APPENDIX 22B
- Document type
- Procedure
- Dated
- Category
- Forms & Appendix (wef 08/04/2005)
BANK CERTIFICATE OF PAYMENTS FOR DOMESTIC SUPPLIES
BANK CERTIFICATE OF PAYMENTS FOR DOMESTIC SUPPLIES
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: | : ........................................... | |
| Date: | Designation | : ........................................... |
| Full official address | : ........................................... | |
| Official Seal/stamp | Full Residential address | : ........................................... |
| (Signature of the Bankers) Full address of the Bankers Branch and City Official Stamp |