Depositor Copy Branch Copy

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

Date: 09-01-2020 Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect
Date: 09-01-2020
Beneficiary/Remittance Details
Beneficiary/Remittance Details
State Bank Collect Reference No. DUC5564999
State Bank Collect Reference No. DUC5564999
Beneficiary: IIT ROORKEE
Beneficiary: IIT ROORKEE
Category: 1. IIT Roorkee Semester Fee
Category: 1. IIT Roorkee Semester Fee
Last Date of Payment: 14-01-2020 23:45
Last Date of Payment: 14-01-2020 23:45
Remitter Rahul Nainawat
Remitter Rahul Nainawat
Rs
Collection Amount 28,600.00 Rs
Comission 59.00 Collection Amount 28,600.00
Total (Rupees Twenty Eight Thousand Six Hundred Fifty Nine Only) 28,659.00 Comission 59.00
Total (Rupees Twenty Eight Thousand Six Hundred Fifty Nine Only) 28,659.00
Details of Cash / Cheques Rs p Mode of Payment (Choose Either Cash / Cheque)

Cash PAN:

Please quote your PAN for Cash remittance >= Rs. 50,000
Total Rs
Amount
Instructions for Depositor: This is not an e-receipt. After payment , please visit www.onlinesbi.com > 'State Bank Cash Notes Rs P
Collect' and click on the hyperlink at the bottom of the page to generate the e-receipt. *2000
*500
(To be Filled in by the Bank)
*200
Journal No: DUC5564999 *100
*50
*20
Branch Name: *10

Branch Code: Deposit Date:

Coins
Total Rs
Branch Stamp
Cheque
Cheque No: Cheque Date:
Authorised Signatory
Drawee Bank: State Bank of India (other bank cheques not accepted under PAP)
Branch:

Signature of the Depositor

Space for Bank use

Branch Stamp