CHALLAN FOR IDBI BANK LTD.

Collecting Branch's copy Executive (on contract) - Post advertised in July 2012 Unique No. (To be entered by Bank) Name of Banker : IDBI BANK LTD. Amount may be deposited in any branch of IDBI BANK LTD A/C No. Branch Code : 126, Cuffe 126102000000408 Parade, Mumbai Date of Receipt : Candidate's Name : * Candidate's copy for submission to HRD - IDBI Bank Ltd. Executive (on contract) - Post advertised in July 2012 Unique No. (To be entered by Bank) Name of Banker : IDBI BANK LTD. Amount may be deposited in any branch of IDBI BANK LTD A/C No. Branch Code : 126, Cuffe Parade, 126102000000408 Mumbai Date of Receipt : Candidate's Name : * Candidate's copy Executive (on contract) - Post advertised in July 2012 Unique No. (To be entered by Bank) Name of Banker : IDBI BANK LTD. Amount may be deposited in any branch of IDBI BANK LTD A/C No. Branch Code : 126, Cuffe Parade, Mumbai 126102000000408 Date of Receipt : Candidate's Name : *

Address :

Address :

Address :

Contact No. Category: Amount in figure : # (in words :) Rupees :

General/OBC/SC/ST/PWD Rs.

Contact No. Category: Amount in figure : # (in words :) Rupees :

General/OBC/SC/ST/PWD Rs.

Contact No. Category: Amount in figure : # (in words :) Rupees :

General/OBC/SC/ST/PWD Rs.

# Application Fee for General/OBC category : Rs.400/& SC/ST/PWD category : Rs.75/-

# Application Fee for General/OBC category : Rs.400/- & SC/ST/PWD category : Rs.75/-

# Application Fee for General/OBC category : Rs.400/- & SC/ST/PWD category : Rs.75/-

Signature of Banks Official

Signature of Candidate/Depositor

Signature of Banks Official

Signature of Candidate/Depositor

Signature of Banks Official

Signature of Candidate/Depositor

* (Name should be indicated in the following manner and it should be entered in the same manner in the On-Line application) (Surname) (First Name) (Middle name )