CHALLAN FORM (CASH VOUCHER) 01 CAUTION : PNB BRANCHES TO MAKE ENTRY THROUGH FCMBR IN FINACLE BRANCH COPY PUNJAB

NATIONAL BANK - 01 Application Fee Details Recruitment of Officer Middle Management (Scale-III), Officer Middle Management (Scale-II) & Officer Junior Management (Scale-I) in Madhya Bihar Gramin Bank INSTITUE ID COLL CODE : MBGB : OFFCR INSTITUE ID COLL CODE

CHALLAN FORM (CASH VOUCHER) 01 CANDIDATES COPY PUNJAB NATIONAL BANK -01 Application Fee Details Recruitment of Officer Middle Management (Scale-III), Place for Officer Middle Management (Scale-II) & Candidates Officer Junior Management (Scale-I) Photograph in Madhya Bihar Gramin Bank : MBGB : OFFCR

Candidates Name : Mr./Mrs/Kum. Candidates Name : Mr./Mrs/Kum. Category* Category*

SC/ST/PWD/EXS Only Postage Rs 50/- + Rs. 25/-** OBC/GEN - Application Fee & Postage Rs. 450/- + Rs.25/-**

SC/ST/PWD/EXS Only Postage Rs 50/- + Rs. 25/-** OBC/GEN - Application Fee & Postage Rs. 450/- + Rs. 25/-**

Date of Birth Date of Birth : _____/_____/_______ (DD) (MM) (YYYY) PNB Branch Name : Branch Code No# Transaction I.D. # Deposit Date :

: _____/_____/_______ (DD) (MM) (YYYY) PNB Branch Name : Branch Code No# Transaction I.D. # : : : _____/_____/_______ (DD) (MM) (YYYY)

: Deposit Date : _____/_____/_______ (DD) (MM) (YYYY)

Application Fee/Postage Rs........................ (Rupees..........................................................................................only)

Application Fee/Postage Rs........................ (Rupees..........................................................................................only) Signature of Depositor Authorized Signatory Address:.................... Stamp ................................... Phone/Mobi. No. * Tick whichever is applicable. **Intersol transaction charges # Fee receiving branch is advised to write the Transaction I.D. and branch code no. above invariably. (This part of the challan will be required to be submitted by the candidate at the time of written test along with a photograph, otherwise the candidate will not be allowed to appear at the examination.)

Signature of Depositor Address:.................... ................................... Phone/Mobi. No.

Authorized Signatory Stamp

* Tick whichever is applicable. **Intersol transaction charges # Fee receiving branch is advised to write the Transaction I.D. and branch code no. above invariably.