State Bank Collect

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

Branch Copy

Branch Teller: Use SCR 008765 Deposit >Fee Collection>State Bank Collect
Beneficiary/Remittance Details
State Bank MOPS Reference No. :

CP32246442

Mode of Payment

Cash

Cash Notes

Amount

Beneficiary

MAHARASHTRA GOVT (GRAS)

1000 x

GRN

MH004675926201516M

500 x

Full Name

Anand Chitra Mandir

100 x

Amount

1,588 One Thousand Five Hundred Eighty Eight R

50 x

upees Only

20 x

Cheque/DD No.

10 x

Cheque/DD
Rs

Paise

Cheque/DD Date
Drawee Bank
Drawee Branch

Total Rs
Branch Stamp

Signature of Depositor

-------------Cut Here---------------------------------------------------------------------Cut Here---------------------------------------------------------------------Cut Here -------------CHALLAN

MTR Form Number-6
GRN

MH 00

4675926 201516M

BARCODE

Date

Department Revenue Department

Type of

04/11/2015-13:49:50 Form ID
Payer Details

Entertrainment Tax

TAX ID (If Any)

Payment

PAN No.(If Appliacable) ADGPA7403G

Office Name TAHSILDAR MIRAJ

Full Name

Anand Chitra Mandir

Location

SANGLI

Year

2015-2016 Specific From 22/10/2015 To 31/10/2015 Flat/Block no,

Account Head Details

Amount in Rs.

0045013101 Tax Collections

Maruti Road

Premises/Bldg

1588.00 Road/Street

Maruti Road

Area/Locality

Sangli

Town/City/District
PIN

REMARKS
(If Any)

Make payment at any branch of

STATE BANK OF INDIA
Before 11/11/2015
Total

1588.00

Amount In

One Thousand Five Hundred Eighty Eight Rupees Only

Words
Payment Details

STATE BANK OF INDIA

Cheque-DD Details

FOR USE IN RECEIVING BANK

Bank CIN

REF No.

Cheque/DD No.

Date

Name of Bank

Bank-Branch

Name of Branch

Scroll No. ,Date

Mobile No. : 9372144783

CP32246442

STATE BANK OF INDIA