(last date to remit the money 08/09/2012) (last date to remit the money 08/09/2012) (last date to remit

to remit the money 08/09/2012)

PAY-IN-SLIP BANK COPY

PAY-IN-SLIP STUDENT COPY

PAY-IN-SLIP
TO BE ENCLOSED WITH THE
APPLICATION

Application No.: Stream: Application No.: Stream: Application No.: Stream:
State Bank of India
Payable at all Branches of SBI in India

Branch Name and Address:

Paid into the credit of Kishore Vaigyanik Protsahan
Yojana (KVPY), IISc., Bangalore 560 012

SB A/C No. 10270577392
State Bank of India
Payable at all Branches of SBI in India

Branch Name and Address:

Paid into the credit of Kishore Vaigyanik Protsahan
Yojana (KVPY), IISc., Bangalore 560 012

SB A/C No. 10270577392
State Bank of India
Payable at all Branches of SBI in India

Branch Name and Address:

Paid into the credit of Kishore Vaigyanik Protsahan
Yojana (KVPY), IISc., Bangalore 560 012

SB A/C No. 10270577392
Application Processing fee

(SC/ST, Girl, Physically and Visually challenged
students are exempted from payment of processing fee)
Application Processing fee

(SC/ST, Girl, Physically and Visually challenged
students are exempted from payment of processing fee)
Application Processing fee

(SC/ST, Girl, Physically and Visually challenged
students are exempted from payment of processing fee)
(a) Processing Fee Rs.
(b) Bank charges if any
Total
200.00 (a) Processing Fee Rs.
(b) Bank charges if any
Total
200.00 (a) Processing Fee Rs.
(b) Bank charges if any
Total
200.00


Rupees.............................. Rupees.............................. Rupees

Name and
address of
the
student

..
..
..
..
..
..Pin

Name and
address of
the
student

.
.
.
.
.
.Pin

Name and
address of
the
student

..
..
..
..
..
..Pin
Signature of the
Depositor
Signature of the
Depositor
Signature of the
Depositor


Signature of the
Cashier
Signature of the
Cashier
Signature of the
Cashier

Bank Stamp with
date
Bank Stamp with
date
Bank Stamp with
date


KVPY 2012
INDIAN INSTITUTE OF SCIENCE
BANGALORE 560 012
KVPY 2012
INDIAN INSTITUTE OF SCIENCE
BANGALORE 560 012
KVPY 2012
INDIAN INSTITUTE OF SCIENCE
BANGALORE 560 012