Depositor Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Date: 06-01-2017

Branch Copy
Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch
Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect

Beneficiary/Remittance Details

Date: 06-01-2017

State Bank Collect Reference No.

DU60248497

Beneficiary:

ONLINE BHM ACCOUNT, NIT SILCHAR

Category:

BHM Fees (BTech)

State Bank Collect Reference No.

DU60248497

Last Date of Payment:

28-02-2017 23:45

Beneficiary:

ONLINE BHM ACCOUNT, NIT SILCHAR

Remitter

Manprit Singh

Category:

BHM Fees (BTech)

Last Date of Payment:

28-02-2017 23:45

Remitter

Manprit Singh

Beneficiary/Remittance Details

Rs
Collection Amount
Comission
Total (Rupees Twelve Thousand Fifty Eight Only)
Details of Cash / Cheques

12,000.00
58.00
12,058.00
Rs

Rs
Collection Amount
Comission
Total (Rupees Twelve Thousand Fifty Eight Only)

12,000.00
58.00
12,058.00

Mode of Payment (Choose Either Cash / Cheque)

Cash

Total Rs
Instructions for Depositor: This is not an e-receipt. After payment , please visit www.onlinesbi.com > 'State Bank
Collect' and click on the hyperlink at the bottom of the page to generate the e-receipt.

PAN:

Please quote your PAN for Cash remittance >= Rs. 50,000

Amount

Cash Notes

Rs

*2000

(To be Filled in by the Bank)

*500
Journal No:

DU60248497

*100
*50
*20

Branch Name:
Branch Code:

*10
Deposit Date:
Coins
Branch Stamp

Total Rs
Cheque

Authorised Signatory

Cheque No:

Cheque Date:

Drawee Bank: State Bank of India (other bank cheques not accepted under PAP)
Branch:
Signature of the Depositor
Space for Bank use
Branch Stamp