New Challan Request Form

1. Challan Request Form
DeliveryNo:- …………………………………………. Reference By:- ………………………………………………….. Date …………………………..
DeliveryTo. ............................................ DeliveryAddress: ..........................................................................................
Contact No. ............................................... ……………………………………………………………………………………………………………………….
PersonName ………………………………………… ………………………………………………………………………………………………………………………..
Terms of Delivery
(.......) Returnable (.......) Non-Returnable Note:- …………………………………………………………………………..
Terms of payment on Delivery
(.......) Cheque (.......) Cash (…….) Other Note:- ……………………………………………………………………………
Goods will Retrun on
(.......) After Meeting (.......) Other Note:- …………………………………………………………………………..
Goods Delivery Date Goods Returnable Date
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Products Details ------------------------------------------------------------------------
S.N. Description of Goods Quantity Amount Goods Taken From
Total
Requested By:-
Remarks :-
Signature
Approved By:-
Remarks :-
Signature
DeliveredBy:-
Remarks :-
Signature
For PIXXTRON EXIM PVT. LTD.
AuthorisedSignatory
Note:-