PAYMENT CHALLAN FORM 01 (CASH VOUCHER)

BRANCH COPY

PAYMENT CHALLAN FORM 01 (CASH VOUCHER)

CANDIDATES COPY

SHREYAS GRAMIN BANK

Application Fee Details
Recruitment of Officer Scale-I, II & III
In Shreyas Gramin Bank

SHREYAS GRAMIN BANK

Application Fee Details
Recruitment of Officer Scale-I, II & III
In Shreyas Gramin Bank

CBS ACCOUNT NO. : 70310101004377 SGB, CITY BRANCH, CENTRE POINT

ALIGARH BRANCH (BRANCH CODE 310)

CBS ACCOUNT NO. : 70310101004377 SGB, CITY BRANCH, CENTRE POINT

ALIGARH BRANCH (BRANCH CODE 310)

Candidates Name
Category *

Candidates Name
Category *

: Mr./Mrs/Kum.............................................................
:
SC/ST/PWD
Rs. 20/For All Others
Rs.100/-

Fee Receiving Branch Name : .................................................

Branch Code No. #

: .................................................

Transaction ID/ GB No. #

: .................................................

Date of Deposit

: .................................................

Application Fee

: .................................................

: Mr./Mrs/Kum.............................................................
:
SC/ST/PWD
Rs. 20/For All Others
Rs.100/-

Fee Receiving Branch Name : .................................................

Branch Code No. #

: .................................................

Transaction ID/ GB No. #

: .................................................

Date of Deposit

: .................................................

Application Fee

: .................................................

(Rupees..............................................................................................................only)

(Rupees..............................................................................................................only)
Signature of Depositor
Address :...................................................................
..................................................................................
..................................................................................
Phone/ Mob. No. .....................................................

Authorised Signatory
Stamp

* Tick whichever is applicable.

# Fee receiving branch is advised to write the Transaction ID/ GB No. and Branch
Code No. above invariably.

Signature of Depositor
Address :...................................................................
..................................................................................
..................................................................................
Phone/ Mob. No. .....................................................

Authorised Signatory
Stamp

* Tick whichever is applicable.

# Fee receiving branch is advised to write the Transaction ID/ GB No. and Branch
Code No. above invariably.
[This part of the challan will be required to be submitted by the candidate at the time
of Interview otherwise the candidate will not be allowed to appear in interview]