Category*. SC/ST/PWD â only Postage Rs. 20/-. For all others â Application Fee & Postage Rs. 100/-. Date of Birt
CHALLAN FORM (CASH VOUCHER)
CHALLAN FORM (CASH VOUCHER) CANDIDATE’S COPY Application Fee Details Affix Passport size Photograph Recruitment of Officer Scale-I in Madhyanchal Gramin Bank
BRANCH COPY Application Fee Details Recruitment of Officer Scale-I in Madhyanchal Gramin Bank
Account No Account No
: 33045455894 at SBI Civil Lines, Sagar (04543) Or : 80005936447 at Madhyanchal Gramin Bank, Tili Road, Sagar (1127)
Candidate’s Name : Mr./Mrs/Kum. ____________________________
Account No Account No
: 33045455894 at SBI Civil Lines, Sagar (04543) Or : 80005936447 at Madhyanchal Gramin Bank, Tili Road, Sagar (1127)
Candidate’s Name : Mr./Mrs/Kum. _____________________________
Category*
SC/ST/PWD – only Postage Rs. 20/Category* SC/ST/PWD – only Postage Rs. 20/For all others – Application Fee & Postage Rs. 100/For all others – Application Fee & Postage Rs. 100/Date of Birth : Date of Birth : : _______________________________________ Branch Name Branch Name : _______________________________________ Branch Code No# : _______________________________________ Branch Code No# : _______________________________________ Journal No # : _______________________________________ Journal No # : _______________________________________ (7 to 10 digits) (7 to 10 digits) Deposit Date : _______________________________________ Deposit Date : _______________________________________ Amount Rs. ....................... Amount Rs. ....................... (Rupees..........................................................................................only) (Rupees..........................................................................................only) Signature of Depositor Authorized Signatory Address:.................... Stamp ................................... Phone/Mob. No. * Tick whichever is applicable. ** Inter core transaction charges. # Fee receiving branch is advised to write the Deposit Journal No. and branch code no. above invariably.
Signature of Depositor Authorized Signatory Address:.................... Stamp ................................... Phone/Mob. No. * Tick whichever is applicable. ** Inter core transaction charges. # Fee receiving branch is advised to write the Deposit Journal No. and branch code no. above invariably. (This part of the challan will be required to be submitted by the candidate at the time of Interview along with a photograph, otherwise the candidate will not be allowed to appear at the Interview.)
