(Branch copy) (Bank copy) (Candidate’s copy)

Challan for remittance of application fee for Challan for the remittance of application fee for Challan for the remittance of application fee for
Recruitment of Probationary Officers/ Clerks Recruitment of Probationary Officers/ Clerks Recruitment of Probationary Officers/ Clerks
Date- _ _/_ _/_ _ _ _ Date- _ _/_ _/_ _ _ _ Date- _ _/_ _/_ _ _ _
{Account No: 10010200150362} {Account No: 10010200150362} {Account No: 10010200150362}

Applicant's Name: (To be filled by the applicant ) Applicant's Name: (To be filled by the applicant) Applicant's Name: (To be filled by the applicant)

Mr./Mrs./ Kum……………………………………….. Mr./Mrs./ Kum……………………………………….. Mr./Mrs./ Kum………………………………………..

Category (Tick which ever is applicable) Category (Tick which ever is applicable)
` 400/- for PO ` 400/- for PO Category (Tick which ever is applicable)
General/OBC ` 300/- for Clerk General/OBC ` 300/- for Clerk ` 400/- for PO
General/OBC ` 300/- for Clerk
SC/ST ` 75/- for P O. SC/ST ` 75/- for P O.
` 50/- for Clerk ` 50/- for Clerk SC/ST ` 75/- for P O.
` 50/- for Clerk
FB Branch Name : FB Branch Name :
FB Branch Name :
SOL ID : SOL ID :
SOL ID :
Transaction ID : Transaction ID :
Transaction ID :
Deposit Date : Deposit Date :
Deposit Date :
Application Fee : ` ……….. Application Fee : `………….
Application Fee : `………………..
(Rupees…………………………. ………….. only) (Rupees…………………………. ………….. only)
(Rupees…………………………. ………….. only)

Signature of the Signature of the authorised Signature of the Signature of the authorised Signature of the Signature of the authorised
remitter official with Branch Seal remitter official with Branch Seal remitter official with Branch Seal

Fee receiving branch is advised to write the Branch Name, Fee receiving branch is advised to write the Branch Fee receiving branch is advised to write the Branch
SOL ID, Transaction ID, Deposit Date invariably and Name, SOL ID, Transaction ID, Deposit Date invariably Name, SOL ID, Transaction ID, Deposit Date invariably
handover the Bank copy and Candidate’s copy to and handover the Bank copy and Candidate’s and handover the Bank copy and Candidate’s
the remitter, duly signed. copy to the remitter, duly signed. copy to the remitter, duly signed.