CMR INSTITUTE OF TECHNOLOGY

UGC AUTONOMOUS
(Approved by AICTE, Permanently Affiliated to JNTUH, Hyderabad, Accredited by NBA and NAAC with ‘A’ Grade)
Kandlakoya (V), Medchal Road, Hyderabad – 501 401
Ph No. 08418-200720

Date: 14.12.2020
REMUNERATION CLAIM FORM

1. Name of the Evaluator : Dr. GOLLAPALLI NARESH

2. Designation : PROFESSOR OF EEE & DEAN-ADMINISTRATION
3. Address of the Institution : PRAGATI ENGINEERING COLLEGE (A)
# 3-180, ADB Road, Surampalem, East Godavari District.
Andhra Pradesh – 533 437
4. Contact Number : 9849898440
5. Email ID : naresh.elec@gmail.com
6. Bank Details for Payment :
Name of the Bank & Branch : State Bank of India, Sriram Nagar Branch, Kakinada
Account Number : 30032126795
IFSC Code : SBIN0008028
PAN Number : AMGPG9106M
Aadhar Number : 5581 0526 1373
7. Details of evaluation of digital answer booklets
S. Year & No. of Total No. Amount
Branch Subject Total
No. Sem. Bundles of Scripts @ Rs.
1 II Year ECE Control Systems 2 59 20/- 1180/-
II Sem
Total Amount in words: One thousand One hundred Eighty Only
Note: TDS will be deducted from the claimed amount.

Receiver’s Signature
(Affix Revenue Stamp, if the amount exceeds Rs.5000/-)
Note: Remuneration: Rs. 20/- per Script (Subject to a minimum of Rs. 200/-)

(For Office use only)

The bill is passed for Rs.__________________________ only

Office Assistant ACE – I / II Controller of Examinations

Payment details: ___________________________________________________________________

Signature of Accounts Officer: