NATIONAL BOARD OF EXAMINATIONS

NATIONAL BOARD OF EXAMINATIONS

NATIONAL BOARD OF EXAMINATIONS

Bank's Copy

NBEs Copy

Depositors/Candidates Copy

Online Fees Account

Indian Bank A/c No. 830641451

Online Fees Account

Indian Bank A/c No. 830641451

Online Fees Account

Indian Bank A/c No. 830641451

NBES copy to be attached with the application form / Banks copy to be

retained by the Bank / Candidates copy to be retained by the candidate.
Date: _ _ _ _ _

Challan No.
1. Name (in Capital letters):

____________________________

NBES copy to be attached with the application form / Banks copy to be

retained by the Bank / Candidates copy to be retained by the candidate.
Date: _ _ _ _ _

Challan No.
1. Name (in Capital letters):

____________________________

NBES copy to be attached with the application form / Banks copy to be

retained by the Bank / Candidates copy to be retained by the candidate.
Date: _ _ _ _ _

Challan No.
1. Name (in Capital letters):

____________________________

_____________________________________________________________

______________________________________________________________

______________________________________________________________

2. Sl. No. of Application Form

2. Sl. No. of Application Form

2. Sl. No. of Application Form

____________________________
____________________________

(if applicable):

____________________________
____________________________

(if applicable):

3. Type of Fee / Amount

3. Type of Fee / Amount

3. Type of Fee / Amount

Code No.

Code No.

Code No.

01) CME WORKSHOP

___________

01) CME WORKSHOP

10) sale of Accreditation
Application Form Fee

02) THESIS FEE

___________

03) REGISTRATION FEE

___________

04) ENROLMENT FEE

___________

05) IN-ABSENTIA FEE

___________

12) CET Centralized

Counselling Fee

06) Teleconferencing Fee

___________

13) Post Diploma CET

Counselling

_________

07) Teleconferencing DVD

___________

14) Others Fee

_________

08) Accreditation Fee

___________

09) Degree Verification Fee

___________

_________

11) Duplicate Certificate Fee

Result/Degree
_________
_________

___________
10) sale of Accreditation
Application Form Fee

____________________________
____________________________

(if applicable):

01) CME WORKSHOP

___________

02) THESIS FEE

___________

03) REGISTRATION FEE

___________

10) sale of Accreditation

Application Form Fee

02) THESIS FEE

___________

03) REGISTRATION FEE

___________

04) ENROLMENT FEE

___________

04) ENROLMENT FEE

___________

05) IN-ABSENTIA FEE

___________

12) CET Centralized

Counselling Fee

_________

05) IN-ABSENTIA FEE

___________

12) CET Centralized

Counselling Fee

_________

06) Teleconferencing Fee

___________

13) Post Diploma CET

Counselling

_________

06) Teleconferencing Fee

___________

13) Post Diploma CET

Counselling

_________

07) Teleconferencing DVD

___________

14) Others Fee

_________

07) Teleconferencing DVD

___________

14) Others Fee

_________

08) Accreditation Fee

___________

08) Accreditation Fee

___________

09) Degree Verification Fee

___________

09) Degree Verification Fee

___________

_________

11) Duplicate Certificate Fee

Result/Degree
_________

_________

11) Duplicate Certificate Fee

Result/Degree
_________

4. Bank Charges :-__________________________________

4. Bank Charges :-__________________________________

4. Bank Charges :-__________________________________

5. Amount (in Figure) :- _________________________________________

5. Amount (in Figure) :- _________________________________________

5. Amount (in Figure) :- _________________________________________

6. Amount (in words) ___________________________________________

6. Amount (in words) ___________________________________________

6. Amount (in words) ___________________________________________

_____________________________________________________________

______________________________________________________________

______________________________________________________________

7. Denomination of notes:

7. Denomination of notes:

7. Denomination of notes:

8. Bank Branch in which fee _____________________________________

____________________________________________________________

8. Bank Branch in which fee _____________________________________

____________________________________________________________

8. Bank Branch in which fee _____________________________________

____________________________________________________________

9. Bank Transaction ID No.

9. Bank Transaction ID No.

9. Bank Transaction ID No.

_______________________

_______________________
(For Bank use only)

(For Bank use only)

_______________________
(For Bank use only)

Bank Seal & Signature of Authorized

Bank Officer receiving the amount

(Signature of the Candidate)

Bank Seal & Signature of Authorized

Bank Officer receiving the amount

(Signature of the Candidate)

Bank Seal & Signature of Authorized

Bank Officer receiving the amount

(Signature of the Candidate)