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CHALLAN FORM (CASH VOUCHER) CHALLAN FORM (CASH VOUCHER)

BRANCH COPY
ICICI BANK LTD
Application Fee Details
Recruitment of Office Assistant
In MEWAR AANCHALIK GRAMIN BANK

Account No. :693805111898 (NBSSS) UDAIPUR, Rajastahan)
Branch Name NAV BHARAT SENIOR SECONDARY SCHOOL
ASHOK NAGAR,UDAIPUR
Candidates Name : Mr./Mrs./Kum.
Category* : SC/ST/PC Fees / postage` 20/-
OBC/GEN Application Fee& Postage ` 100/-

Date of Birth :

Banks Branch Name:

Branch Code No.#:
(Sol I.D.)
Transaction I.D.No. #:
Deposit Date :

Post Applied for (PleaseTick in appropriateBox)
OfficeAssistant
Specialist Officer Scale-II
Application Fee/Postage `
(Rupees in words.only)

Signature of Depositor Authorized Signatory
Address :. Stamp

Phone/Mob.No
*Tick whichever is applicable.
#Fee receiving branch is advised to write the Transaction I.D. No.
and Branch Code no.(Sol I.D.) above invariably.
CANDIDATES COPY
ICICI BANK LTD
Application Fee Details
Recruitment of Office Assistant
In MEWAR AANCHALIK GRAMIN BANK

Account No. :693805111898 (NBSSS) UDAIPUR, Rajastahan)
Branch Name NAV BHARAT SENIOR SECONDARY SCHOOL
ASHOK NAGAR,UDAIPUR
Candidates Name : Mr./Mrs./Kum.
Category* : SC/ST/PC Fees / postage` 20/-
OBC/GEN Application Fee& Postage ` 100/-

Date of Birth :

Banks Branch Name:

Branch Code No.#:
(Sol I.D.)
Transaction I.D.No. #:
Deposit Date :

Post Applied for (PleaseTick in appropriateBox)
OfficeAssistant
Specialist Officer Scale-II
Application Fee/Postage `
(Rupees in words.only)

Signature of Depositor Authorized Signatory
Address :. Stamp

Phone/Mob.No
*Tick whichever is applicable.
#Fee receiving branch is advised to write the Transaction I.D. No. and
Branch Code no.(Sol I.D.) 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

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