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CHALLAN NO.

DI6IFIq( s

CHALLAN OF CASH rAID INTO ffm _Eql.y / Sub Treasury at


State Bank of India
To be filled in by the remiter To be filled in by the
Department Officer
wrfr.e"sRfrfi<
or the Treasury
By whom Name (or Designation Amount
Full particulars of the
Tendered and address ofthe tro-"funR<<q
person on whose remittance and authority
Name
behalf money is paid (if any) Head of
TR<trlTcqtrfl frfl
q,$ fiTttrfl-"Rfl< csnm qr[c{ Rs.
qlc{frrq P. Account
4tr t<E, m.,<i<q|n
qttfr-rq w ry{fr'<<.t bol ?fut
(Tt
"trrftq+Smn

TOTAL
rbto
(in words) Rupees
\{t{r+rqtrst
Signature (n-vrtvl
pate (qfu)
Received Payment Date
Treasurer Accountant Treasury Officer/Agent

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