West Bengal Joint Entrance Examinations Board

AQ-13/1, Salt Lake City, Sector-V, Kolkata- 700 091

PRE-RECEIPT BILL

(FOR BOARD OBSERVER)

Centre Code __________________

B.O. ID No __________________

Name of the Examination _____________________________________________________________________________________

Name of the Examinations Centre____________________________________________________________________________

Name of Board Observer______________________________________________________________________________________

Institution Designation :_______________________________Institution (full Name) _____________________________

__________________________________________________________________________________________________________________

Mailing Address________________________________________________________________________________________________

____________________________________________________________Mobile No___________________________________________

Office Telephone No._________________________________ Telephone No. ®_____________________________________

A. Honorarium ( as per annexed guideline) : ______________________________________________

Performed duty as Period of Performance Rate of remuneration / Total amount (Rs.)

honorarium

B. Travelling allowance (as per annexed guideline) :

Name of the place Date(s) and Time No. of days engaged Total (Rs.)
From (Station of
starting) :
To. (Reporting
station for duty)
:
Return to
starting sation :
Total-Rs.
Grand Total (A+B)= Rs.

Bank Details: (for money transfer though RTGS/ NEFT)

Name of the Bank Name of the Branch Bank A/C. No. IFS Code No

Declared that I have obtained/ applied for permission from the competent authority for performing
the above mentioned duty.

___________________________________

(Signature in full with date)

Received from the office of the West Bengal Joint Entrance Examination Board a Sum of Rs___________________

Rupees ) only.

Revenue.
Stamp (Signature in full with date)