BRANCH COPY APPLICANT’S COPY

FEES PAYMENTCHALLAN FEES PAYMENT CHALLAN

STATE BANK OF INDIA STATE BANK OF INDIA

Recruitment of Administrative Officers in Recruitment of Administrative Officers in
UNITED INDIA INSURANCE CO. LTD UNITED INDIA INSURANCE CO. LTD
Date Date:
Account No. 31601917796 at Triplicane, Chennai – 600 005 Account No. 31601917796 at Triplicane, Chennai – 600 005

Name of the Applicant: Name of the Applicant:

Address: Address:

Fee Required : `. 540/- (including Rs.40/- for bank charges) Fee Required : `. 540/- (including Rs.40/- for bank charges)

Signature of the Applicant: Signature of the Applicant:

(To be filled by the Bank) (To be filled by the Bank)

Branch Stamp Branch Stamp

SBI Branch Name :________________ SBI Branch Name :______________

Branch Code Deposit Date Branch Code Deposit Date

02 2011 02 2011

Journal No. Journal No.

Authorised Signatory Authorised Signatory

Fees Payment Challan shall be produced by the Applicant at the time of written
Fees Payment Challan shall be produced by the Applicant at the time of written
examination. Otherwise Applicant will not be allowed to write the test.
examination. Otherwise Applicant will not be allowed to write the test.