NATIONAL BOARD OF EXAMINATIONS

NATIONAL BOARD OF EXAMINATIONS

NATIONAL BOARD OF EXAMINATIONS

NBE'S Copy

Depositors/Candidate's Copy

Bank's Copy

DNB FINAL EXAM FEE

Indian Bank A/c No. 6008280724

DNB FINAL EXAM FEE

Indian Bank A/c No. 6008280724

DNB FINAL EXAM FEE

Indian Bank A/c No. 6008280724

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.

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: _ _ _ _ _
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: _ _ _ _ _
1. Name (in Capital letters):

_____________________________

Date: _ _ _ _ _
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):

3. Type of Fee

_____________________________
____
_____________________________
__

Amount in `.

(if applicable):

3. Type of Fee

Examinations Fee _______

DNB FINAL

Only Practicle Fee ______

Amount in `.

(if applicable):

3. Type of Fee

Examinations Fee _______

DNB FINAL

Registration Fee ________

SUBJECT

_____________________________
____
_____________________________
__

Only Practicle Fee ______

Amount in `.

Examinations Fee _______

DNB FINAL

Registration Fee ________

SUBJECT

_____________________________
____
_____________________________
__

Only Practicle Fee ______

Registration Fee ________

SUBJECT

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 Deposited ___________________________

___________________________________________________________

8. Bank Branch in which fee Deposited ___________________________

___________________________________________________________

8. Bank Branch in which fee Deposited ___________________________

___________________________________________________________

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)