Ðèþ’yæþÐèþ É糁 Æðÿ™yæþÐèþ É糁 AçÜː É糁

TRIPLICATE DUPLICATE ORIGINAL

Qgê¯é ¯ðþ™. Qgê¯é ¯ðþ™. Qgê¯é ¯ðþ™.
__________ TREASURY/Sub-Treasury __________ TREASURY/Sub-Treasury __________ TREASURY/Sub-Treasury
B™É«æþÉ糧óþԏý É糿æý€èþә B™É«æþÉ糧óþԏý É糿æý€èþә B™É«æþÉ糧óþԏý É糿æý€èþә
GOVERNMENT OF ANDHRA PRADESH GOVERNMENT OF ANDHRA PRADESH GOVERNMENT OF ANDHRA PRADESH
Qgê¯èþ ^èþÌê¯èþ Qgê¯èþ ^èþÌê¯èþ Qgê¯èþ ^èþÌê¯èþ
TREASURY CHALLAN No.____________ TREASURY CHALLAN No.____________ TREASURY CHALLAN No.____________
ò³§æþª 糧æþª ò³§æþª 糧æþª ò³§æþª 糧æþª
Major Head Major Head Major Head
Eç³ ò³§æþª 糧æþª Eç³ ò³§æþª 糧æþª Eç³ ò³§æþª 糧æþª
Sub-Major Head Sub-Major Head Sub-Major Head
_¯èþ² ³ç §æþª _¯èþ² ³ç §æþª _¯èþ² ³ç §æþª
Minor Head Minor Head Minor Head
ÝëÐèþ’íßMæü Eç³ ç³§æþª ÝëÐèþ’íßMæü Eç³ ç³§æþª ÝëÐèþ’íßMæü Eç³ ç³§æþª
Group Sub-Head Group Sub-Head Group Sub-Head
Eç³ ç³§æþª Eç³ ç³§æþª Eç³ ç³§æþª
Sub-Head Sub-Head Sub-Head
ç³°ç³ÆæÿÐðþ”¯èþ 糧æþª ç³°ç³ÆæÿÐðþ”¯èþ 糧æþª ç³°ç³ÆæÿÐðþ”¯èþ 糧æþª
Detailed Head Detailed Head Detailed Head
Eç³ ç³°ç³ÆæÿÐðþ”¯èþ 糧æþª Eç³ ç³°ç³ÆæÿÐðþ”¯èþ 糧æþª Eç³ ç³°ç³ÆæÿÐðþ”¯èþ 糧æþª
Sub-detailed head Sub-detailed head Sub-detailed head
Ððþ€èþ¢™ Ææÿ’. / Amount Rs. Ððþ€èþ¢™ Ææÿ’. / Amount Rs. Ððþ€èþ¢™ Ææÿ’. / Amount Rs.
A„æþÆéÌê Ææÿ’. A„æþÆéÌê Ææÿ’. A„æþÆéÌê Ææÿ’.
in words Rupees in words Rupees in words Rupees
yìþ´ëhr§éÆæÿ õ³Ææÿ, _Ææÿ¯éÐèþ’ yìþ´ëhr§éÆæÿ õ³Ææÿ, _Ææÿ¯éÐèþ’ yìþ´ëhr§éÆæÿ õ³Ææÿ, _Ææÿ¯éÐèþ’
Remitter's Name & Address Remitter's Name & Address Remitter's Name & Address
§óþ° °Ñ€èþ¢Ðèþ ò³”MæüÐèþ fÐèþ^óþÄèÿºyìþ¯èþ¨ §óþ° °Ñ€èþ¢Ðèþ ò³”MæüÐèþ fÐèþ^óþÄèÿºyìþ¯èþ¨ §óþ° °Ñ€èþ¢Ðèþ ò³”MæüÐèþ fÐèþ^óþÄèÿºyìþ¯èþ¨
Purpose for which the amount is deposited. Purpose for which the amount is deposited. Purpose for which the amount is deposited.
fÐèþ ^óþÄèÿÐèþËíܯèþ¨Vé Møǯèþ É糿æý€èþÓ A¨MéÇ fÐèþ ^óþÄèÿÐèþËíܯèþ¨Vé Møǯèþ É糿æý€èþÓ A¨MéÇ fÐèþ ^óþÄèÿÐèþËíܯèþ¨Vé Møǯèþ É糿æý€èþÓ A¨MéÇ
Office at whose instance Amount Office at whose instance Amount Office at whose instance Amount
Head of Account verified Head of Account verified Head of Account verified

€ôþ¨ yìþ´ëhr§éÆæÿ çܙ€èþMæü™ €ôþ¨ yìþ´ëhr§éÆæÿ çܙ€èþMæü™ €ôþ¨ yìþ´ëhr§éÆæÿ çܙ€èþMæü™

Dated Signature of the Remitter S.T.O./T.O. Dated Signature of the Remitter S.T.O./T.O. Dated Signature of the Remitter S.T.O./T.O.
A„æþÆéÌê Ææÿ’. Ðèþsìüt¯èþÑ A„æþÆéÌê Ææÿ’. Ðèþsìüt¯èþÑ A„æþÆéÌê Ææÿ’. Ðèþsìüt¯èþÑ
Received Rs. .......................... Received Rs. .......................... Received Rs. ..........................
¯èþ§æþVæü §éÓÆé / yìþ.yìþ. §éÓÆé / ^ðþMü §éÓÆé ¯èþ§æþVæü §éÓÆé / yìþ.yìþ. §éÓÆé / ^ðþMü §éÓÆé ¯èþ§æþVæü §éÓÆé / yìþ.yìþ. §éÓÆé / ^ðþMü §éÓÆé
by cash / D.D.No. / Cheque No. .................... by cash / D.D.No. / Cheque No. .................... by cash / D.D.No. / Cheque No. ....................

ÄèÿŽÜsìü.K. / »êřN Ðóþ¯óþfÆæÿ ÄèÿŽÜsìü.K. / »êřN Ðóþ¯óþfÆæÿ ÄèÿŽÜsìü.K. / »êřN Ðóþ¯óþfÆæÿ

S.T.O. / BANK MANAGER S.T.O. / BANK MANAGER S.T.O. / BANK MANAGER
Note: Seperate challan should be used for each detailed head. Note: Seperate challan should be used for each detailed head. Note: Seperate challan should be used for each detailed head.