Karnataka State Open University, Mysore Karnataka State Open University, Mysore Karnataka State Open University, Mysore

Karnataka State Open University, Mysore Karnataka State Open University, Mysore Karnataka State Open University, Mysore
PÀ£ÁðlPÀ gÁdå ªÀÄÄPÀÛ «±Àé«zÁ央AiÀÄ, ªÉÄʸÀÆgÀÄ PÀ£ÁðlPÀ gÁdå ªÀÄÄPÀÛ «±Àé«zÁ央AiÀÄ, ªÉÄʸÀÆgÀÄ PÀ£ÁðlPÀ gÁdå ªÀÄÄPÀÛ «±Àé«zÁ央AiÀÄ, ªÉÄʸÀÆgÀÄ PÀ£ÁðlPÀ gÁdå ªÀÄÄPÀÛ «±Àé«zÁ央AiÀÄ, ªÉÄʸÀÆgÀÄ
Name of the Bank & Name of the Bank & Name of the Bank & Name of the Bank &
Place of Remittance ....................................................................... Place of Remittance ....................................................................... Place of Remittance ....................................................................... Place of Remittance .......................................................................

Name of the Course ....................................................................... Name of the Course ....................................................................... Name of the Course ....................................................................... Name of the Course .......................................................................

Class : I / II / III Year Class : I / II / III Year Class : I / II / III Year Class : I / II / III Year
NOTE: Please key in Roll No. before affording credit NOTE: Please key in Roll No. before affording credit NOTE: Please key in Roll No. before affording credit NOTE: Please key in Roll No. before affording credit
Subject: Roll No: Subject: Roll No: Subject: Roll No: Subject: Roll No:
ORIGINAL DUPLICATE TRIPLICATE QUADRUPLICATE
State Bank of Mysore ¸ÉÖÃmï ¨ÁåAPï D¥sï ªÉÄʸÀÆgÀÄ State Bank of Mysore ¸ÉÖÃmï ¨ÁåAPï D¥sï ªÉÄʸÀÆgÀÄ State Bank of Mysore ¸ÉÖÃmï ¨ÁåAPï D¥sï ªÉÄʸÀÆgÀÄ State Bank of Mysore ¸ÉÖÃmï ¨ÁåAPï D¥sï ªÉÄʸÀÆgÀÄ
(Code: 40166) PÉÆÃqï : 40166 (Code: 40166) PÉÆÃqï : 40166 (Code: 40166) PÉÆÃqï : 40166 (Code: 40166) PÉÆÃqï : 40166
Manasagangotri, Mysore-570 006 ªÀiÁ£À¸À UÀAUÉÆÃwæ, ªÉÄʸÀÆgÀÄ -570 006 Manasagangotri, Mysore-570 006 ªÀiÁ£À¸À UÀAUÉÆÃwæ, ªÉÄʸÀÆgÀÄ -570 006 Manasagangotri, Mysore-570 006 ªÀiÁ£À¸À UÀAUÉÆÃwæ, ªÉÄʸÀÆgÀÄ -570 006 Manasagangotri, Mysore-570 006 ªÀiÁ£À¸À UÀAUÉÆÃwæ, ªÉÄʸÀÆgÀÄ -570 006
State Bank of India ¸ÉÖÃmï ¨ÁåAPï D¥sï EArAiÀiÁ State Bank of India ¸ÉÖÃmï ¨ÁåAPï D¥sï EArAiÀiÁ State Bank of India ¸ÉÖÃmï ¨ÁåAPï D¥sï EArAiÀiÁ State Bank of India ¸ÉÖÃmï ¨ÁåAPï D¥sï EArAiÀiÁ
(Code: 3130) PÉÆÃqï : 3130 (Code: 3130) PÉÆÃqï : 3130 (Code: 3130) PÉÆÃqï : 3130 (Code: 3130) PÉÆÃqï : 3130
New Sayyaji Rao Road, Mysore-01 £ÀÆå ¸ÀAiÀiÁåfgÁªï gÀ¸ÉÛ, ªÉÄʸÀÆgÀÄ -01 New Sayyaji Rao Road, Mysore-01 £ÀÆå ¸ÀAiÀiÁåfgÁªï gÀ¸ÉÛ, ªÉÄʸÀÆgÀÄ -01 New Sayyaji Rao Road, Mysore-01 £ÀÆå ¸ÀAiÀiÁåfgÁªï gÀ¸ÉÛ, ªÉÄʸÀÆgÀÄ -01 New Sayyaji Rao Road, Mysore-01 £ÀÆå ¸ÀAiÀiÁåfgÁªï gÀ¸ÉÛ, ªÉÄʸÀÆgÀÄ -01

KSOU-500-EXAMINATION FUND KSOU-500-EXAMINATION FUND KSOU-500-EXAMINATION FUND KSOU-500-EXAMINATION FUND

PÀgÁªÀÄÄ«-500-¥ÀjÃPÁë ¤¢ü SÁvÉ PÀgÁªÀÄÄ«-500-¥ÀjÃPÁë ¤¢ü SÁvÉ PÀgÁªÀÄÄ«-500-¥ÀjÃPÁë ¤¢ü SÁvÉ PÀgÁªÀÄÄ«-500-¥ÀjÃPÁë ¤¢ü SÁvÉ
SBM - 54035420128 SBI- 31106997538 SBM - 54035420128 SBI- 31106997538 SBM - 54035420128 SBI- 31106997538 SBM - 54035420128 SBI- 31106997538
Name and Address of the Student Name and Address of the Student Name and Address of the Student Name and Address of the Student
«zÁåyðAiÀÄ ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ «¼Á¸À : «zÁåyðAiÀÄ ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ «¼Á¸À : «zÁåyðAiÀÄ ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ «¼Á¸À : «zÁåyðAiÀÄ ºÉ¸ÀgÀÄ ªÀÄvÀÄÛ «¼Á¸À :

Code No: Amount Rs. Code No: Amount Rs. Code No: Amount Rs. Code No: Amount Rs.
501: Examination Fee : 501: Examination Fee : 501: Examination Fee : 501: Examination Fee :
¥ÀjÃPÁë ±ÀÄ®Ì ¥ÀjÃPÁë ±ÀÄ®Ì ¥ÀjÃPÁë ±ÀÄ®Ì ¥ÀjÃPÁë ±ÀÄ®Ì
502: Revaluation / Retotaling Fee : 502: Revaluation / Retotaling Fee : 502: Revaluation / Retotaling Fee : 502: Revaluation / Retotaling Fee :
ªÀÄgÀĪÀiË®åªÀiÁ¥À£À / ªÀÄgÀÄJtÂPÉ ±ÀÄ®Ì ªÀÄgÀĪÀiË®åªÀiÁ¥À£À / ªÀÄgÀÄJtÂPÉ ±ÀÄ®Ì ªÀÄgÀĪÀiË®åªÀiÁ¥À£À / ªÀÄgÀÄJtÂPÉ ±ÀÄ®Ì ªÀÄgÀĪÀiË®åªÀiÁ¥À£À / ªÀÄgÀÄJtÂPÉ ±ÀÄ®Ì
503: Rank / Provisional Certificate Fee : 503: Rank / Provisional Certificate Fee : 503: Rank / Provisional Certificate Fee : 503: Rank / Provisional Certificate Fee :
gÁåAPï/¥Á櫱À£À¯ï ¥ÀæªÀiÁt¥ÀvÀæ ±ÀÄ®Ì gÁåAPï/¥Á櫱À£À¯ï ¥ÀæªÀiÁt¥ÀvÀæ ±ÀÄ®Ì gÁåAPï/¥Á櫱À£À¯ï ¥ÀæªÀiÁt¥ÀvÀæ ±ÀÄ®Ì gÁåAPï/¥Á櫱À£À¯ï ¥ÀæªÀiÁt¥ÀvÀæ ±ÀÄ®Ì
504: Convocation Fee : 504: Convocation Fee : 504: Convocation Fee : 504: Convocation Fee :
WÀnPÉÆÃvÀìªÀ ±ÀÄ®Ì WÀnPÉÆÃvÀìªÀ ±ÀÄ®Ì WÀnPÉÆÃvÀìªÀ ±ÀÄ®Ì WÀnPÉÆÃvÀìªÀ ±ÀÄ®Ì
505: Sale of Old Answer Books : 505: Sale of Old Answer Books : 505: Sale of Old Answer Books : 505: Sale of Old Answer Books :
ºÀ¼Éà GvÀÛgÀ ¥ÀĸÀÛPÀUÀ¼À ªÀiÁgÁl ºÀ¼Éà GvÀÛgÀ ¥ÀĸÀÛPÀUÀ¼À ªÀiÁgÁl ºÀ¼Éà GvÀÛgÀ ¥ÀĸÀÛPÀUÀ¼À ªÀiÁgÁl ºÀ¼Éà GvÀÛgÀ ¥ÀĸÀÛPÀUÀ¼À ªÀiÁgÁl
506: Miscellaneous Fee (Specify) : 506: Miscellaneous Fee (Specify) : 506: Miscellaneous Fee (Specify) : 506: Miscellaneous Fee (Specify) :
EvÀgÉ dªÉÄUÀ¼ÀÄ (¸ÀàµÀÖ¥Àr¹) EvÀgÉ dªÉÄUÀ¼ÀÄ (¸ÀàµÀÖ¥Àr¹) EvÀgÉ dªÉÄUÀ¼ÀÄ (¸ÀàµÀÖ¥Àr¹) EvÀgÉ dªÉÄUÀ¼ÀÄ (¸ÀàµÀÖ¥Àr¹)
......................................................... ......................................................... ......................................................... .........................................................
Total / MlÄÖ gÀÆ. Total / MlÄÖ gÀÆ. Total / MlÄÖ gÀÆ. Total / MlÄÖ gÀÆ.
Amount (in words) Rupees .................................................................................................... Amount (in words) Rupees .................................................................................................... Amount (in words) Rupees .................................................................................................... Amount (in words) Rupees ....................................................................................................

ºÀt gÀÆ. .................................................................................................................... ºÀt gÀÆ. .................................................................................................................... ºÀt gÀÆ. .................................................................................................................... ºÀt gÀÆ. ....................................................................................................................

Note: Fees once paid will not be Refunded. Note: Fees once paid will not be Refunded. Note: Fees once paid will not be Refunded. Note: Fees once paid will not be Refunded.
«.¸ÀÆ: MªÉÄä dªÉÄAiÀiÁzÀ ±ÀÄ®ÌUÀ¼À£ÀÄß ªÀÄgÀÄ¥ÁªÀw¸ÀĪÀÅ¢®è. «.¸ÀÆ: MªÉÄä dªÉÄAiÀiÁzÀ ±ÀÄ®ÌUÀ¼À£ÀÄß ªÀÄgÀÄ¥ÁªÀw¸ÀĪÀÅ¢®è. «.¸ÀÆ: MªÉÄä dªÉÄAiÀiÁzÀ ±ÀÄ®ÌUÀ¼À£ÀÄß ªÀÄgÀÄ¥ÁªÀw¸ÀĪÀÅ¢®è. «.¸ÀÆ: MªÉÄä dªÉÄAiÀiÁzÀ ±ÀÄ®ÌUÀ¼À£ÀÄß ªÀÄgÀÄ¥ÁªÀw¸ÀĪÀÅ¢®è.

Date: Signature of the Remitter Date: Signature of the Remitter Date: Signature of the Remitter Date: Signature of the Remitter
¢£ÁAPÀ: ºÀt ¥ÁªÀw ªÀiÁqÀĪÀªÀgÀ ¸À» ¢£ÁAPÀ: ºÀt ¥ÁªÀw ªÀiÁqÀĪÀªÀgÀ ¸À» ¢£ÁAPÀ: ºÀt ¥ÁªÀw ªÀiÁqÀĪÀªÀgÀ ¸À» ¢£ÁAPÀ: ºÀt ¥ÁªÀw ªÀiÁqÀĪÀªÀgÀ ¸À»

For the use of the Bank For the use of the Bank For the use of the Bank For the use of the Bank
¨ÁåAQ£À G¥ÀAiÉÆÃUÀPÁÌV ªÀiÁvÀæ ¨ÁåAQ£À G¥ÀAiÉÆÃUÀPÁÌV ªÀiÁvÀæ ¨ÁåAQ£À G¥ÀAiÉÆÃUÀPÁÌV ªÀiÁvÀæ ¨ÁåAQ£À G¥ÀAiÉÆÃUÀPÁÌV ªÀiÁvÀæ
The Amount of Rupees (in words)........................................................................................ The Amount of Rupees (in words)........................................................................................ The Amount of Rupees (in words)........................................................................................ The Amount of Rupees (in words)........................................................................................
ªÉÄÃ¯É £ÀªÀÄÆ¢¹zÀ ºÀt gÀÆ. ....................................................................................................CPÀëgÀUÀ¼À°è ªÉÄÃ¯É £ÀªÀÄÆ¢¹zÀ ºÀt gÀÆ. ....................................................................................................CPÀëgÀUÀ¼À°è ªÉÄÃ¯É £ÀªÀÄÆ¢¹zÀ ºÀt gÀÆ. ....................................................................................................CPÀëgÀUÀ¼À°è ªÉÄÃ¯É £ÀªÀÄÆ¢¹zÀ ºÀt gÀÆ. ....................................................................................................CPÀëgÀUÀ¼À°è
............................................................................................................................................................................ ............................................................................................................................................................................ ............................................................................................................................................................................ ............................................................................................................................................................................
has been received / ¸ÀAzÁAiÀĪÁVzÉ. has been received / ¸ÀAzÁAiÀĪÁVzÉ. has been received / ¸ÀAzÁAiÀĪÁVzÉ. has been received / ¸ÀAzÁAiÀĪÁVzÉ.
Challan No. Challan No. Challan No. Challan No.
Date & Signature of the Officer Date & Signature of the Officer Date & Signature of the Officer Date & Signature of the Officer
Bank Seal receiving the money Bank Seal receiving the money Bank Seal receiving the money Bank Seal receiving the money
¢£ÁAPÀ ªÀÄvÀÄÛ ¨ÁåAQ£À ªÀÄÄzÉæ ºÀt ¹éÃPÀj¸ÀĪÀ C¢üPÁjAiÀÄ ¸À» ¢£ÁAPÀ ªÀÄvÀÄÛ ¨ÁåAQ£À ªÀÄÄzÉæ ºÀt ¹éÃPÀj¸ÀĪÀ C¢üPÁjAiÀÄ ¸À» ¢£ÁAPÀ ªÀÄvÀÄÛ ¨ÁåAQ£À ªÀÄÄzÉæ ºÀt ¹éÃPÀj¸ÀĪÀ C¢üPÁjAiÀÄ ¸À» ¢£ÁAPÀ ªÀÄvÀÄÛ ¨ÁåAQ£À ªÀÄÄzÉæ ºÀt ¹éÃPÀj¸ÀĪÀ C¢üPÁjAiÀÄ ¸À»
To be sent to State Bank Of Mysore, Manasagangotri Branch, Mysore - 570 006 and State Bank Of India, (To be issued to the Remitter) (Student Copy)
To be retained with the receiving Bank
New Sayyaji Rao Road, Mysore - 1, by the receiving Bank along with M.T. and Statement (Student will send this copy to the University) (No separate receipt will be issued)