Pay-in-Slip – Application fee Bank’s Copy

for Recruitment of Clerks A

Payment can be made at any branch of Indian Bank Date: ______________
Paid into credit of Application Fee - Recruitment of Clerks-2010

Account Nos: 890571092 890571127 890571150 Paying Branch Name

Rupees (in words): ___________________________________________________________

____________________________________________________
Rs.
Name and Address Mobile :
of the Candidate
with Pincode Telephone :

Application Fee: Tick as Applicable

SC/ST/PWD/EXSM Category Rs.50/- OBC/GEN Category Rs.300/-
Signature of the depositor

* For Bank’s Use (not to be filled in by the Candidate).

Deposit Journal Number Signature of the Cashier

Branch CBS code, date of remittance and branch Amount paid into Credit of(to be filled by Branch)
Seal 890571092 890571127 890571150

Pay-in-Slip - Application fee Candidate’s Copy

for Recruitment of Clerks A
Payment can be made at any branch of Indian Bank Date: ______________
Paid into credit of Application Fee-Recruitment of Clerks-2010

Account Nos: 890571092 890571127 890571150 Paying Branch Name

Rupees (in words): ___________________________________________________________

____________________________________________________
Rs.
Name and Address Mobile :
of the Candidate
with Pincode Telephone :

Application Fee: Tick as Applicable

SC/ST/PWD/EXSM Category Rs.50/- OBC/GEN Category Rs.300/-
Signature of the depositor

* For Bank’s Use (not to be filled in by the Candidate).

Deposit Journal Number Signature of the Cashier

Branch CBS code, date of remittance and branch Amount paid into Credit of(to be filled by Branch)
Seal 890571092 890571127 890571150

Note: Original of Candidate’s copy of the Challan after payment of application fee has to be
submitted along with the Call Letter at the time of written test on 22.08.2010.