PAY-IN-SLIP
(To be retained by the Bank)
Remittance of Fee through Bank Challan for applying ON-LINE.
Detail of Fee
(please Tick fee, as applicable)
Category
Amount
General
Rs.1000/OBC
Rs.500/SC/ST/PH/VH
Rs.250/To be filled in by the Applicant
Subject Code:
Centre Code:
Category:
Name (Block letters) :
Address (Block letters):
..
Deposit Amount:
Date:
Deposit Fee Amount .
(in words)
Phone/Mobile Number:
APPLICANT SIGNATURE
__________________________________________________
For Bank Use Only
Received the above amount on.. (date)
Deposit Journal No.
Bank Name..
Bank/Branch Code..
Branch Name/City
(Signature with seal of the depositing Bank)
Note: 1. Bank name, Branch code and Branch Name/City must
be given by the Bank.
2. Bank is requested to accept deposits only upto : 16.09.2016.
__________________________________________________
As per agreement with Indian Bank, West Patel Nagar, New
Delhi all CBS branches of Indian Bank are authorized to collect
the fees.
Important Instructions: Candidates may also deposit
their fees through NEFT by giving the following particulars of
the Indian bank
Bank Name
A/c No.
6151487178
A/c Name
Detail of Fee
(please Tick fee, as applicable)
Category
Amount
General
Rs.1000/OBC
Rs.500/SC/ST/PH/VH
Rs.250/-
Detail of Fee
(please Tick fee, as applicable)
Category
Amount
General
Rs.1000/OBC
Rs.500/SC/ST/PH/VH
Rs.250/-
Subject Code:
Centre Code:
Category:
Name (Block letters) :
Address (Block letters):
..
Subject Code:
Centre Code:
Category:
Name (Block letters) :
Address (Block letters):
..
Deposit Amount:
Date:
Deposit Fee Amount .
(in words)
Phone/Mobile Number:
Deposit Amount:
Date:
Deposit Fee Amount .
(in words)
Phone/Mobile Number:
APPLICANT SIGNATURE
__________________________________________________
For Bank Use Only
APPLICANT SIGNATURE
__________________________________________________
For Bank Use Only