TO BE PAID THROUGH SYSTEM ONLY

PFMS Generated Print Payment Advice

Approval date in PFMS: 01 Oct 2022 Payment Advice No.: C092238158576
Expiry date of PPA PFMS: 11 Oct 2022 Advice Print Date : 01 Oct 2022
PAN No. : TAN No.:
Note For Branch:
Contact Details BANK PFMS
Name: Shailesh Shah
Email : Shailesh.Shah@hdfcbank.com Helpdesk-pfms@gov.in
Phone No. : 9312845391 011-23343860
Note:
To,

The Branch Head

HDFC BANK LTD
HAILAKANDI Branch

We authorise the bank to debit our undernoted account maintained with the bank with batch
amount and credit the beneficiary(ies) [#21] as per ANNEXURE-I uploaded to bank's central
system through PFMS O/o CGA.
Bank Account No. 50100470448680 Total Amount of Debit : Rs 21,000.00
(Amount in words : Twenty-One Thousand )
No. Of Beneficiaries as per Annexure-I. Batch No. C092238158576

Agency Seal
.................................................. ..................................................
(Sign by Authorized Signatory) (Sign by Authorized Signatory)
Name - ________________________ Name - ________________________
Designation - __________________ Designation - __________________
Mobile No - ____________________ Mobile No - ____________________

To,
NTEP NHM FUND HKD-[ASHA00003532]
Ref: Account No. 50100470448680 / Payment Advice Number C092238158576
We confirm having received the captioned advice of credit(s) for payment today for further
processing as per arrangement of bank on integrated PFMS-Bank payment system.
No. Of Beneficiaries : 21 Amount (in Rs.) : 21,000.00
Date & Time :

HDFC BANK LTD Branch Seal Branch Authorized Official

Agency to enter date of delivery in PFMS using option | E-Payment => PPA Submission Status

Public Financial Management Page No:1 / 3 01/10/22 11:26

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 ANNEXURE -I
(All page to be stamped and initial and last page to be signed in FULL with stamp)

Payment Advice No.: C092238158576

Sr.No. Name of PFMS Txn ID Account IFSC/IIN/MICR Aadhaar Amount(In
Beneficiary Number Code Number Rs.)
1 ASHIM KUMAR C092238158588 xxxxxxxxxxxx4838 PUNB0RRBAGB 1,000.00
NATH
2 AYESHA BEGUM C092238158590 xxxxxxxxxxxx1427 UCBA0001675 1,000.00
BARBHUIYA
3 Havaldar C092238158587 xxxxxxxxxxxx0721 SBIN0008407 1,000.00
MAKHAN
LASKAR
4 ISAK ALI C092238158591 xxxxxxxxxxxx5249 PUNB0RRBAGB 1,000.00
CHOUDHURY
5 LOVELY DAS C092238158583 xxxxxxxxxxxx5896 PUNB0RRBAGB 1,000.00
6 MISBA BEGUM C092238158580 xxxxxxxxxxxx1281 BARB0KATIGO 1,000.00
CHAUDHURY
7 Miss SUFIA C092238158594 xxxxxxxxxxxx8372 SBIN0000087 1,000.00
BEGOM LASKAR
8 Mr ABDUL C092238158584 xxxxxxxxxxxx0052 SBIN0000087 1,000.00
HAMID
BARBHUIYA
9 Mr AMIR C092238158596 xxxxxxxxxxxx1206 SBIN0013250 1,000.00
HUSSAIN
MAJUMDER
10 Mr BAMA C092238158597 xxxxxxxxxxxx9914 SBIN0007034 1,000.00
CHARANSINGH
BHUMIJ
11 Mrs SAHIDA C092238158582 xxxxxxxxxxxx1487 SBIN0008407 1,000.00
BEGUM
MAZUMDER
12 NIZAM UDDIN C092238158578 xxxxxxxxxxxx2786 UBIN0540919 1,000.00
13 NURJAN BIBI C092238158586 xxxxxxxxxxxx6557 PUNB0RRBAGB 1,000.00
LASKAR
14 RAINA BEGOM C092238158592 xxxxxxxxxxxx6284 PUNB0RRBAGB 1,000.00
15 RAM KEWAL C092238158589 xxxxxxxxxxxx1617 UTBI0RRBTGB 1,000.00
MALI
16 RUMA ROBIDAS C092238158595 xxxxxxxxxxxx5478 PUNB0RRBAGB 1,000.00
17 SAHARUL ALAM C092238158579 xxxxxxxxxxxx5773 PUNB0059620 1,000.00
LASKAR
18 SIWNATH KEOT C092238158593 xxxxxxxxxxxx2953 PUNB0RRBAGB 1,000.00
19 SOFATUN C092238158581 xxxxxxxxxxxx4808 PUNB0RRBAGB 1,000.00
NESSA
LASKARABDUL
MANIK LASKAR
20 SOFIQUE UDDIN C092238158585 xxxxxxxxxxxx1988 PUNB0RRBAGB 1,000.00
CHOUDHURY

Public Financial Management Page No:2 / 3 01/10/22 11:26

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 ANNEXURE -I
(All page to be stamped and initial and last page to be signed in FULL with stamp)

Payment Advice No.: C092238158576

Sr.No. Name of PFMS Txn ID Account IFSC/IIN/MICR Aadhaar Amount(In
Beneficiary Number Code Number Rs.)
21 SOKAT ALI C092238158577 xxxxxxxxxxxx7938 PUNB0RRBAGB 1,000.00
LASKAR
Total Amount(Rs) 21,000.00

Please acknowledge and do the needful as prescribed by bank to complete transactions.

Public Financial Management Page No:3 / 3 01/10/22 11:26

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