APPLICATION

APPLICATION FEE / POSTAL CHARGES PAYMENT CHALLAN APPLICATION FEE / POSTAL CHARGES PAYMENT CHALLAN
CHALLAN
BRANCH COPY CANDIDATE COPY

Application Fee / Postal Charges Details Application Fee / Postal Charges Details
Recruitment Project – 2 / 2010 – Investment Officers on Contract Recruitment Project – 2 / 2010 – Investment Officers on Contract
TO BE FILLED-IN BY THE CANDIDATE TO BE FILLED-IN BY THE CANDIDATE
Mr. / Mrs. / Kum Mr. / Mrs. / Kum
Applicant’s Name : Applicant’s Name :

Date of Birth [DD-MM-YYYY] : Date of Birth [DD-MM-YYYY] :

Contact Phone No : Contact Phone No :
Rs.50/- Rs.300/- Rs.50/- Rs.300/-
Category* Category*
: SC ST PWD All Others : SC ST PWD All Others
[Tick appropriate box] [Tick appropriate box]

Post Applied for : Investment Officers on Contract Post Applied for : Investment Officers on Contract
Rs. _______/- Rs. _______/-
Amount deposited : Amount deposited :
[Rupees _________________________only [Rupees _________________________only
Depositing Branch Name & City : Depositing Branch Name & City :
TO BE FILLED-IN BY THE BRANCH OFFICIALS TO BE FILLED-IN BY THE BRANCH OFFICIALS
D P Code of Branch where Fees / D P Code of Branch where Fees /
: :
Postage Paid Postage Paid
Canara Bank, South End Road, Bangalore Canara Bank, South End Road, Bangalore
Payee Branch Name : Payee Branch Name :
[DP Code-1173] [DP Code-1173]
Name of the Account : Canara Bank Recruitment Project – 2/2010
2/2010 Name of the Account : Canara Bank Recruitment Project – 2/2010
2/2010
Account Number : 1173201002148 Account Number : 1173201002148
Transaction Sequence No. [for CBS Transaction Sequence No. [for CBS
: :
Br.] / Batch No. [for Non-CBS Br.] Br.] / Batch No. [for Non-CBS Br.]
Date of Deposit [should be from : Date of Deposit [should be from :
2 2 .06.2010 to 10.07.2010]
10.07.2010 ] 2 2 .06.2010 to 10.07.2010]
10.07.2010 ]

Authorised Signatory Authorised Signatory

Signature of Depositor Signature of Depositor
SP No:___________ & SP No:___________ &
Branch Seal:__________ Branch Seal:__________
* Tick whichever is applicable. * Tick whichever is applicable.
Note: Fee receiving branch is advised to write Transaction Sequence No.[for CBS Br.] / Note: Fee receiving branch is advised to write Transaction Sequence No.[for CBS Br.] /
Batch No. [for Non-CBS Br.] & Branch DP Code No. above invariably Batch No. [for Non-CBS Br.] & Branch DP Code No. above invariably