Challan Form

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CHALLAN FORM (CASH VOUCHER) CHALLAN FORM (CASH VOUCHER)

BRANCH COPY CANDIDATE’S COPY


PUNJAB GRAMIN BANK PUNJAB GRAMIN BANK
APPLICATION FEE DETAILS APPLICATION FEE DETAILS
RECRUITMENT OF OFFICER JR.MANAGEMENT SCALE-I RECRUITMENT OF OFFICER JR.MANAGEMENT SCALE-I
IN PUNJAB GRAMIN BANK IN PUNJAB GRAMIN BANK
ACCOUNT NO : _____________________
AT BO: KAPURTHALA ACCOUNT NO : _____________________
CANDIDATE’S NAME : MR./MRS/KUM. AT BO: KAPURTHALA
CANDIDATE’S NAME : MR./MRS/KUM.
CATEGORY* SC/ST/PWD/EXS – ONLY POSTAGE RS 75/-
OBC/GEN - APPLICATION FEE & POSTAGE RS.400/- CATEGORY* SC/ST/PWD/EXS – ONLY POSTAGE RS 75/-
OBC/GEN - APPLICATION FEE & POSTAGE RS.400/-
DATE OF BIRTH :
DATE OF BIRTH :
BANK’S BRANCH NAME : BANK’S BRANCH NAME :

BRANCH CODE NO# : BRANCH CODE NO# :

JOURNAL/TXN NO # : JOURNAL/TXN NO # :
(7 TO 10 DIGITS) (7 TO 10 DIGITS)

DEPOSIT DATE : DEPOSIT DATE :

APPLICATION FEE/POSTAGE RS........................ APPLICATION FEE/POSTAGE RS........................


(RUPEES..........................................................................................ONLY) (RUPEES..........................................................................................ONLY)

SIGNATURE OF DEPOSITOR AUTHORIZED SIGNATORY SIGNATURE OF DEPOSITOR AUTHORIZED SIGNATORY


ADDRESS:.................... STAMP ADDRESS:.................... STAMP
................................... ...................................
PHONE/MOBI. NO. PHONE/MOBI. NO.
* TICK WHICHEVER IS APPLICABLE.
* TICK WHICHEVER IS APPLICABLE. # FEE RECEIVING BRANCH IS ADVISED TO WRITE THE DEPOSIT JOURNAL NO.
# FEE RECEIVING BRANCH IS ADVISED TO WRITE THE DEPOSIT JOURNAL NO. AND AND BRANCH CODE NO. ABOVE INVARIABLY.
BRANCH CODE NO. ABOVE INVARIABLY. (THIS PART OF THE CHALLAN WILL BE REQUIRED TO BE SUBMITTED BY THE
CANDIDATE AT THE TIME OF WRITTEN TEST ALONG WITH A PHOTOGRAPH,
OTHERWISE THE CANDIDATE WILL NOT BE ALLOWED TO APPEAR AT THE
EXAMINATION.)

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