Depositor Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Date: 16-09-2015

CP28891204

Beneficiary:

GATE 2016 IISC Bangalore

Merchant Reference No:

10233631

Candidate Name:

KAUSTAV ROY CHOUDHURY

Enrolment ID:

B140A41

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch
Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect

Benificiary/Remittance Details
State Bank MOPS Reference No.

Branch Copy

Date: 16-09-2015

Benificiary/Remittance Details

Rs
Collection Amount
Comission
Total ( One Thousand And Five Hundred And Fifty Seven Rupees Only)

P
1500 00
57 00
1557 00

State Bank MOPS Reference No.

CP28891204

Beneficiary:

GATE 2016 IISC Bangalore

Merchant Reference No:

10233631

Candidate Name:

KAUSTAV ROY CHOUDHURY

Enrolment ID:

B140A41
Rs

Details of Cash

Rs

1500 00
57 00
1557 00

Cash

Total Rs

Amount

Cash Notes

Instructions for Depositor: This is not an e-receipt.

Rs

*1000

(To be Filled in by the Bank)

Journal No:

Collection Amount
Comission
Total ( One Thousand And Five Hundred And Fifty Seven Rupees Only)

*500
CP28891204

*100
*50
*20

Branch Name:

*10
Branch Code:

Deposit Date:
Coins
Branch Stamp

Total Rs

Authorised Signatory
Signature of the Depositor

Space for Bank use

Branch Stamp