You are on page 1of 1

FEE PAYMENT CHALLAN (CASH VOUCHER) HARYANA GRAMIN BANK Application Fee Details Recruitment of Officer Junior Management

(Scale-I) & Office Assistant (Multipurpose) in Haryana Gramin Bank Account No : 80562100003427 BRANCH COPY
Institute ID : HGBRP (2) 2013

FEE PAYMENT CHALLAN (CASH VOUCHER) HARYANA GRAMIN BANK Application Fee Details Recruitment of Officer Junior Management (Scale-I) & Office Assistant (Multipurpose) in Haryana Gramin Bank CANDIDATES COPY
Photograph Affix Pass port

size

Candidates Name : Mr./Ms. .. Category (Tick whichever applicable) Date of Birth


SC/ST/PWD OBC/GEN/EXS Rs.20/- (Only Postage) Rs.100/- (Application fee & Postage)

Account No
Institute ID

: 80562100003427
: HGBRP (2) 2013

Candidates Name : Mr./Ms.. is Category (Tick whichever applicable) Date of Birth


SC/ST/PWD OBC/GEN/EXS Rs.20/- (Only Postage) Rs.100/- (Application fee & Postage)

is

: :

HGB Branch Name : Branch Code No# Transaction ID # Deposit Date Applied for : : : : Officer Scale-I / Office Assistant (Multipurpose)

HGB Branch Name: Branch Code No# : Transaction ID # Deposit Date Applied for : : : Officer Scale-I / Office Assistant (Multipurpose)

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

Amount Rs. ....................... (Rupees..........................................................................................only)

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

Signature of Depositor Authorized Signatory Address:.................... Stamp ................................... Phone/Mob. No. . . . . . . . . . . . . . # Fee receiving branch is advised to write the Transaction ID and Branch (Make entry in Tran. Particular Column of payee) No. above invariably. # Fee receiving branch is advised to write the Transaction ID and Code (This part of the challan will be required to be submitted by the candidate at the time of interview Branch Code No. above invariably. along with a photograph, otherwise the candidate will not be allowed to appear at the venue.)

Authorized Signatory Stamp