APPENDIX - 22-A
- Document type
- Procedure
- Dated
BANK CERTIFICATE OF PAYMENTS FOR DOMESTIC SUPPLIES
BANK CERTIFICATE OF PAYMENTS FOR DOMESTIC SUPPLIES
NOTE: PLEASE SEE CHAPTER 4,5 AND 8 OF THE POLICY AND CHAPTER 4, 5 AND 8 OF THE PROCEDURE.
To ______________________________ (Name and address of Licensing Authority). We ________________________ (Name and address of the domestic supplier) hereby declare that we have received payment through banking channel in respect of supplies given hereunder.
| Invoice | Description of goods as given in the invoice | Details of payment/ advance payment received | Date of issue of this Certificate | ||||
| No. | Date | FOR value | Cheque /DD No./ *Bank Ref. No. | Date | Amount | ||
| [1] | [2] | [3] | [4] | [5] | [6] | [7] | [8] |
* The Bank Reference Number would be applicable for documents routed through bank & payments released through banking channels.
We further declare that the aforesaid particulars are correct.
Place: Official Seal/ stamp | Signature of the domestic supplier. Name in block letters Designation Full official address Full Residential address | : .................... : .................... : .................... : .................... : .................... |
This is to certify that we have received the amount mentioned in column 7 against invoice mentioned in column 1 above/** details mentioned in Column 5 above.
** (Please Strike out one of the options)
Full address of the Bankers Branch and City Official Stamp |
(Appendix 22A has been amended vide P.N. No.22/2004, DT. 08/11/2004)
[OLD-
BANK CERTIFICATE OF PAYMENTS FOR DOMESTIC SUPPLIES
NOTE: PLEASE SEE CHAPTER 4,5 AND 8 OF THE POLICY AND CHAPTER 4, 5 AND 8 OF THE PROCEDURE.
To ______________________________ (Name and address of Licensing Authority). We ________________________ (Name and address of the domestic supplier) hereby declare that we have received payment through banking channel in respect of supplies given hereunder.
| Invoice | Description of goods as given in the invoice | Details of payment/ advance payment received | Date of issue of this Certificate | ||||
| No. | Date | FOR value | Cheque /DD No./ *Bank Ref. No. | Date | Amount | ||
| [1] | [2] | [3] | [4] | [5] | [6] | [7] | [8] |
* The Bank Reference Number would be applicable for documents routed through bank & payments released through banking channels.
We further declare that the aforesaid particulars are correct.
| Signature of the domestic supplier. | : | .................... | |
| Name in block letters | : | .................... | |
| Place: | : | .................... | |
| Designation | : | .................... : .................... | |
| Full official address | : | .................... | |
| Official Seal/ stamp | Full Residential address | : | .................... |
This is to certify that we have received the amount mentioned in column 7 against invoice mentioned in column 1 above.
(Signature of the Bankers)
Full address of the Bankers
_______________________________________
Branch and City_______________________
Official Stamp. ]