Depositor Copy

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

Date: 09-05-2016

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

Beneficiary/Remittance Details

Date: 09-05-2016

State Bank Collect Reference No.

DU45075479

Beneficiary:

UP SUBORDINATE SERVICES SELECTION COMMISSION

Category:

ADVT. NO. 09(02)-2016

State Bank Collect Reference No.

DU45075479

Last Date of Payment:

25-05-2016 21:00

Beneficiary:

UP SUBORDINATE SERVICES SELECTION COMMISSION

Remitter

SULABH UPADHYAY

Category:

ADVT. NO. 09(02)-2016

Last Date of Payment:

25-05-2016 21:00

Remitter

SULABH UPADHYAY

Rs
Collection Amount
Comission
Total (Rupees One Hundred Five Only)

105.00
0.00
105.00

Details of Cash / Cheques

Rs

Beneficiary/Remittance Details

Rs
Collection Amount
Comission
Total (Rupees One Hundred Five Only)

105.00
0.00
105.00

Mode of Payment (Choose Either Cash / Cheque)

Cash

Total Rs
Instructions for Depositor: This is not an e-receipt. After payment , please visit www.onlinesbi.com > 'State Bank
Collect' and click on the hyperlink at the bottom of the page to generate the e-receipt.

PAN:

Please quote your PAN for Cash remittance >= Rs. 50,000

Amount

Cash Notes

Rs

*1000

(To be Filled in by the Bank)

*500
Journal No:

DU45075479

*100
*50
*20

Branch Name:
Branch Code:

*10
Deposit Date:
Coins
Branch Stamp

Total Rs
Cheque

Authorised Signatory

Cheque No:

Cheque Date:

Drawee Bank: State Bank of India (other bank cheques not accepted under PAP)
Branch:
Signature of the Depositor
Space for Bank use
Branch Stamp