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(last date to remit the money 09/09/2011)

PAY-IN-SLIP BANKS COPY

(last date to remit the money 09/09/2011)


PAY-IN-SLIP CANDIDATESS COPY

(last date to remit the money 09/09/2011)


PAY-IN-SLIP TO BE ENCLOSED WITH THE APPLICATION
KVPY 2011 INDIAN INSTITUTE OF SCIENCE

KVPY 2011 INDIAN INSTITUTE OF SCIENCE BANGALORE 560 State Bank of India 012

KVPY 2011 INDIAN INSTITUTE OF SCIENCE BANGALORE 560 State Bank of India 012

StateBANGALOREIndia012 Bank of 560


Payable at all Branches of SBI in India

Payable at all Branches of SBI in India

Payable at all Branches of SBI in India

Branch Name and Address:

Branch Name and Address:

Branch Name and Address:

Paid into the credit of Kishore Vaigyanik Protsahan Yojana(KVPY)

Paid into the credit of Kishore Vaigyanik Protsahan Yojana(KVPY)

Paid into the credit of Kishore Vaigyanik Protsahan Yojana(KVPY)

SB A/C No. 10270577392 SB A/C No. 10270577392


Rs.
Rupees Rupees

SB A/C No. 10270577392


Rs.
Rupees

Rs.

Application No.:

Application No.:

Application No.:

. Name and address of the candidate . . . Name and address of the candidate

. . . . Name and address of the candidate

. . . .

. Pin

. Pin

. Pin

Application Processing fee: Tick as applicable General Category (a) Rs. 200/- (b) Bank charges if any Signature of the Depositor Signature of the Cashier Bank Stamp with date SC/ST (a) Rs. 100/- (b) Bank charges if any

Application Processing fee: Tick as applicable General Category (a) Rs. 200/- (b) Bank charges if any Signature of the Depositor Signature of the Cashier Bank Stamp with date SC/ST (a) Rs. 100/- (b) Bank charges if any

Application Processing fee: Tick as applicable General Category (a) Rs. 200/- (b) Bank charges if any Signature of the Depositor Signature of the Cashier SC/ST (a) Rs. 100/- (b) Bank charges if any

Bank Stamp with date

*Girl/Physically/Visually challenged students are exempted from payment of processing fee.

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