Ring road, Bellandur Village Varthur Hobil, Bangalore - 56003
OIN/INV/2011/I106
dated 12/04/2011
Forest Fruit Crush, Kiwi Crush, Pink Guava
Crush, Strawberry Crush, Muskmelon Crush
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla
Industrial Area, New Delhi
CST No. 07120245040
OIN/INV/2011/I107
dated 12/04/2011
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla
Industrial Area, New Delhi
CST No. 07120245040
OIN/INV/2011/I108
dated 12/04/2011
Au Bon Pain Café India Ltd. No.67/4, Yeshwantpur Industrial Suburbs, Near Ullas
Theater, Bangalore- 560022
OIN/INV/2011/I109
dated 12/04/2011
Au Bon Pain Café India Ltd. No.67/4, Yeshwantpur Industrial Suburbs, Near Ullas
Theater, Bangalore- 560022
OIN/INV/2011/I10
dated 12/04/2011
Future Value retail Ltd. Big Bazzar, Bangalore Central - 3, Soul Space Sprit, bangalore Outer
Ring road, Bellandur Village Varthur Hobil, Bangalore - 56003
OIN/INV/2011/I111
dated 12/04/2011
Forest Fruit Crush, Kiwi Crush, Pink Guava
Crush, Strawberry Crush, Muskmelon Crush
Future Value retail Ltd. Big Bazzar, Bangalore Central - 3, Soul Space Sprit, bangalore Outer
Ring road, Bellandur Village Varthur Hobil, Bangalore - 56003
OIN/INV/2011/I112
dated 12/04/2011
Trinity Enterprises, Building no - 29, A-405, Tilak Nagar, Chember, Mumbai - 400089
OIN/INV/2011/I113
dated 12/04/2011
Lemon Green Tea Syrup, Peach Green Tea Syrup, Green Apple Syrup, Passion Fruit Syrup, Pinnacolada Syrup, Strawberry Syrup, Pink Guava Crush, Strawberry Crush
Anp Associate,#25 Gajapathy Street, Ground Floor, Shnoy Nagar, Chennai - 600030
OIN/INV/2011/I114
dated 12/04/2011
Green Apple Syup, Passion Fruit Syrup, Black
Currant syrup, Strawberry syrup, Strawberry
crush,Forest Fruit Crush, Kiwi Crush,
Muskmelon Crush, Pink Guava Crush
18
24573601280
Muskmelon Crush
120 Bottle
36,000.00 36,000.00
19
29910870135 Banana Strawberry Crush, Black Currant crush 36 Bottle 11580
11,580.00
20
156 Bottle
41,760.00 41,760.00
21
29270836246 187.20 Kg
32,470.00 32,470.00
22
29910870135 24 Bottle
8,280.00 8,280.00
23
27410138869C
Green Apple Crush
48 Bottle
14,400.00 14,400.00
24
29910870135 24 Bottle
8,280.00 8280
33591121863
Green Apple Crush, Cherry Crush
24 Bottle
7,440.00 7,440.00
25
12235207575
Raspberry Filling
81.60 Kg
21,216.00 21,216.00
07310344603
282 Bottles 67248 67,248.00
Rita Enterprises, H-33 Parshwanath Tower, Subhah Chowk, Gurukul Road, Ahmedabad -
380052
OIN/INV/2011/I115
dated 12/04/2011
Future Value retail Ltd. Big Bazzar, Bangalore Central - 3, Soul Space Sprit, bangalore Outer
Ring road, Bellandur Village Varthur Hobil, Bangalore - 56003
OIN/INV/2011/I116
dated 12/04/2011
M.K. Sales SCO - 90, Basement, Sector - 44C, Chandigarh
OIN/INV/2011/I117
dated 12/04/2011
Black Currant Syrup, Green Apple Syrup, Passion Furit Syrup, Strawberry Syrup, Lychee Green Tea Syrup, Peach Green Tea Syrup,Black Currant Crush, Strawberry Crush
Au Bon Pain Café India Ltd. No.67/4, Yeshwantpur Industrial Suburbs, Near Ullas
Theater, Bangalore- 560022
OIN/INV/2011/I118
dated 14/04/2011Lychee Green Tea Syrup, Peach Green Tea Syrup
Future Value retail Ltd. Big Bazzar, Bangalore Central - 3, Soul Space Sprit, bangalore Outer
Ring road, Bellandur Village Varthur Hobil, Bangalore - 56003
OIN/INV/2011/I121
dated 15/04/2011Cherry Crush, Green Apple Crush, Mixec Berry Cursh
Trinity Enterprises, Building no - 29, A-405, Tilak Nagar, Chember, Mumbai - 400089
OIN/INV/2011/I122
dated 15/04/2011
Future Value retail Ltd. Big Bazzar, Bangalore Central - 3, Soul Space Sprit, bangalore Outer
Ring road, Bellandur Village Varthur Hobil, Bangalore - 56003
OIN/INV/2011/I123
dated 15/04/2011Cherry Crush, Green Apple Crush, Mixec Berry Cursh
Anp Associate,#25 Gajapathy Street, Ground Floor, Shnoy Nagar, Chennai - 600030
OIN/INV/2011/I124
dated 15/04/2011
Tropilite Foods Pvt. Ltd. Davar Campus, Industrial Area, Tansen, Gwalior - 474002
(M.P.)
OIN/INV/2011/I125
dated 19/04/2011
Mekail Trading Company Pvt Ltd. 19-A, New Colony Model Basti, karol Bagh,
Delhi - 110005
OIN/INV/2011/I126
dated 19/04/2011
Green Apple Syrup, Passion Fruit
Syrup,Pinnacolada Syrup,Black Currant Syrup,
Pink Guava Crush, Forest Fruit Crush
26
27410138869C 298 Bottles
74,210.00 74,210.00
27
28240993919
Muskmelon Crush, Pink Guava Crush
30 Bottles
8,760.00 8,760.00
28 Green apple Crush, Forest Fruit crush
18 Bottles
4,980.00 4,980.00
29 Black Currant Crush
47 Bottles
80,843.70 80,843.70
30
270 Bottles
78,846.60 78,846.60
31
CST No. 20254430
Black Currant Crush
360 Bottles
103,572.00 103,572.00
CST No. 20254430
Banana Strawberry Crush, Kiwi Crush
62 Bottles
20,982.00 20,982.00
32
Black Currant Crush 240 Bottles
69,048.00 69,048.00
33
33591121863
Green Apple Crush, Musk Melon Crush
30 Bottles
9,300.00 9,300.00
34
33591121863 48 Bottle
10,200.00 10,200.00
Trinity Enterprises, Building no - 29, A-405, Tilak Nagar, Chember, Mumbai - 400089
OIN/INV/2011/I129
dated 25/04/2011
Lemon Green Tea Syrup, Lychee Green Tea Syrup, Peach Green Tea Syrup,Strawberry Green Tea Syrup, Green Apple Syrup, Passion Fruit Syrup, Pinnacolada Syrup, Strawberry Syrup, Pink Guava Crush,Forest Fruit Crush, Musk Melon Crush
Trupti Food and Beverages, 3-6-271, Sudheer tapani towes, Himalayanagar Main Road, Beside Punjab National Bank, Hydrabad -
500028
OIN/INV/2011/I130
dated 28/04/2011
Sachin Chawla 1982, Outram Lane, Kingsway Camp, Delhi - 110006
OIN/INV/2011/I131
dated 03/05/2011
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla
Industrial Area, New Delhi
CST No. 07120245040
OIN/INV/2011/I134
dated 05/05/2011
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla
Industrial Area, New Delhi
CST No. 07120245040
OIN/INV/2011/I135
dated 05/05/2011
Black Currant Crush, Banana Strawberry
Crush,Peach Crush
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I136
dated 05/05/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I137
dated 05/05/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-REG, Central
Mumbai, MD-1 &2, Gupta Warehousing Complex, Bhiwandi - 421302
CST No. 27720001492 C
OIN/INV/2011/I138
dated 05/05/2011
Anp Associate,#25 Gajapathy Street, Ground Floor, Shnoy Nagar, Chennai - 600030
OIN/INV/2011/I139
dated 05/05/2011
Anp Associate,#25 Gajapathy Street, Ground Floor, Shnoy Nagar, Chennai - 600030
OIN/INV/2011/I140
dated 05/05/2011Forest Fruit Crush, Peach Green Tea Syrup,Pink Guava crush
35
08720600732
Aronia Concentrate
2000 Kg
1,642,000.00 1,642,000.00
36
23964102489
Mixed Berry Concentrate
3300 Kg
1,056,000.00 1,056,000.00
37
23964102489
Orange Concentrate
5200 kg
1,190,800.00 1,190,800.00
38
08720600732
Pomegranate Juice Concentrate
2970 Kg
1,143,450.00 1,143,450.00
39
07710224685
Green Apple Crush
156 Bottle
23,400.00 23,400.00
40
29270836246 234 Kg
40,586.00 40,586.00
41
84 Bottles
20,700.00 20,700.00
42
27110410052
Strawberry Syrup
400 Kg
132,000.00 132,000.00
43
24573601280 108 Bottles
25,440.00 25,440.00
44
24573601280
Muskmelon Crush
60 Bottle
9,000.00 9,000.00
45
08720600732
Pomegranate Juice Concentrate
11440 Kg
4,404,400.00 4,404,400.00
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I141
dated 09/05/2011
Godrej Hershey Ltd, Plot no. 5, New Industrial Area No. 1, Mandideep - 462046
OIN/INV/2011/I142
dated 09/05/2011
Godrej Hershey Ltd, Plot no. 5, New Industrial Area No. 1, Mandideep - 462046
OIN/INV/2011/I143
dated 09/05/2011
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I144
dated 09/05/2011
Barista Coffee Company Ltd.55 Community Center, Basant Lok Market, Vasant Vihar,
New Delhi - 110057
OIN/INV/2011/I145
dated 12/05/2011
Au Bon Pain Café India Ltd. No.67/4, Yeshwantpur Industrial Suburbs, Near Ullas
Theater, Bangalore- 560022
OIN/INV/2011/I146
dated 12/05/2011Peach Green Tea Syrup, Lychee Green Tea Syrup
Kasturi Agro Foods & Marketing Pvt. Ltd. Plot no. 35, Shivaji Society, B/H Hotel
Marriott, Senapati Bepat Road, Pune - 411016
OIN/INV/2011/I147
dated 12/05/2011
Lemon Green Tea Syrup, Peach Green Tea
Syrup, Lychee Green Tea syrup, Green Apple
Syrup, Passion Fruit Syrup, Pinnacolada Syrup,
Black Currant Syrup, Forest Fruit Crush,
Muskmelon Crush
Schreiber Dynamix Dairies Ltd. , E-94, M.I.D.C, Bhigwan Road, Baramati - 413133,
Pune - Maharashtra
OIN/INV/2011/I151
dated 16/05/2011
Rita Enterprises, H-33 Parshwanath Tower, Subhah Chowk, Gurukul Road, Ahmedabad -
380052
OIN/INV/2011/I152
dated 18/05/2011Muskmelon Crush, Green Apple Crush, Forest Fruit Crush
Rita Enterprises, H-33 Parshwanath Tower, Subhah Chowk, Gurukul Road, Ahmedabad -
380052
OIN/INV/2011/I153
dated 18/05/2011
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I154
dated 18/05/2011
46
Black currant Crush
120 Bottle
34,524.00 34,524.00
47
CST No. 20254430 Black Currant Crush 240 Bottles
69,048.00 69,048.00
48 Black Currant Crush
102 Bottles
29,345.00 29,345.00
49
04350014588 234 Bottles
53,100.00 53,100.00
50
27110410052 6825 Kg
931,950.00 931,950.00
51
02235207575
Dark Cherry Filling, red Cherry Filling
1922 Kg
500,216.00 500,216.00
52
CST No. 29740879686 2000 Kg
330,000.00 330,000.00
53
02876295129
Muskmelon Crush, Forest Fruit Crush
24 Bottles
7,320.00 7,320.00
54
27610646651
Strawberry Compound
10 Kg
4,700.00 4,700.00
55
27610646651 252 Bottles
59,550.00 59,550.00
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-REG, Central
Mumbai, MD-1 &2, Gupta Warehousing Complex, Bhiwandi - 421302
CST No. 27720001492 C
OIN/INV/2011/I155
dated 23/05/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I156
dated 23/05/2011
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla
Industrial Area, New Delhi
CST No. 07120245040
OIN/INV/2011/I157
dated 23/05/2011
M.K. Sales, SCO - 90, Basement, Sector 44C, Chandigarh
OIN/INV/2011/I158
dated 23/05/2011
Lemon Green Tea Syrup,Apple Green Tea Syrup, strawberry Green tea Syrup,Green Apple Syrup, Passion Fruit Syrup, Strawberrry Syrup, Lychee Green Tea Syrup,Peach Green tea syrup, Green Apple Crush, Forest Fruit Crush, Kiwi Crush,Pink Guava Crush, Muskmelon Crush
Schreiber Dynamix Dairies Ltd. , E-94, M.I.D.C, Bhigwan Road, Baramati - 413133,
Pune - Maharashtra
OIN/INV/2011/I161
dated 23/05/2011Strawberry Syrup, Strawberry Syrup, Mango Syrup
Tropilite Foods Pvt. Ltd. Davar Campus, Industrial Area, Tansen, Gwalior - 474002
(M.P.)
OIN/INV/2011/I162
dated 23/05/2011
Shriram Distribution Services Pvt. Ltd. No. 14 & 15 Cross, Hosur Main Road, Behind the
State Bank of Mysore, Singasandra, Bangalore - 560068
OIN/INV/2011/I163
dated 23/05/2011Cranberry Compound, Passion of Guava Compound
lohiyo Agro tech India Pvt. Ltd, 7-4-246/95, BJR Nagar, Balkampet - 5600018, Hydrabad
OIN/INV/2011/I164
dated 23/05/2011
Pushpam Foods & Beverages Pvt Ltd, Gat No. 104/2A, Village - Barote Vasi(Nandur) -
Pune
OIN/INV/2011/I165
dated 25/05/2011
Strategic Marketing And Research Team, # 253, 67th Cross, 5th Block, Rajaji
Nagar,560010, Bangalore
OIN/INV/2011/I166
dated 25/05/2011
Green Apple Syrup, Strawberry Syrup, Pinacolada Syrup, passion Fruit Syrup, Peach green tea syrup, strawberry Green Tea Syrup, Lemon Green Tea Syrup, Apple Green Tea Syrup,Forest Fruit Crush, Pink Guava Crush, Muskmelon Crush, Green Apple Crush
56
CST No. 29740879686
Muskmelon Crush
180 Bottles
55,800.00 55,800.00
57 Muskmelon Crush
18 Bottles
2,700.00 2,700.00
58
09766101264
Orange Flavour
10 Kg
32,000.00 32,000.00
59 Green Apple Crush
30 Bottles
4,800.00 4,800.00
60
72 Bottle
16,740.00 16,740.00
61
08720600732
Aronia Concentrate
4000 Kg
3,284,000.00 3,284,000.00
62
07710224685
Green Apple Crush
300 Bottle
45,000.00 45,000.00
63
07710224685
Forest Fruit Crush
204 Bottles
35,700.00 35,700.00
64
CST No. 29740879686
Muskemelon Crush
150 Bottles
46,500.00 46,500.00
65
CST No. 20254430
Peach Crush, Kiwi Crush
84 Bottles
25,688.00 25,688.00
Shriram Distribution Services Pvt. Ltd. No. 14 & 15 Cross, Hosur Main Road, Behind the
State Bank of Mysore, Singasandra, Bangalore - 560068
OIN/INV/2011/I167
dated 25/05/2011
M.K. Sales SCO - 90, Basement, Sector - 44C, Chandigarh
OIN/INV/2011/I168
dated 27/05/2011
Surya Fresh Foods Ltd., Unit - 1, Factory, Plot no - 14 Noida Dadri Road, Surajpur
Greater Noida (U.P.)
OIN/INV/2011/I169
dated 27/05/2011
Sachin Chawla 1982, Outram Lane, Kingsway Camp, Delhi - 110006
OIN/INV/2011/I170
dated 30/05/2011
Kasturi Agro Foods & Marketing Pvt. Ltd. Plot no. 35, Shivaji Society, B/H Hotel
Marriott, Senapati Bepat Road, Pune - 411016
OIN/INV/2011/I171
dated 30/05/2011
Apple Green Tea Syrup, Peach Green Tea
Syrup,Strawberry Green Tea syrup, Green
Apple Syrup, Passion Fruit Syrup, Green Apple
Crush, Kiwi Crush, Forest Fruit Crush, Pink
Guava Crush Muskmelon Crush
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I172
dated 02/06/2011
Barista Coffee Company Ltd.55 Community Center, Basant Lok Market, Vasant Vihar,
New Delhi - 110057
OIN/INV/2011/I173
dated 02/06/2011
Barista Coffee Company Ltd.55 Community Center, Basant Lok Market, Vasant Vihar,
New Delhi - 110057
OIN/INV/2011/I174
dated 02/06/2011
Shriram Distribution Services Pvt. Ltd. No. 14 & 15 Cross, Hosur Main Road, Behind the
State Bank of Mysore, Singasandra, Bangalore - 560068
OIN/INV/2011/I175
dated 07/06/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I176
dated 09/06/2011
66
08720600732
Pomegranate Juice Concentrate
11440 Kg
4,404,400.00 4,404,400.00
9537 DTD 15.10.2005
Black Currant Syrup
203 Kg
56,231.00 56,231.00
67
CST No. 20254430
Black Currant Crush
360 Bottles
103,572.00 103,572.00
68
27110410052
Strawberry Syrup, Mango Syrup
3750 Kg
512,250.00 512,250.00
69
12235207575
Strawberry Filling
983 Kg
196,680.00 196,680.00
70
07710224685
Forest Fruit Crush
120 Bottle
21,000.00 21,000.00
71
07710224685 126 Bottles
37,022.00 37,022.00
72
32071893625C 66 Bottles
17,700.00 17,700.00
73
29270836246 187 Kg
32,470.00 32,470.00
74
23031301495 84 Bottles
19,830.00 19,830.00
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I177
dated 10/06/2011
Devyani Food Industries Pvt. Ltd. Plot no - 1-21, EPIP Phase - 2, Village Thana, Baddi,
Tehsil - Nalagarh, Dist, Solan
OIN/INV/2011/I178
dated 13/06/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-HQ, #5,II
Cross, PM Ind Area, NS Palya, Bangalore - 560076
OIN/INV/2011/I181
dated 14/06/2011
Schreiber Dynamix Dairies Ltd. , E-94, M.I.D.C, Bhigwan Road, Baramati - 413133,
Pune - Maharashtra
OIN/INV/2011/I183
dated 14/06/2011
Tropilite Foods Pvt. Ltd. Davar Campus, Industrial Area, Tansen, Gwalior - 474002
(M.P.)
OIN/INV/2011/I184
dated 14/06/2011
Barista Coffee Company Ltd.55 Community Center, Basant Lok Market, Vasant Vihar,
New Delhi - 110057
OIN/INV/2011/I185
dated 15/06/2011
Barista Coffee Company Ltd.55 Community Center, Basant Lok Market, Vasant Vihar,
New Delhi - 110057
OIN/INV/2011/I186
dated 16/06/2011Kiwi Crush, banana Strawberry Crush, Peach
Crush
As & Company, 39/6218 B - 3, Peru Estate, Kizhavana road, Atlantis, cochin 682015,
India
OIN/INV/2011/I187
dated 16/06/2011
Strawberry Green Tea, Lemon Green Tea Syrup, Apple Green Tea Syrup, Forest Fruit
Crush, Black Currant crush, Strawberry Crush, Pink Guava Crush, Muskmelon Crush, Green
Apple Crush
Au Bon Pain Café India Ltd. No.67/4, Yeshwantpur Industrial Suburbs, Near Ullas
Theater, Bangalore- 560022
OIN/INV/2011/I188
dated 22/06/2011Peach Green Tea Syrup, Lychee Green Tea
Syrup
Bajaj Frozen Food, LG-2, J.V. Complex Opp. Yeshwant Club, Race Course Road, Race
Course Road, Indore
OIN/INV/2011/I189
dated 22/06/2011
Black current crush, Forest Fruit Crush, Green Apple Crush, Kiwi Crush, Muskmelon Crush,
Green Apple Syrup
75
9537 DTD 15.10.2005
Black Currant Syrup
257.40 Kg
71,300.00 71,300.00
76
33591121863 54 Bottles
12,420.00 12,420.00
77
27800300014C
Mango Concentrate, Strawberry Concentrate
710 Kg 326840
326,840.00
78
24571600064
Mango Concentrate, Strawberry Concentrate
1323 Kg
592,200.00 592,200.00
79
08720600732
Pomegranate Juice Concentrate
11440 Kg
4,404,400.00 4,404,400.00
80 Black Currant crush
126 bottles
36,250.00 36,250.00
81
516 Bottles
148,587.00 148,587.00
82
27610646651
Pink guava Fruit Compound
100 Kg
90,000.00 90,000.00
Devyani Food Industries Pvt. Ltd. Plot no - 1-21, EPIP Phase - 2, Village Thana, Baddi,
Tehsil - Nalagarh, Dist, Solan
OIN/INV/2011/I190
dated 22/06/2011
Anp Associate,#25 Gajapathy Street, Ground Floor, Shnoy Nagar, Chennai - 600030
OIN/INV/2011/I191
dated 22/06/2011Forest Fruit Crush, Green Apple Syrup, Lemon
Green Tea Syrup, Strawberry Syrup
Valshad DCMPU Ltd, Vasudhara Dairy, Plot No. E - 23, MIDC, Tarapur IND Area, Boisar
(Maharastra)
OIN/INV/2011/I192
dated 24/06/2011
M/s Mother Dairy , A unit of Gujrat Co-operative, Plot no - 35, Near Indira Bridge
OIN/INV/2011/I193
dated 24/06/2011
Dabur India Ltd., Plot No. G- 50-59, Road No.1, II D Centre, National Highway No.12, Newai-304020-
Rajasthan
OIN/INV/2011/I194
dated 24/06/2011
Amalgamated Bean Coffee Trading Co. Ltd., Café Coffee Day - Divison, SCM-REG, Central
Mumbai, MD-1 &2, Gupta Warehousing Complex, Bhiwandi - 421302
CST No. 27720001492 C
OIN/INV/2011/I195
dated 28/06/2011
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla
Industrial Area, New Delhi
CST No. 07120245040
OIN/INV/2011/I196
dated 28/06/2011Kiwi Crush, banana Strawberry Crush, Black
Currant Crush
Pushpam Foods & Beverages Pvt Ltd, Gat No. 104/2A, Village - Barote Vasi(Nandur) -
Pune
OIN/INV/2011/I197
dated 29/06/2011
TOTAL 28059669.70 28,059,669.70 - 209,245.00
Note : Total must tally with figures in 2B(2)(b) of the return. 27,850,424.70
Place: GURGAON Date: Ful Signature of the authorised signatory
Name
DECLARATION: I ---------- (name in CAPITALS ) hereby declare that the contents of the above list and table are true and correct and nothing has been concealed therein.
Note:1. An authorised person alone shall sign each page of this list. A list signed by any person not authorised or an unsignd list shall be treateed as no list. 2. Where a list runs into more than one page, each page will show both page total
for Consumables
Name and TIN of the VAT dealer furnishing the list
Name and style of businessD D M M Y
3 1 0 3 1TIN 0 6 0 7 1 8 2 8 3 1 8 Economic activity code
TIN Description of goods Quantity / Weight
@' 4% @' 0% @' 12.5%
1 2 3 4 5 6 7 8
0.00 0.00Note : Total of Columns 6-9 must tally with figure in 3A (3) (c ) of the return. TOTAL Col. 6-9
Gross
Place: GURGAON Date: Ful Signature of the authorised signatory
Name
TIN Description of goods Quantity / Weight
@' 4% @' 0% @' 12.5%
1 2 3 4 5 6 7 8
FORM LP-3(See VAT-R1/ R6/ R7/ R8/ R9/ R11)
LIST OF PURCHASE OF GOODS IN THE COURSE OF INTERESTATE TRADE OR COMMERCE FOR THE QUARTER ENDED
Orana India Pvt. Ltd 7-HSIDC, Palam Gurgaon Road Gurgaon Haryana, PIN 122015
Sr.
No.
Name and address of the Dealer /Person form whom
goods purchased
Sale Invoice /Delivery
Note No./ Date
Break up of Value of goods leviable to tax at different rates in the State of Haryana
DECLARATION: I RAJESH DUDEJA (name in CAPITALS ) hereby declare that the contents of the above list and table are true and correct and nothing has been concealed therein.
Note:1. An authorised person alone shall sign each page of this list. A list signed by any person not authorised or an unsignd list shall be treateed as no list. 2. Where a list runs into more than one page, each page will show both page total
Sr.
No.
Name and address of the Dealer /Person form whom
goods purchased
Sale Invoice /Delivery
Note No./ Date
Break up of Value of goods leviable to tax at different rates in the State of Haryana
0.00 0.00Note : Total of Columns 6-9 must tally with figure in 3A (3) (c ) of the return. TOTAL Col. 6-9
Gross
Place: GURGAON Date: Ful Signature of the authorised signatory
Name
DECLARATION: I RAJESH DUDEJA (name in CAPITALS ) hereby declare that the contents of the above list and table are true and correct and nothing has been concealed therein.
Note:1. An authorised person alone shall sign each page of this list. A list signed by any person not authorised or an unsignd list shall be treateed as no list. 2. Where a list runs into more than one page, each page will show both page total
LIST OF SALE OF GOODS IN THE COURSE OF INTERESTATE TRADE AND COMMERCE FOR THE QUARTER ENDED
Y
1
Value of Goods
8 9
492
214
1,883
335
7,800
3,549
141
No. of Declaration in
Form 'C' issued, if any
Sold without
declaration in
form "C"
1,381
994
352
1,518
292
189
108
352
232
942
604
720
232
2,192
649
166
288
166
149
424
1,345
1,484
460
261
1,617
1,577
2,071
419
1,381
186
204
32,840
21,120
23,816
22,869
468
813
1,087
2,640
509
180
88,088
690
1,381
587
2,788
18,639
10,004
6,600
146
94
1,191
1,116
142
640
252
879
65,680
900
714
930
513
88,088
1,125
2,072
10,245
3,934
420
741
354
649
1,041
1,426
248
6,537
11,844
88,088
725
2,972
1,800
- 567,995
Ful Signature of the authorised signatory
Status
Y
1
@
9 10 B/F 28,059,670
TOTAL Col. 6-9 0.00Gross 28,059,670
Ful Signature of the authorised signatory
@
9 10 B/F -
LIST OF PURCHASE OF GOODS IN THE COURSE OF INTERESTATE TRADE OR COMMERCE FOR THE QUARTER ENDED
Break up of Value of goods leviable to tax at different rates in the No. of Declaration in
Form 'C' issued, if any
Break up of Value of goods leviable to tax at different rates in the No. of Declaration in
Form 'C' issued, if any
TOTAL Col. 6-9 0.00Gross -
Ful Signature of the authorised signatory
For Raw Material
LIST OF PURCHASE OF GOODS IN THE COURSE OF INTERESTATE TRADE OR COMMERCE FOR THE QUARTER ENDED
Name and TIN of the VAT dealer furnishing the list
Name and style of businessD D M M
3 0 0 6 2 0TIN 0 6 0 7 1 8 2 8 3 1 8 Economic activity code
TIN Description of goods Quantity / Weight
@ 2% @
1 2 3 4 5 6 7 8
1 27860246922C 1401200983/17.05.11
Pomegranate Concentrate 11440 Kg
2905760.00
2 27860246922C 1401201153/17.05.11
Pomegranate Concentrate 11440 Kg
2905760.00
3 Mane India Pvt. Ltd. 28570126340 0350/23.06.11
Guava Flavour 25 Kg
15610.00
4
Alphanso Mango Pulp 149 Kg
9200.00
5 Freshtop Fruit Ltd, 10/13.05.11
Pomegranate Concentrate 2970 Kg
964091.00
FORM LP-3(See VAT-R1/ R6/ R7/ R8/ R9/ R11)
Orana India Pvt. Ltd 7-HSIDC, Palam Gurgaon Road Gurgaon Haryana, PIN 122015
Sr.
No.
Name and address of the Dealer /Person form
whom goods purchased
Sale Invoice /Delivery Note
No./ Date
Break up of Value of goods leviable to tax at different rates in the
State of Haryana
Jain Irrigation Systems Ltd, Food Processing, Jalgaon Jain Food Park, Jain Velley, P.O. Box No. 20, Jalgaon, Maharastra - 425001
Jain Irrigation Systems Ltd, Food Processing, Jalgaon Jain Food Park, Jain Velley, P.O. Box No. 20, Jalgaon, Maharastra - 425001
Foods And Inn Limited, National Highway No. 8, Vav Falia, Abrama, Valsad, Gujrat
FPP/11/2/2011-12/06.04.11
6 27860246922C 1401201153/23.06.11
Pomegranate Concentrate 11440 Kg
2905760.00
7 N.A 123391/01.04.2011
Apple Flavour, Apple Flavour 50 Kg
200094.00
8 Prodalim B.V. N.A 1121043/01.04.2011
Orange Concentrate 10140 Kg
1420817.00
9 N.A 001148/06.04.2011
8622 Kg
878531.00
10 N.A 000001/13.04.2011
Peach Pieces In Light Syrup 50 Kg
19022.00
11 N.A 000003/13.04.2011
1188 Kg
125997.00
12 N.A 000007/14.04.2011
7053 Kg
655594.00
13 N.A 123437 / 19.04.2011
Aronia Concentrate 6000 kg
1124486.00
14 N.A 000022/27.04.2011
24278 Kg
1901736.00
Jain Irrigation Systems Ltd, Food Processing, Jalgaon Jain Food Park, Jain Velley, P.O. Box No. 20, Jalgaon, Maharastra - 425001
Danish Fruit Production A/S Rynkebyvej 243, 5350 Rynkeby, Denmark
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Apple Green Tea Syrup,Apple Green Tea Syrup,
Lemon Green Tea Syrup,Strawberry Green Tea
Syrup, Strawberry Compound, Mango Syrup,Mango
SyrupOrana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Mixedberry Fruit preperation, Strawberry Fruit
Preperation
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Apple Green Tea Syrup,Peach Green Tea Syrup,Strawberry Green Tea Syrup, Green Apple Crush, Passion Puree Compound, Cranberry Compound, Passion of Guava Compound
Danish Fruit Production A/S Rynkebyvej 243, 5350 Rynkeby, Denmark
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Red Cherry Filling, Dark Cherry Filling, Mango Syrup,
Strawberry Syrup, Lemon Green Tea Syrup, Lychee
Green Tea Syrup, Pineapple Fruit Preperation, Mango
Fruit Preperation,Tropical Mixed Fruit Preperation,
Peach Fruit Prepration, Mango Syrup, Strawberry
Syrup, Strawberry Syrup, Mango Syrup,
15 N.A 000030/03.05.2011
1175 Kg
137869.00
16 N.A 000035/10.05.2011
Strawberry Syrup 2500 Kg
492390.00
17 N.A 000040/17.05.2011
8631 Kg
812847.00
18 N.A 000052/25.05.2011
Strawberry Syrup, Mango Syrup 9675 Kg
772784.00
19 N.A 000063/15.06.2011
10848 Kg
975316.00
20 N.A 108178/ 01.03.2011
Red Grape Concentrate 21000 Kg
1695715.00
21 N.A 000073/22.06.2011
Pink Guava Fruit Compound 100 kg
34700.00
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Mixedberry Fruit preperation, Strawberry Fruit
PreperationOrana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Mango Syrup, Kiwi Crush,Peach Crush, Banana
Strawberry Crush, Black Currant crush, Strawberry
Filling, Black Currant Syrup, Green Apple Syrup,
Passion Fruit Syrup, Pink Guava fruit Compound, kiwi
Compound, Forest Fruit compound, Green Apple
Compound
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Strawberry Syrup, Mango Syrup, Lychee Compound,
Strawberry Compound, Mixed Berry Compound
Orana Puchase A/c, Orana A/s, RYNKEBYVEJ 243, 5350 RYNKEBY, DENMARK
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
22 N.A 000075/28.06.2011
1152 Kg
132325.00
23 27270667984 DFIA/034/11-12
DFIL
300119.00
24 27290735679 MPC/C/JUL/11-12/17
DFIL
290168.00
25 27270667984 DFIA/074/11-12
DFIL
339715.00
Orana Vietnam Co. Ltd. Lot 3-5, F1 Area, Tan Thoi Hiep I.Z, District 12, Ho Chi Minh City, Vietnam
Mixedberry Fruit preperation, Strawberry Fruit
Preperation
B D Internationala 203/A, Bank House, 3rd Floor, Room No. 2, Kalbadevi Road, Mumbai
M.P. Sons, 28 Kewal Industial Estate, S.B. Marg, Lower Panel, Mumbai - 400013
B D Internationala 203/A, Bank House, 3rd Floor, Room No. 2, Kalbadevi Road, Mumbai
TOTAL 11380223.00 10636183.00Note : Total of Columns 6-9 must tally with figure in 3A (3) (c ) of the return. TOTAL Col. 6-9
Place: GURGAON 3 1 0 3 2 0 1 1 Ful Signature of the authorised signatory
Name
DECLARATION: I ---------- (name in CAPITALS ) hereby declare that the contents of the above list and table are true and correct and nothing has been concealed therein.
Note:1. An authorised person alone shall sign each page of this list. A list signed by any person not authorised or an unsignd list shall be treateed as no list. 2. Where a list runs into more than one page, each page will show both page total
LIST OF PURCHASE OF GOODS IN THE COURSE OF INTERESTATE TRADE OR COMMERCE FOR THE QUARTER ENDED
Y Y
1 2
@ @
8 9 10
Break up of Value of goods leviable to tax at different rates in the No. of Declaration in
Form 'C' issued, if any
TOTAL Col. 6-9 22016406.00
Ful Signature of the authorised signatory
Form LS-4(See VAT-R1 )
List of sale of goods in the course of export of the goods out of the territory of India for the quarter
ended 30.06.2011
Name and TIN of the registered dealer furnishing the list
Name and style of business ORANA INDIA PRIVATE LIMITED
TIN 06 07182831 Economic Activity Code
A - List of sale of goods under section 5 (1) of the Central Act– out of purchases u/s 5(3) of Central Act.
Date Description of goods
1 2 3 4 5 6 7 8 9
1
2
Total A 0
B - List of sale of goods under section 5 (1) of the Central Act– other than covered by Table –A.Date Description of goods
1 2 3 4 5 6 7 8 9
1 OIN EX 008 20.04.2011 1188 Kg 173124 Srilanka
2 OIN EX 009 12.05.2011 1175 Kg 170550 Srilanka
3 OIN EX 010 13.06.2011 90 Bottle 24060 Nepal
4 OIN EX 011 24.06.2011 210 Bottle 56400 Nepal
Sr. No.
Sale Invoice/ Delivery Note
No.
Name & address of the foreign buyer
No. & date of agreement/ order of
foreign buyer to whom goods sold
Quantity/ Weight
Value of the goods
Country of destination
Vessel or Airlines name, date of shipping/ Airfreight carrier number by which goods dispatched out of
India.
Sr. No.
Sale Invoice/ Delivery Note
No.
Name & address of the foreign buyer
No. & date of agreement/ order of
foreign buyer to whom goods sold
Quantity/ Weight
Value of the goods
Country of destination
Vessel or Airlines name, date of shipping/ Airfreight carrier number by which goods dispatched out of
India.
Fonterra Brands Lanka Pvt Ltd. 100, Delgoda Road,
11650 Blyagama, Colombo, Srilanka
10022184 Dt. 25.03.2011
Mixed Berry Fruit
Preperation, Strawberry
Fruit PreprationFonterra Brands Lanka Pvt
Ltd. 100, Delgoda Road, 11650 Blyagama, Colombo,
Srilanka
I0022839 Dt. 18.04.11
Mixed Berry Fruit
Preperation, Strawberry
Fruit PreprationTrishul, 48/57, Khadya
Bazaar Marg, Balkhu -14, Kathmandu, Nepal
Lemon Green Tea Syrup,Peach Green Tea Syrup, Strawberry Green Tea Syrup, Lychee Green Tea Syrup, Pink Guava Crush
Trishul, 48/57, Khadya Bazaar Marg, Balkhu -14,
Kathmandu, Nepal
Lemon Green Tea Syrup,Peach Green Tea Syrup, Strawberry Green Tea Syrup, Lychee Green Tea Syrup, Pink Guava Crush
.
Total B 424134
C - List of sale of goods under section 5 (3) of the Central Act.
Date TIN Quantity/ Weight
1 2 3 4 5 6 7 8 9 10
Total C 0
Note : Gross total of Total A, Total B and Total C must tally with figures in 2B(4)(b) of the return.
DECLARATION
I, (name in CAPITALS), hereby declare that the contents of the above list and table
are true and correct and nothing has been concealed therein.
Place :
Date : Full signature of the authorised signatory
Name
Status
Note :- 1. An authorised person alone shall sign each page of this list. A list signed by any person not authorised or an unsigned list shall be treated as no list.
2. Where a list runs into more than one page, each page will show both page totals and progressive totals
Sr. No.
Sale Invoice/ Delivery Note
No.
Name & address of the purchaser
Description of goods
Value of the goods
No. and date of purchase order
given by exporter
Number and date of agreement/ order received
by exporter from foreign buyer.
Name and address of the foreign buyer
Form LS-4(See VAT-R1 )
List of sale of goods in the course of export of the goods out of the territory of India for the quarter
ORANA INDIA PRIVATE LIMITED
9
9
Vessel or Airlines name, date of shipping/ Airfreight carrier number by which goods dispatched out of
India.
Vessel or Airlines name, date of shipping/ Airfreight carrier number by which goods dispatched out of
India.
10 11
(name in CAPITALS), hereby declare that the contents of the above list and table
are true and correct and nothing has been concealed therein.
An authorised person alone shall sign each page of this list. A list signed by any person not authorised or an unsigned list shall be treated as no list.
Name and address of the foreign buyer
No. & date of the certificate in form 'H' or form VAT-D2 issued by the
purchaser
Name & Address :M/S ORANA INDIA PVT. LTD.
TIN : Economic Activity Code :A. List of return of goods sold
Particulars of Debit-cum delivery Note(DDN) issued by the person to whom goods were sold and who returned the same Particulars of the original sale invoice(s) issued for the sale of goods
Name of the person issuing DDN TIN If held No Date Amount No
1
23
Total 0.00
B. List of escalation in the price of goods soldParticulars of suppliementary sale invoice issued to the purchaser for escalation in the price or goods sold previously Particulars of the original sale invoice(s) issued for the sale of goods
Name of the purchaser TIN If held No Date Amount No
1
I008 13.05.2011
293.45
2 PNP/HGST/7580 I009 19.05.2011 3308
3 PNP/HGST/7580
I010 19.05.2011
209
FORM LS-10(See VAT- R1)
List of goods returned and escalation or de-escalaltion in the price of goods sold for the quarter ended 31-03-2011
Sr.
no
Sr.
no
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla Industrial Area, New Delhi
CST No. 07120245040 OIN/INV/2011-
12/,I134
Nestle India Ltd., Post Box No. - 01, Patti Kalyana Kiwana Road, Samalkha -
132101, Dist. Panipat, Haryana
OIN/INV/2010-11, 2011-
12 ,I078,I119,I128,I132,I133
Nestle India Ltd., Post Box No. - 01, Patti Kalyana Kiwana Road, Samalkha -
132101, Dist. Panipat, HaryanaOIN/INV/2011/I150
4
27110410052 I011 19.05.2011
1402.5
5 06641934947 I012 02.06.2011 15390
6 I013 02.06.2011 9131 OIN/INV/I026
7
07710224685
I014 13.06.2011 1071
8
27610646651 I015 13.06.2011
4794
9 I016 29.06.2011 3840
6
7
8Total 39438.95
C. List of de-escalation in the price of goods soldParticulars of Debit Note raised by the purchaser for de-escalation in the price or goods sold previously Particulars of the original sale invoice(s) issued for the sale of goods
Name of the person issuing DN TIN If held No Date Amount No
1
2
3
4
5
6
7
Total -
D. Summary of value of goods returned and descalation or de-escalation in the price of goods sold
(a) (b) ©(1) Local sales VAT & other
(I) @ 4 %(ii) @ 0 %
Schreiber Dynamix Dairies Ltd. , E-94, M.I.D.C, Bhigwan Road, Baramati - 413133, Pune - Maharashtra
OIN/INV/2010-11/I098
GFB Great Food Pvt. Ltd., Plot No. 36, Sector 3, Manesar - 122050
OIN/INV/2011/I031,I048
Horizon RHI, 32, Defence Colony, A Block Market, New Delhi
Barista Coffee Company Ltd.55 Community Center, Basant Lok Market,
Vasant Vihar, New Delhi - 110057OIN/INV/2010-11/I012
Pushpam Foods & Beverages Pvt Ltd, Gat No. 104/2A, Village - Barote Vasi(Nandur) - Pune
OIN/INV/2010-11/I165
Amalgamated Bean Coffee Trading Co. Ltd C/O TCI Logistics, A - 25, Phase 1, Okhla Industrial Area, New Delhi
CST No. 07120245040 OIN/INV/2010-
11/I186
Sr.
No
Name of sale and break up of turnover according to rate of tax
value of goods
returned
escalation in the price of goods sold
(2) Inter -state sales(I) @ %(ii) @ %(iii) @ %(iv) @ %
(3) Export Sales(4) Import Sales
Declaration:
Place : GURGAON For Climate Linkers
Date :(Authorised Signatory)
Break up of Sales
I J.B. KATARIA hereby declare that the contents of the above lists and tables are true and correct and nothing has been concealed therein.
M/S ORANA INDIA PVT. LTD.
Particulars of the original sale invoice(s) issued for the sale of goods
Date Amount Nature of sale
Total 0.00
Particulars of the original sale invoice(s) issued for the sale of goods
Date Amount Nature of sale
05.05.2011 82461 Central Sale 2%
2,168,520
18.05.2011 317783 Local Sale 4 %
15.03.2011,14.04.2011,21.04.11,05.05.2011,05.05.2
011
Local Sale 5%, Local Sale 4 %
05.04.2011 13754 Central Sale 2%
25.01.2011,15.02.2011 234,653 Local Sale 4 %
25.02.2011 11095 Central Sale 2%
10.01.2011 1071 Central Sale 2%
25.05.2011 6994 Central Sale 2%
16.06.2011 37763 Central Sale 2%
Total 2874094
Particulars of the original sale invoice(s) issued for the sale of goods
Date Amount Nature of sale
Total 0
De-escalation in the price of goods sold
(D) (e)=©-(b)-(d)
0.000.00
Net effect of goods
returned and
(de-)/escalation
hereby declare that the contents of the above lists and tables are true and correct and nothing has been concealed therein.
LIST OF SALE OF GOODS IN THE STATE FOR
THE QUARTER ENDEDD D M M Y Y
3 1 - 0 3 - 1 1Name and TIN of the VAT dealer furnishing the list
Name and style of business ORANA INDIA PVT LTD.
TIN 0 6 0 7 1 8 2 8 3 1 8 Economic activity codeA. List showing Sale of goods to registered dealers at full rate of tax
(A)Name with TIN of the registered dealer to whom goods sold (B) Turnover of Sale taxable at different rates
S. NO. Name TIN (I)@ 4 % (ii)@ 12.5% (iii)@ 5%
1 Nestle India Ltd PNP/HGST/7580 4,378,785.00
2 Nestle India Ltd PNP/HGST/7580 215775
3 Pepsico Holding India Pvt, Ltd. 00664300786 46000
4 Cocoberry Retail Pvt. Ltd. 81,900.00
40.00
Total 4,378,825.00 81,900.00 261,775.00 B. List showing Sale of goods to authorised dealers at lower rate of tax applicable under sec. 7(2)
(A)Name with TIN of the authorised dealer to whom goods sold (B) Turnover of Sale taxable at different rates
S. NO. Name TIN (I)@ 4 % (ii)@ 12.5 % (iii)@ %
1 -
Total 0.00 0.00 0.00
Note:- In list A and B.
2. Where a list runs into more than one page, each page will show both page totas and progressive totals.
C. Summary of taxable sales made in the State during the return period.(a) category of sale (b) Turnover of Sale taxable at different rates
S. NO. Name (I)@ 4 % (ii)@ 12.5 % (iii)@ 5 % (iv)@ %1 Sale to registered dealers at full rate of tax (List A) 4,378,825.00 261,775.00 2 Sale to authorised dealers at lower rate of tax (List B) 81900.003 Sale to unregistered dealers & consumers full rate of tax (List C) - 4 Total of row 1 to 3: 4,378,825.00 81900.00 261,775.00
Gross total of sub-colums (I) to (iv) 4722500.00
FORM LS-9(See VAT-R1)
1. There will be a single entry in respect of each registered/authrrised dealer to whomgoods have been sold during the return period. The date recorded on
a tax/ sale invoice will be taken as the date of sale for the purpose of aggregation sale made durin
Note : Gross total of sub-columns (I) to (v) must tally with figure in 2C (b) of the return.
DECLARATION : I ___J.B. KATARIA (name in CAPITALS ) hereby declare that the contents of the above list and tabel are true and correct and nothing has been concealed therein.
Full Signatures of the Authorised SignatoryPlace : GURGAON
Date :…………………………
Inv NoI128,I133,I132,I148,I149,I150,I159,I160,I179,I180,I182.I119.I127I120
29207638
Raw Material
LIST OF PURCHASE OF GOODS IN THE STATE FOR
THE QUARTER ENDEDD D M M Y Y
3 1 - 0 3 - 1 1Name and TIN of the VAT dealer furnishing the list
Name and style of business ORANA INDIA PVT. LTD.
TIN Economic activity codeA. List showing Purchase of goods from VAT dealers on tax invoice of full rate of taxS. NO. Name TIN (I)@ 4 % (ii)@ % (iii)@ %
1 0.00Total 0.00
GROSS TOTAL (I)+(ii)+(iii) 0.00
B. List of Purchase of goods from VAT Dealers on Tax Invoice at Lower Rates of Tax Application uncer section 7(2)
(a) Name with TIN of VAT dealer from whom goods purchased (b) Turnover charged to tax at different rates
S.NO. Name TIN (I)@ 4 % (ii)@ % (iii)@ %
Total 0.00
GROSS TOTAL (I)+(ii)+(iii) 0.00
C. List of Purchase of goods from Lump Sum Dealers(a) Name with TIN of Lump sum dealer from whom goods purchased
S.NO. Name TIN (I)@ % (ii)@ % (iii)@ %
Total
GROSS TOTAL (I)+(ii)+(iii)
D. List of Purchase of goods in the State without Payment of Tax(a) Name of person/ deealer from whom goods purchased
S.NO. Name TIN (I)@ % (ii)@ % (iii)@ %
Total
GROSS TOTAL (I)+(ii)+(iii)
DECLARATION
FUL SIGNATURE OF THE AUTHORISED SIGNATORYPlace Gurgaon Name Date Status
FORM LP- 7(See VAT-R1/R6/R11)
(b) Break up of turnover of purchase of goods according to rate of tax otherwise applicatio on goods
(b) Break up of turnover of purchase of goods according to rate of tax otherwise applicatio on goods
Note:-In Lists A, B, C and D,-1. There will be a single entry in respect of each dealer/person form whom good have been purchased during the return period. The date recorded on a tax/sale invoice by the selling dealer will be taken as the date of purchase for the purpose of aggregatin
2. Where a list runs in more than one page, each page will show both page totals and progressive totals. Sum of gross totals in lists A and B must tally with 3A (7)
(I) © in the return and in lists C and D with entry 3A (7) (ii) © in the return.
I _____________ (name in CAPITALS, herby declare that the contents of the above lists of purchase are true and correct and nothing has
been concealed therein.
NIL
VAT-R1 ORIGINAL/ DUPLICATE COPY OF RETURNFOR THE QUARTER ENDED ON
[See Rule 16(1) Table] D D M M Y Y1. Dealer's Identity 3 0 - 0 6 - 1 1Name & Style of Business ORANA INDIA PVT. LTD.
PALAM GURGAON ROAD
GURGAON(HARYANA)
TIN 06071828318 Economic Activity Code2. Gross turnover, taxable turnover of sales & comutation of tax (See Section (1)(u)3, 6 & 7 of the Act.)
(a) Discription (b) Value of goods
33,206,304.00
2B.DEDUCTION(1) Sale Outside the State (of Goods Purchased outside the State) - LS-1(2) Sale in the Cource of Inter-State Trade 28,059,670.00 LS-2(3) Sale in the Cource of Import into India - LS-3(4) Sale in the Cource of Export out of India 424,134.00 LS-4(5) sale of Exempted Goods in the State -
- LS-5(7) Value of goods sent for Sale to local Agents (VAT Dealers) - LS-6(8) Value of Goods Exported out of State (Consingment Transfers) - LS-7(9) Value of Goods Disposed of Otherwise than by Sale - LS-8(10) TOTAL OF (1) TO (9) 28,483,804.00
2C. TAXABLE TURNOVER OF SALES 2A(b)-2B(10)(b) 4,722,500.00 LS-9
2D (d) Rate of tax
1 4,378,785.00 - 4,378,785.00 4% 183,909
2 81,900.00 - 81,900.00 13.13% 10,749
3 261,775.00 261,775.00 5.25% 13,743 4 - 5 Total Tax Amount 208,402
3. Purchase, Import & Receipt of Goods & Computation of tax paid on Purchase made in the State( c) Amount
(1) Purchase ouside the State (for outside) LP-1 - (2) Purchase in the cource of export out of India LP-2 - (3) Purchase in the Cource of Inter State Trade LP-3 22,016,406.00 (4) Purchase in the cource of Import in to India LP-4 - (5) Import in to Stare LP-5 - (6) Received for sale from dealsers regd. Under VAT LP-6 - (7) (I) Purchase from VAT dealers on tax invoice
LP-7/8 -
(ii) Other Purchase in the State - (8) Total of rows (1) to (7) 22,016,406.00
(d) Rate of tax
1 - - - 4% - 2 - - - 3 - - 4 Add : Excess of VAT in last qtr 5,458.00 5 Total Tax Amount 5,458.00
4. Aggregate of tax levied on sale or purchase(1) Sale Tax 2D (5) 208,401.53 (2) Purcahse tax 11(4) (d) page3 - (3) TOTAL TAX (1)+(2) 208,401.53
5. Computation of input tax (see section 8 of the Act(1) Tax paid on purcahses made in the State 3B (5)(e) 5,458.00 (2) Lease tax paid, not part of input tax 10G(3) g - (3) Input tax (1) - (2) 5,458.00
6. Tax payable, refundable or adjustable(see section 20 of Act(1) Tax Payable 4(3) - 5(3) 202,943.53 (2) Tax adjueste under CST Act.(3) Refund Claimed(4) Excess Carried Forward 202,943.53
2A. Sale price received/ receivable in respect of goods and sold plus value of goods exported out of State or
desposed of otherwise than sale or sent to local agents(VAT dealses)
© List appended to the return
(6) Sale of Goods to UNICEF, UNTAB, WHO other Prescribe UN Bodies Foreign Missions
(a) Break up of 2c according to rate
tax
(b) Effect of reutrn of goods & (de-)/
escalation[LS-10]
( c) Net taxable turnover [(a)# (b)]
(e) Tax amount [( c)x(d)]
3A. (a) DescriptionAggregate of Price/ Value of goods
(b) List appeded to
return
(d) Stock as on 31st March last
to be given with return for 31/3
(a) Break up of 3A(7)(I) according
to rate tax
(b) Effect of reutrn of goods & (de-)/
escalation[Lp-8]
( c) Net purchaser [(a)# (b)]
(e) Tax amount [( c)x(d)]
Note:- if 6(1) is a negative value, the adsolute value there of will be carried forward for adjustment with future tax liability bur refund may be claimed in
case of. (I) Ecport of goods out of India. (ii) Difference in rate of tax or (iii) Inadvertent ex
Date : [ Signature of Authorised Person]
7. Details of tax deposited
Treasury Receipt (Tr)/ DD/PO/ RAO For office use
Type or Insuturment No Date Amount DCR No Date12345 Excess Paid Brought Forward From Last return6 Total of rows (1) to (7) -
8. Account of forms printed under the Government authority/required to be authenticated by theassesing authorityType of form
12 ST 38 (out)3 VAT-4 C5 E-16 E-II7 F8 H *
9. Staturory declaration and certificates received from the dealer furnished with the returnType of form Type of form
1 VAT-38(out) 1 C2 VAT- 2 D3 VAT- 3 E-14 VAT- 4 E-115 VAT- 5 F6 VAT- 6 H
Declaration:
Place:Date: (Signature)
For use in the Office of the Assessing Authority
(Affix Stamp of Name & Designation)
(Affix Stamp of Name & Designation)
ACKNOWLEDGEMENTThe undersigned acknowledges having received the original of this return on the date mentioned below:
(1) Date of receipt of return (2) Signature with Stamp of name & designation of receipt clerk)
sr.
No
Name or Treasury where tax deposeted or Bank on which DD Pay order drawn or office from where RAO issued etc.
sr.
No
Opening stock at the beginning of the ruturn peirod
Blank forms received or authenticated during the return period
Number of forms used during the
return period
Aggregate of amount of transction for
which forms furnished
Sr.
No.
No of Forms
furnished
Aggregate of amount transaction for which forms furnished
Sr.N
o
No of Forms
furnished
Aggregate of amount transaction for which forms furnished
1 I J.B. KATARIA (Name in CAPITALS, hereby solemnly affirm that I am authorised to furnish this return and all its contents including table 10 & 11 List, Statements, Declarations, Certificates & other documents appended to it or filed with it are
Status: Tick ( ) applicable [ Karta, Proprietor, Partner, Director, President, Secretary, Manager, Authorised Officer]
1. Date of data entry in VAT- Ragister/ Computer
2. Signature of the Offical Making the data entry:
3. Signature of the Assessing Authority with date:
Note: 1. Reference to sections or schedules in the Act in the return is indicative and not comprehensive. 2. A dealer who has not dealt goods in the circumstances specified in Schedule E or section 3(3) of the Act during the return period, does not have to
fill in the next page of the return.
Circumstances in which tax paid in respect of purchase of certain goods not to form part of input tax Purchase Value(a) (b)
A. Petroleum based fuels & natural gas purchased from VAT dealers on tax invoice and not resoldB. Capital goods purchased from VAT dealers on tax invoice.(1) For use mainly:- (i) In the manufacutre of exempted goods: (ii) In minning: (iii) In the Telecommunications Network: (iv) In the generation and distribution of electric energy or other form of power,(2) Which forrm part of gross block on the day cancellation of registration certificate takes effect
D. Rice purchased from VAT dealers on tax invoice when sold in the course of export out of India
E. All goods mentioned at A & B above purchased from VAT dealers on tax invoice when:
2. Exported out of State.3. Dispoded of otherwise than by sale;
5. Used in manufacture of packing of taxable goods which goods are:- (i) Exported out of state; or (ii) Disposed of otherwise than by sale,
F. Total A to E
G. Calculation of input tax at different rates (b) ( c) (d) (e) (f) (g) Total (b) to (f)
(1) Break-up of F (b) accourding to Tax Rates
(2) Rates of Tax.
(3) Input tax to be reversed (1) x (2)
Rate of Tax Purchase Tax(a) (b) ( c ) (d)
(4) Total [(1)(i)+(1)(ii)+ (2)(i)+ (2)(ii)+ (3)]
Date : [Signature of authorised person]
10. Computatio of tax paid in respect of goods purchased in the State from VAT dealer on Tax invoice which is not to from of input tax (See
Section 8(1) and Schedule E to the Act.
C. Paddy purchased from VAT dealers on tax invoice when such paddy or rice manufactured therefrom is sold in the course of export out of India
1. Used in the Telecommunications network, in mining or in the generation and distribution of electricity or other form of power.
4. Used in manufacture or packing of exempted goods (except when such goods are sold in the course export out of India
6. Left in stock, whether in the form purchased or in manufactured or processed form on the day cancellation of the registration certificate takes effect.
Notes : Where any goods purchase in the State are used or disposed of partly in the circumastances mentioned in colum (a) against entries A to E above and partly otherwise, the purchase value of such goods shall be computed pro-rate
11. Purchase tax [See section 3(3) of the Act]Circumstances in which purchase tax levied
Purchase value of goods taxable at different rates
(1) Taxable goods purchase in the State without payment of Tax when such
goods or the goods manufactured therefrom are either exported out of State
or used or disposed of (except when sold in the course of export out of
India ) in a manner that no tax or (2) Goods purchase in the State at lower rate of tax for specified purposes
but not made use of for true said purposes tax computed under provision to
section 7 (5)(3) Paddy purchased in the State without payment of Tax when such paddy
or the rice manufactured therefrom is exported out of India.
Note :- where any goods purcahsed in the State are used or disposed of partly in the circumstance mentioned in column (a) aginst entries at serial
number (1) and (2) above and partly otherwise, the purchase tax leiable on such goods shall computed pro-rat
4722500.00
FORM 1FORM OF RETURN UNDER RULE 7-A OF THE CENTRAL SALES TAX
(Haryana Rules 1957)
Returned of the Qtr endingod… 6/30/2011
Registration Make No…………
Name of the Dealer…………… M/s ORANA INDIA PRIVATE LIMITEDGP-28, 3rd Floor, Sector-18,GURGAON-122015(HARYANA)
Status : COMPANY Style Of Business:
1. Gross amounts received or receivable by the dealer during 33,206,304.00
period in respect of goods Deduct: (i) Sale of goods outside state - (ii) Sale of good in course of export out side India - (iii) Turnover of goods transferred outside the state as defined in Section-6A (1) -
2. Balance : Turnover on inter State sale deduct: 33,206,304.00 Deduct : Turnover on sale within the state 28,059,671.00
3. Balance :Turnover on inter state sales 5,146,633.00 Deduct : Cost of freight or installation when such cost is separately charged
4. Balance :Turnover of inter state sales. 5,146,633.00 Deduct : ( I ) Turnover on inter state sales of goods unconditionally exempted from tax under the Haryana General Sales Tax Act 1973 - (ii) Turover of sale sgoods returned by the purchase within a period of six months under section 8A (b) (i) of the Central Sales Tax Act 1957 - (iii) Turnover in respect of subsequent sales falling under clauses (a) & (b) of section -6 (2) of the Act -
5. Balance : Taxable turnover in respect of inter satate sales 5,146,633.00
6. Goodwise break up of the above (i) sold to registered dealers on prescribed declaration (Vide declaration attached) - (ii) sold otherwise
Total :(a) Taxable at 2% % Rs. 27,850,426.00 Tax Rs. 557,008.52 (b) Taxable at 5.25% % Rs. 209,245.00 Tax Rs. 10,985.36 (c) Taxable at % Rs. - Tax Rs. -
7. Total Tax Payable on Rs 28,059,671.00 amount to Rs. 567,993.88 8. a) Tax paid if any menas by Treasury Challan /Draft No Rs.
DD No. 570,012.00 b) Excess of VAT adjusted with CST payable Rs.9. Balance Due/ Excess paid if Any Rs. (2,018.12)
I Declare that the statement made and particulars furnished in and with return are true and complete.
Place Gurgaon Signature Date Status
VAT Summary
Payable Return
Sales Amount Vat Output Payment Detail
4% 4,378,785 175,151 VAT Paid Details:5.00% 261,775 13,089 4%
12.50% 81,900 10,238 Surchrge 5% on VAT - 9,924 5.00%
Less: Sales Return 18,907 - S.C 5%
Less: Surcharge Amount - - Less: Surcharge
Total 4,621,653 208,402 Total VAT & Surc Paid
Central Sale Amount CST
2% 27,850,426 557,009
4% - -
12.50% - -
5.00% 209,245 10,462 Less: Returned CST 2% 11,178 224
Less: Returned Without CST 9,131 - CST Paid Details:Less: Material Lost CST - - - Interest 1% Net Central Sales 28,079,980 567,247 Total VAT & Surc Paid
Export 424,134 NIL
Total Net Sales 33,125,767 NIL
Purchase Amount Vat Input Import 11,380,223 Central Purchase 10,636,183
Local 4% - -
Total Purchase 22,016,406
Return
Payment Detail
Amount 175,153
13,089
9,929 5
- -
198,171
570,012 - - 570,012