STATE BANK OF MYSORE (Bank Copy) STATE BANK OF MYSORE (K-SET Copy) STATE BANK OF MYSORE (Candidate’s Copy)

(To be attached by
Candidate in Original with
Application From)
Application fee detail for MAY, 2011 Application fee detail for MAY, 2011 Application fee detail for MAY, 2011
K-SET Examination, UNIVERSITY OF MYSORE K-SET Examination, UNIVERSITY OF MYSORE K-SET Examination, UNIVERSITY OF MYSORE
(To be filled by the candidate) (To be filled by the candidate) (To be filled by the candidate)
Account No. : 64070864723 Account No. : 64070864723 Account No. : 64070864723
Candidate’s Name: ________________________ Candidate’s Name: ________________________ Candidate’s Name: ________________________
Father’s Name: ___________________________ Father’s Name: ___________________________ Father’s Name: ___________________________
Address: ________________________________ Address: ________________________________ Address: ________________________________
________________________________________ ________________________________________ ________________________________________
____________________Pin _________________ ____________________Pin _________________ ____________________Pin _________________
Category Fees Required: Category Fees Required: Category Fees Required:
GEN IIA IIB IIIA IIIB GEN IIA IIB IIIA IIIB GEN IIA IIB IIIA IIIB
(Please tick (Please tick (Please tick
800 800 800 800 800 Mark for Proper 800 800 800 800 800 Mark for Proper 800 800 800 800 800 Mark for Proper
Category) Cat-1 SC ST PH VH Category) Cat-1 SC ST PH VH Category)
Cat-1 SC ST PH VH
400 400 400 400 400 400 400 400 400 400 400 400 400 400 400

+ + +
Bank Charges (Commission) : Rs 20/- Bank Charges (Commission) : Rs 20/- Bank Charges (Commission) : Rs 20/-
K-SET Centre Code Subject Code K-SET Centre Code Subject Code K-SET Centre Code Subject Code

Signature of the Candidate Signature of the Candidate Signature of the Candidate

______________________________________________________ ______________________________________________________ ______________________________________________________

(To be filled by Bank) (To be filled by Bank) (To be filled by Bank)

SBM Branch Name: _________________________ SBM Branch Name: _________________________ SBM Branch Name: _________________________

Branch Code Journal No. Branch Code Journal No. Branch Code Journal No.
aaaaaaaaaaa0 aaaaaaaaaaa0 aaaaaaaaaaa0

Deposit Date: 22&&&&&&12 Deposit Date: Deposit Date:

D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y

Branch Stamp Authorized Signatory Branch Stamp Authorized Signatory Branch Stamp Authorized Signatory