2admission Receipt

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DD/PO/RTGS/

T TWApplication Cum AY-IN-SLIP FOR


NEFTITRANSFER OF FUND"
Ho No.
(Cash/Cheque/Customer Instruction)
India
gAT&d t gir United Bank of

Account with Brançh (Application) Mchsagsn.


fT/Date..bklha.l.kk.fKki.. oboaodae**po*ednase sesenesa*a*

Deposited at Branch.
1 Beneficiary Name. IIAMK.ASSOM...
WNLVLREL.MAU.LADIMIKSIONCOUNI,
Beneficiary A/C. No. (For RTGS/NEFT/Inter-Sol Txn.)

BeneficiaryBank IFSC (For RTGS/NEFT)

LICICAOOUzooSTITO
4. f TOT*ais ge ad/Payable at Branch Name (For DD)
6. TarT
Amount to be remitted
FoRs. 0IKA0O
6. 3T4TR/ Charges oRs.
7.F/Total Ho /Rs.

3447 F fTA m **
Terms of remittac
are on the
revese
Authorised Signatory(s) of Bank Please Tickas applicaa
PUR

lauchaclespb Ma2umele

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