BRANCH COPY

CANDIDATE COPY

CHALLAN FORM (CASH VOUCHER)

CHALLAN FORM (CASH VOUCHER)

For Recruitment of Office Assistant (Multipurpose) in Baroda Uttar Pradesh Gramin Bank (To be filled by candidate)
Name of Account Account Number B.U.P.G.B. Recruitment Project - Group B 00520200000639

For Recruitment of Office Assistant (Multipurpose) in Baroda Uttar Pradesh Gramin Bank (To be filled by candidate)
Name of Account Account Number B.U.P.G.B. Recruitment Project - Group B 00520200000639

Application Fee/Postal Charges (Tick whichever is applicable)

SC/ST/PWD/EXS OTHERS Applicants Name Date of Birth BOB Branch Name Branch Code No*. (SOL ID) Transaction ID. * . Date of Deposit : : : Rs. 20/- per candidate (Only Postage Charges) Rs. 100/- per candidate (including Postage charges) : : .. . : .. ... .. .. .. (Rupees .only)

Application Fee/Postal Charges (Tick whichever is applicable)

SC/ST/PWD/EXS OTHERS Applicants Name Date of Birth BOB Branch Name Branch Code No*. (SOL ID) Transaction ID. * . Date of Deposit : : : Rs. 20/- per candidate (Only Postage Charges) Rs. 100/- per candidate (including Postage charges) : : .. . : .. ... .. .. .. (Rupees .only)

Application Fee / postage Rs. :

Application Fee / postage Rs. :

Signature of Depositor Phone/Mobile No. ..

Authorised Signatory Branch Stamp

Signature of Depositor Phone/Mobile No. ..

Authorised Signatory Branch Stamp

*Fee receiving branch is advised to

invariably write the BRANCH CODE NO. (SOL ID) & TRANSACTION ID as above. WILL BE REQ

*Fee receiving branch is advised to

invariably write the BRANCH CODE NO. (SOL ID) & TRANSACTION ID as above. WILL BE REQ