Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

APPLICATION PROCESSING FEE APPLICATION PROCESSING FEE APPLICATION PROCESSING FEE APPLICATION PROCESSING FEE

ORIGINAL DUPLICATE TRIPLICATE QUADRAPLICATE


NIMHANS, BENGALURU NIMHANS, BENGALURU NIMHANS, BENGALURU NIMHANS, BENGALURU
STATE BANK OF MYSORE, NIMHANS Branch STATE BANK OF MYSORE, NIMHANS Branch STATE BANK OF MYSORE, NIMHANS Branch STATE BANK OF MYSORE, NIMHANS Branch
Bengaluru - 560 029 Bengaluru - 560 029 Bengaluru - 560 029 Bengaluru - 560 029
Paying in slip for Paying in slip for Paying in slip for Paying in slip for
S.B. ACCOUNT NO: 64118462718 S.B. ACCOUNT NO: 64118462718 S.B. ACCOUNT NO: 64118462718 S.B. ACCOUNT NO: 64118462718
IFSC Code No: SBMY0040675 IFSC Code No: SBMY0040675 IFSC Code No: SBMY0040675 IFSC Code No: SBMY0040675
Date: ___________ Date: ___________ Date: ___________ Date: ___________

Details of amount remitted by _______________________ Details of amount remitted by _______________________ Details of amount remitted by _______________________ Details of amount remitted by _______________________

________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________

Application Processing Fee Rs. Application Processing Fee Rs. Application Processing Fee Rs. Application Processing Fee Rs.

for the post of ___________________ for the post of ___________________ for the post of ___________________ for the post of ___________________

Total: _________________________ Total: _________________________ Total: _________________________ Total: _________________________

Rupees__________________________________________ Rupees__________________________________________ Rupees__________________________________________ Rupees__________________________________________

________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________

In Cash In Cash In Cash In Cash

Bank Name Bank Name Bank Name Bank Name

Branchcode: Branchcode: Branchcode: Branchcode:

NIMHANS Copy NIMHANS Copy


Branch Copy Remitters Copy To be attached alongwith Application To be attached alongwith Application

You might also like