PAYMENT CHALLAN Branch Copy

PAYMENT CHALLAN

Candidates Copy CANARA BANK

Application Fee Details
Affix photograph and bring while attending written test

CANARA BANK
Application Fee Details Recruitment of Officer JMG Scale-I in PRAGATHI GRAMIN BANK

Recruitment of Officer JMG Scale-I in PRAGATHI GRAMIN BANK

Account No.

Account No.

0506201003871 (0506) Canara Bank, Main Br, Bellary

(Payment of Application fee/postage from 12.01.2012 to 10.02.2012 only) Name of the Candidate : Mr./Mrs/Kum. (Capital Letters) Category* SC/ST/PC - Only Postage Rs 50/GEN/OBC Application Fee & Postage Rs 350/Date of Birth : Branch Name # : Branch DP Code No# : Transaction ID # : Deposit Date : Application Fee/Postage `. (Rupees.only)

0506201003871 (0506) Canara Bank, Main Br, Bellary

(Payment of Application fee/postage from 12.01.2012 to 10.02.2012 only) Name of the Candidate : Mr./Mrs/Kum. (Capital Letters) Category* SC/ST/PC - Only Postage Rs 50/GEN/OBC Application Fee & Postage Rs 350/Date of Birth : Branch Name # : Branch DP Code No # : Transaction ID # : Deposit Date : Application Fee/Postage . (Rupees.only) Signature of the Depositor Address: ___________________ ___________________________ ___________________________ Phone: Mob No: Authorized Signatory Seal

Signature of the Depositor Address: ___________________ ___________________________ ___________________________ Phone: Mob No:

Authorized Signatory Seal

* Tick whichever is applicable # Fee receiving branch is advised to write the Branch name, Branch DP Code No and Transaction ID above invariably.

* Tick whichever is applicable # Fee receiving branch is advised to write the Branch name, Branch DP Code No and Transaction ID above invariably (This part of the challan will be required to be submitted by the candidate at the time of written test along with a photograph affixed thereon , otherwise the candidate will not be allowed to appear at the examination)