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INDIAN BANK

Head Office: 66, Rajaji Salai, Chennai - 600001 Challan No.03 Challan No.03 CASH VOUCHER Branch Copy

INDIAN BANK
Head Office: 66, Rajaji Salai, Chennai - 600001 CASH VOUCHER Candidates Copy Affix Passport Size Photograph

Recruitment of Office Assistant (Multipurpose) in Pallavan Grama Bank Account No Candidates Name Category* Date of Birth :

952188625

Recruitment of Office Assistant (Multipurpose) in Pallavan Grama Bank Account No :

952188625

: Mr./Mrs./Kum.___________________________ Candidates Name : SC/ST/PC/EXS Only Postage Rs.50/OBC / General- Application Fee & Postage Rs.300/- Category* : : Mr./Mrs./Kum.____________________________ : SC/ST/PC/EXS Only Postage Rs.50/OBC / General- Application Fee & Postage Rs.300/:

Indian Bank Branch Name: Branch Code No # : :

Date of Birth I ndian Bank Branch Name: Branch Code No #

Deposit Journal No (to be filled by branch) Date of Deposit :

Deposit Journal No (to be filled by branch) : Date of Deposit :

Rs. (Rupees only)

Rs. (Rupees only) Signature of Depositor Address: Authorized Signatory Cash Seal

Signature of Depositor Address:

Authorized Signatory Cash Seal

Mobile No/Phone No: * Tick whichever is applicable # Fee receiving branch is advised to write the Deposit Journal No. and branch code No. above invariably and affix cash received stamp

Mobile No/Phone No: * Tick whichever is applicable # Fee receiving branch is advised to write the Deposit Journal No. and branch code No. above invariably and affix cash received stamp.
(This part of the challan will be required to be submitted by the candidate at the time of written test along with a photograph, otherwise candidate will not be allowed to appear at the examination.

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