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Challan: Application No / Reg. No: 127508 Application No / Reg. No: 127508 Application No / Reg. No: 127508

This document is a challan form containing details of a fee payment made by Tulu Bhuyan to the SLET Commission, Assam. It contains information such as the applicant's name, date of birth, address, examination fees of Rs. 1200, bank charges of Rs. 60, and total amount of Rs. 1260. The form is made in triplicate - original for bank, duplicate for commission office, and triplicate for depositor.

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103 views2 pages

Challan: Application No / Reg. No: 127508 Application No / Reg. No: 127508 Application No / Reg. No: 127508

This document is a challan form containing details of a fee payment made by Tulu Bhuyan to the SLET Commission, Assam. It contains information such as the applicant's name, date of birth, address, examination fees of Rs. 1200, bank charges of Rs. 60, and total amount of Rs. 1260. The form is made in triplicate - original for bank, duplicate for commission office, and triplicate for depositor.

Uploaded by

sanjay_dutta_5
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Challan

SL.No 1 SL.No 2 SL.No 3


ORIGINAL DUPLICATE TRIPLICATE
(Bank's Copy) (SLET Commission Office Copy) (Depositor's Copy)
STATE BANK OF INDIA STATE BANK OF INDIA STATE BANK OF INDIA
..................Branch ..................Branch ..................Branch
SLET Commission,Assam(NE Region) 781014 SLET Commission,Assam(NE Region) 781014 SLET Commission,Assam(NE Region) 781014

Fee Type : 427 Screen No.: 8888 Fee Type : 427 Screen No.: 8888 Fee Type : 427 Screen No.: 8888

A/C No : 34966566918 A/C No : 34966566918 A/C No : 34966566918

Application No / Reg. No : 127508 Application No / Reg. No : 127508 Application No / Reg. No : 127508

Subject : Education Subject : Education Subject : Education

Name : Tulu Bhuyan Name : Tulu Bhuyan Name : Tulu Bhuyan

DOB : 31-01-1976 DOB : 31-01-1976 DOB : 31-01-1976

Category : GENERAL Category : GENERAL Category : GENERAL

Address : C/O: Indreswar Bhuyan Address : C/O: Indreswar Bhuyan Address : C/O: Indreswar Bhuyan
Kowamara satra Kowamara satra Kowamara satra
P.O. Sukan Pukhuri P.O. Sukan Pukhuri P.O. Sukan Pukhuri
Sivasagar Sivasagar Sivasagar

a)Examination Fees : 1200.00 a)Examination Fees : 1200.00 a)Examination Fees : 1200.00

b)Bank Charges : 60.00 b)Bank Charges : 60.00 b)Bank Charges : 60.00

Total : 1260.0 Total : 1260.0 Total : 1260.0

Rupees(in words): ONE THOUSAND TWO HUNDRED Rupees(in words): ONE THOUSAND TWO HUNDRED Rupees(in words): ONE THOUSAND TWO HUNDRED
SIXTY RUPEES ONLY SIXTY RUPEES ONLY SIXTY RUPEES ONLY

Date: Full Signature of Depositor Date: Full Signature of Depositor Date: Full Signature of Depositor
(For BANK USE ONLY) (For BANK USE ONLY) (For BANK USE ONLY)

Transaction/BankJournal No : Transaction/BankJournal No : Transaction/BankJournal No :

(Rupees in words only) (Rupees in words only) (Rupees in words only)

Credited to the account of SLET commission,Assam Credited to the account of SLET commission,Assam Credited to the account of SLET commission,Assam

Chief Manager Chief Manager Chief Manager


State Bank of india State Bank of india State Bank of india
Date : Branch Date : Branch Date : Branch
Last date of Fee Payment: 9th/Dec/2017 Last date of Fee Payment: 9th/Dec/2017 Last date of Fee Payment: 9th/Dec/2017

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