SONALI BANK LTD. SONALI BANK LTD. SONALI BANK LTD. SONALI BANK LTD.

..................................... Branch, ..................................... Branch, ..................................... Branch, ..................................... Branch,

......................... ......................... ......................... .........................
University of Dhaka University of Dhaka University of Dhaka University of Dhaka
Bank A/C :- SND#4405703000066 Bank A/C :- SND#4405703000066 Bank A/C :- SND#4405703000066 Bank A/C :- SND#4405703000066
Date:…................... Date:…................... Date:…................... Date:…...................
For University For College For Student For Bank
Name:….................................................. Name:….................................................. Name:….................................................. Name:…..................................................
Roll No :…...................Regi. No…............. Roll No :…...................Regi. No…............. Roll No :…...................Regi. No…............. Roll No :…...................Regi. No….............
Subject:…....................Session….............. Subject:…....................Session….............. Subject:…....................Session….............. Subject:…....................Session…..............
Description of Payment Amount Description of Payment Amount Description of Payment Amount Description of Payment Amount
Re-scrutiny Fee :…....... Re-scrutiny Fee :…....... Re-scrutiny Fee :…....... Re-scrutiny Fee :….......

Certificate Fee: …………. Certificate Fee: …………. Certificate Fee: …………. Certificate Fee: ………….
Academic Transcript Fee… Academic Transcript Fee… Academic Transcript Fee… Academic Transcript Fee…
Others Fee :…............... Others Fee :…............... Others Fee :…............... Others Fee :…...............
Total= Total= Total= Total=

Online Bank Charge Online Bank Charge Online Bank Charge Online Bank Charge
(including VAT)= (including VAT)= (including VAT)= (including VAT)=
Grand Total= Grand Total= Grand Total= Grand Total=

(Taka:....................................................) (Taka:....................................................) (Taka:....................................................) (Taka:....................................................)

Pay Order/ Draft No :........................ Pay Order/ Draft No :........................ Pay Order/ Draft No :........................ Pay Order/ Draft No :........................
Bank:.................................................. Bank:.................................................. Bank:.................................................. Bank:..................................................
Branch:.............................................. Branch:.............................................. Branch:.............................................. Branch:..............................................
Date of Issue..................................... Date of Issue..................................... Date of Issue..................................... Date of Issue.....................................

Amount Received and Signed Amount Received and Signed Amount Received and Signed Amount Received and Signed
N.B.:- Certificate Fee=300/-, Transcript N.B.:- Certificate Fee=300/-, Transcript N.B.:- Certificate Fee=300/-, Transcript N.B.:- Certificate Fee=300/-, Transcript
Fee=450/- and re-scrutiny Fee=800/- Fee=450/- and re-scrutiny Fee=800/- Fee=450/- and re-scrutiny Fee=800/- Fee=450/- and re-scrutiny Fee=800/-
(0001---10,000/-)Bank Charge=10/- + Vat=2/- = total=(10+2)=12tk (0001---10,000/-)Bank Charge=10/- + Vat=2/- = total=(10+2)=12tk (0001-10,000/-)Bank Charge=10/- + Vat=2/- = total=(10+2)=12tk

Officer Cashier Officer Cashier Officer Cashier Officer Cashier