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(Candidate Copy)

(Bank Copy)

JEE(Main)-2015

JEE(Main)-2015

Cash can be deposited at any CBS Branch of ICICI Bank

Cash can be deposited at any CBS Branch of ICICI Bank

Bank A/C No. :


Application No.:

JEE(Main)-2015 Fee A/C

Bank A/C No. :


Application No.:

JEE(Main)-2015 Fee A/C

Name :

KARHADKAR SIDDHANT PRASHANT

Name :

Date of Birth :
Category :
Person with Disability (PwD) :
Course :
Mobile No. :
Fee Rs :
Printed on :

KARHADKAR SIDDHANT PRASHANT

04/01/1997
GENERAL
NO
JEE(Main) Paper - 1 (B.E./B.Tech.) Only
9004641904
1000/07-12-2014 07:00:37 PM

Date of Birth :
Category :
Person with Disability (PwD) :
Course :
Mobile No. :
Fee Rs :
Printed on :

04/01/1997
GENERAL
NO
JEE(Main) Paper - 1 (B.E./B.Tech.) Only
9004641904
1000/07-12-2014 07:00:37 PM

50510827

Signature of the Depositor

----

50510827

Signature of the Depositor


Instructions for ICICI Bank Branches
1. This is an I Sure Pay Challan & Inst Code/ Account No. not required
2. Type "HCOREFEE" in finacle --> Select "JEE(Main)-2015 CBSE" --> Enter "Application No.:" -> Click Submit --> Verify Details --> Accept Cash --> Click Submit -->Generate Receipt -->
Handover to Depositor.

(To be filled by the bank)

(To be filled by the bank)

Branch Name:

Branch Name:

Branch Code:

Branch Code:

Transaction Id:

Transaction Id:

Deposit Date:
______/______/20_____

Deposit Date:
______/______/20_____

Authorized Signatory

Authorized Signatory

Branch Stamp
Candidate should revisit the website to download Acknowledgement Page after depositing the fee.

Branch Stamp
Bank official is requested to enter Application No. and Name of candidate only in narrative column.