Bank Branch Copy

BANK CHALLAN FORM

Applicants Copy
BANK CHALLAN FORM

WB Co-operative Service Commissions Copy

BANK CHALLAN FORM

THE WEST BENGAL STATE CO-OPERATIVE BANK LTD.

Home Branch : Kolkata Main Branch
Branch where deposited .
Deposit Date //2014

THE WEST BENGAL STATE CO-OPERATIVE BANK LTD.

Home Branch: Kolkata Main Branch
Branch where deposited .
Deposit Date //2014

THE WEST BENGAL STATE CO-OPERATIVE BANK LTD.

Home Branch : Kolkata Main Branch
Branch where deposited .
Deposit Date //2014

WBCSC
Advt.No.

Post
Code

01/2014

WBCSC
Advt. No.

0 1 1 4

01/2014 Post 0 1
Code

WBCSC
Advt.No.

Post applied for

Post applied for

Post applied for

Name of the Co-operative

Institution to which the
post belongs

Name of the Cooperative

Institution to which the
post belongs

Name of the Co-operative

Institution to which the
post belongs

Applicants name

Applicants name

Applicants name

Fathers name

Fathers name

Fathers name

Date of birth
Contact e-mail id
Name of the CD
Account credited

Date of birth
Contact e-mail id
Name of the CD
Account credited

Date of birth
Contact e-mail id
Name of the CD
Account credited

CD Account No.
Total Amount
tendered
(Rupees one
hundred and
seventy) only

West Bengal Co-operative

Service Commission

29312051276
Application Fee (to be
credited to CD A/c No.
29312051276
Service Charge for the
receiving Branch
(including S.T.)
TOTAL

Rs.160.00

Rs.10.00
Rs.170.00

Bank Branch Stamp

BRANCH COPY

CD Account No.
Total Amount
tendered
(Rupees one
hundred and
seventy)

West Bengal Co-operative Service

Commission

29312051276
Application Fee (to
be credited to CD A/c
No.29312051276
Service Charge for
receiving Branch
(including S.T.)
TOTAL

Rs.160.00

Rs.10.00
Rs.170.00

Bank Branch Stamp

Post
Code

01/2014

CD Account No.
Total Amount
tendered
(Rupees one
hundred and
seventy) only

West Bengal Co-operative

Service Commission

29312051276
Application Fee (to
be credited to CD
A/c No.29312051276
Service Charge for
the receiving Branch
(including S.T.)
TOTAL

Bank Branch Stamp

Remitters
signature

Remitters
signature

Received
by

Received
by
APPLICANTS COPY (may have to be shown during exams.)

0 1 1 4

Rs.160.00

Rs.10.00
Rs.170.00
Remitters
signature

Received
by
CSC WB COPY (to be attached with the Application)