CUCET 2012 - ACKNOWLEDGEMENT FORM "Write your CUCET ID and name at the backside of the Acknowledgement Form"

Full Name CUCET ID Program Name Transaction / UTR No. Payment Date Amount Branch Name Branch Code

: AKANKSHA SRIVASTAV : 205774 : CUCET Test Fee : 1150 : May-4-2012 : 250 : INDIAN OVERSEAS BANK ,ALLAHABAD : 350

I declare that the statements on this form are correct. Candidate's Signature

CUCET ID: 205774