3/9/2015

tnusrbexams.net/challan_indianbank.php?regno=605549
PAY IN SLIP (Bank Copy)

PAY IN SLIP (TNUSRB Copy)

PAY IN SLIP (Candidate Copy)

APPLICATION FEE PAYABLE AT ALL

BRANCHES OF INDIAN BANK
Paid in to the credit of T N U S R B - 2015
CASH A/C no 6304977024, Ethiraj Salai,
Chennai,
BRANCH CODE : 495

APPLICATION FEE PAYABLE AT ALL

BRANCHES OF INDIAN BANK
Paid in to the credit of T N U S R B - 2015
CASH A/C no 6304977024, Ethiraj Salai,
Chennai,
BRANCH CODE : 495

APPLICATION FEE PAYABLE AT ALL

BRANCHES OF INDIAN BANK
Paid in to the credit of T N U S R B - 2015
CASH A/C no 6304977024, Ethiraj Salai,
Chennai,
BRANCH CODE : 495

MUP Reference No : MU00481201969

MUP Reference No : MU00481201969

MUP Reference No : MU00481201969

Name of the Candidate: S CHANDRAMOULI

Name of the Candidate: S CHANDRAMOULI

Name of the Candidate: S CHANDRAMOULI

Application No : 605549

Application No : 605549

Application No : 605549

Phone no: 9444522231

Phone no: 9444522231

Phone no: 9444522231

Date of Birth: 28-05-1992

Date of Birth: 28-05-1992

Date of Birth: 28-05-1992

Registration Fee : Rs. 230.00 /Service Charges : Rs. 12.00 /Total

: Rs. 242.00 /-

Registration Fee : Rs. 230.00 /Service Charges : Rs. 12.00 /Total

: Rs. 242.00 /-

Amount: 242.00
Amount in words :(Rupees ______________
________________________________only)
Name of the receiving branch____________
__________________________________

Amount: 242.00
Amount in words :(Rupees ______________
________________________________only)
Name of the receiving branch____________
__________________________________

Signature of the Candidate

Signature of the Candidate

To be filled by the Bank:

MUP Ref. No:_____________________
Branch Name:_____________________
Journal No:_____________________

To be filled by the Bank:

MUP Ref. No:_____________________
Branch Name:_____________________
Journal No:_____________________

Signature of the Authorized

Official w ith branch seal

Date

Registration Fee : Rs. 230.00 /Service Charges : Rs. 12.00 /Total

: Rs. 242.00 /-

Amount: 242.00
Amount in words :(Rupees ______________
________________________________only)
Name of the receiving branch____________
__________________________________

Signature of the Candidate

To be filled by the Bank:
MUP Ref. No:_____________________
Branch Name:_____________________
Journal No:_____________________

Signature of the Authorized

Official w ith branch seal

Date

http://tnusrbexams.net/challan_indianbank.php?regno=605549

Signature of the Authorized

Official w ith branch seal

Date

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