APPENDIX - 22A
- 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.
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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] |
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* 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 7against invoice mentioned in column 1 above.
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(Signature of the Bankers)
Full address of the Bankers
_______________________________________
Branch and City _______________________
Official Stamp.