Depositor Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Date: 26-09-2016

CP59119944

Beneficiary:

GATE 2017 IIT ROORKEE

Merchant Reference No:

20592925

Candidate Name:
Registration ID:

Date: 26-09-2016
Benificiary/Remittance Details

PARTHA SARATHEE NAYAK

R328F78
Rs

Collection Amount

1500 00

Comission
Total ( One Thousand And Five Hundred And Fifty Eight Rupees Only)

58 00
1558 00

Details of Cash

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch
Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect

Benificiary/Remittance Details
State Bank MOPS Reference No.

Branch Copy

Rs

State Bank MOPS Reference No.

CP59119944

Beneficiary:

GATE 2017 IIT ROORKEE

Merchant Reference No:

20592925

Candidate Name:

PARTHA SARATHEE NAYAK

Registration ID:

R328F78
Rs

Collection Amount

1500 00

Comission
Total ( One Thousand And Five Hundred And Fifty Eight Rupees Only)

58 00
1558 00

Cash

Amount

Cash Notes

Total Rs

Rs

Instructions for Depositor: This is not an e-receipt.

*1000
*500

(To be Filled in by the Bank)

*100
*50

Journal No:

*20
*10
Branch Name:
Branch Code:

Coins

Deposit Date:

Total Rs
Branch Stamp
Signature of the Depositor
Authorised Signatory
Space for Bank use
Branch Stamp