IAC, Dept. of CSE, BUET IAC, Dept.

of CSE, BUET
Office Copy Applicant Copy

1. Application Serial No: 163696 Batch ID: Batch28 1. Application Serial No: 163696 Batch ID: Batch28
2. Course Code: IAC-KIV-MLAI 2. Course Code: IAC-KIV-MLAI
3. Course Title: IAC-KIV-MLAI 3. Course Title: IAC-KIV-MLAI
4. Name: Masum Billah 4. Name: Masum Billah
5. Father's Name: Abdul Aziz 5. Father's Name: Abdul Aziz
6. Date of Submission: August 2, 2023, 7:01 pm 6. Date of Submission: August 2, 2023, 7:01 pm
7. Application Fee: Tk 300.00 (Tk Three Hundred Only) 7. Application Fee: Tk 300.00 (Tk Three Hundred Only)

Signature of Receiving Staff Signature of Receiving Staff Signature of Applicant

[] Accepted [] Rejected

Signature of IAC incharge

1. Bank Draft/payorder Number: 1. Bank Draft/payorder Number:

2. Bank Name: 2. Bank Name:

3. Bank Branch Name: 3. Bank Branch Name:

4. Payment Date: 4. Payment Date:

5. Amount Paid: 5. Amount Paid:

Signature of Receiving Staff Signature of Receiving Staff