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Depositor Copy Branch Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch Date: 30-06-2019 Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Benificiary/Remittance Details Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect
Date: 30-06-2019
State Bank MOPS Reference No. CPT0729660
Benificiary/Remittance Details
Beneficiary: JOSAA 2019
State Bank MOPS Reference No. CPT0729660
Merchant Reference No: 1903100726382019202
Beneficiary: JOSAA 2019
Candidate Name: GANESH CHILAKA
Merchant Reference No: 1903100726382019202
JEE (Main) 2019 Application No: 190310072638
Candidate Name: GANESH CHILAKA
Rs P
JEE (Main) 2019 Application No: 190310072638
Collection Amount 15000 00
Comission 59 00 Rs P
Total ( Fifteen Thousand And Fifty Nine Rupees Only) 15059 00 Collection Amount 15000 00
Comission 59 00
Details of Cash Rs p Total ( Fifteen Thousand And Fifty Nine Rupees Only) 15059 00

Cash

Amount
Total Rs
Cash Notes Rs P

Instructions for Depositor: This is not an e-receipt. *2000


*500
(To be Filled in by the Bank) *200
*100
Journal No:
*50
*20
Branch Name: *10

Branch Code: Deposit Date:


Coins
Total Rs
Branch Stamp

Authorised Signatory Signature of the Depositor

Space for Bank use


Branch Stamp

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