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BankCopy

BRiCSCopy

ApplicantsCopy

STATEBANKOFINDIA
Challanforremittanceoffeefor
BRiCSTrainingProgram

PowerJyotiAccountNo.31481400942
A/CName:SimplifixAutomation&SolutionsPvt.Ltd.
AtSBIIITKanpurBranch(Code01161)

STATEBANKOFINDIA
Challanforremittanceoffeefor
BRiCSTrainingProgram

PowerJyotiA/CNo.31481400942
A/CName:SimplifixAutomation&SolutionsPvt.Ltd.
AtSBIIITKanpurBranch(Code01161)

STATEBANKOFINDIA
Challanforremittanceoffeefor
BRiCSTrainingProgram

PowerJyotiAccountNo.31481400942
A/CName:SimplifixAutomation&SolutionsPvt.Ltd.
AtSBIIITKanpurBranch(Code01161)

TobefilledbyApplicant

TobefilledbyApplicant

TobefilledbyApplicant

ApplicantsName:

ApplicantsName:.

ApplicantsName:

Institute/CollegeName:..

Institute/CollegeName:

Institute/CollegeName:

Branch&Year:

Branch&Year:.

Branch&Year:

City:..

City:

City:

DateofDeposit:...

DateofDeposit:

DateofDeposit:

FeeParticulars
BRiCSFee
BankCharges
Total

FeeParticulars
BRiCSFee

FeeParticulars
BRiCSFee

Amountinwords:

Rs.

25

TobefilledbyBranch

BankCharges
Total
Amountinwords:

Rs.

25

TobefilledbyBranch

BranchName
BranchCode
JournalNo

BranchName
BranchCode
JournalNo

Signatureofthe
Remitter

Signatureoftheauthorized
officialwithBranchSeal

Signatureofthe
Remitter

BankCharges
Total
Amountinwords:

Rs.

25

TobefilledbyBranch

BranchName
BranchCode
JournalNo

Signatureoftheauthorized
officialwithBranchSeal

Signatureofthe
Remitter

Signatureoftheauthorized
officialwithBranchSeal

BranchshouldcollectRs.25extrafromtheremitterasBankchargesandto
becreditedtotheBranchCommissionaccount.

BranchshouldwritethebranchName,BranchCode,JournalNo.&Dt.of
remittanceinvariablyandhandoverboththeBRiCSscopyandapplicants
copytotheremitterdulysigned

BranchshouldcollectRs. 25 extrafromtheremitterasBankchargesandto
becreditedtotheBranchCommissionaccount.

BranchshouldwritethebranchName,BranchCode,JournalNo.&Dt.of
remittanceinvariablyandhandoverboththeBRiCSscopyandapplicants
copytotheremitterdulysigned

BranchshouldcollectRs. 25 extrafromtheremitterasBankchargesandto
becreditedtotheBranchCommissionaccount.

BranchshouldwritethebranchName,BranchCode,JournalNo.&Dt.of
remittanceinvariablyandhandoverboththeBRiCSscopyandapplicants
copytotheremitterdulysigned

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