Sellers Registration Numbers			Buyers Registration Numbers
TIN NO.:	{LST_NO}		TIN NO.:	{LST_NO}
CST NO.:	{CST_NO}		CST NO.:	{CST_NO}
ECC NO.:	{ECC_NO}		ECC NO.:	{ECC_NO}
TAN NO.:	{TDS_TAN_NO}		TAN NO.:	{TDS_TAN_NO}
PAN No.:	{ITAX_PAN_NO}		PAN No.:	{ITAX_PAN_NO}
			Range :	{RANGE}
			Div. :	{DIVISION}
Prepared By & Date			Checked By & Date For {COMPANYNAME}					Authorised Signatory
			(Subject to {JURISDICTION} Jurisdiction only)