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

BRANCH COPY CANDIDATE’S COPY

ARYAVART GRAMIN BANK ARYAVART GRAMIN BANK AFFIX RECENT

PHOTOGRAPH
RECRUITMENT PROJECT-2011 RECRUITMENT PROJECT-2011
Application Fee Details Application Fee Details
Recruitment of Office Assistant (Post Code-4) Recruitment of Office Assistant (Post Code-4)
in Aryavart Gramin Bank in Aryavart Gramin Bank

Account No : 683821110000002 (Aryavart Gramin Bank Recruitment A/C) Account No : 683821110000002 (Aryavart Gramin Bank Recruitment A/C)
at Bank of India , Patrakarpuram Branch, Lucknow at Bank of India , Patrakarpuram Branch, Lucknow

Candidate’s Name : Mr./Mrs/Kum._____________________________ Candidate’s Name : Mr./Mrs/Kum._____________________________

Category* : SC/ST/PC/EXS - ` 100/-( Including Postage) Category* : SC/ST/PC/EXS - ` 100/-( Including Postage)
BC/GEN - ` 400/- (Including Postage) BC/GEN - ` 400/- (Including Postage)

Candidate’s Date of Birth :______________________________ Candidate’s Date of Birth :______________________________

Bank of India Bank’s Branch Name :________________________ Bank of India Bank’s Branch Name :________________________

Branch Code No# : _____________________________ Branch Code No# : _____________________________

Transaction No # : __________________________ Transaction No # : __________________________

Date of Deposit : ______________________________ Date of Deposit : ______________________________

Application Fee including Postage `______________________ Application Fee including Postage `______________________
(` _______________________________________________________________only) (` _______________________________________________________________only)

______________________ ______________________ ______________________ ______________________

Signature of Depositor Authorized Signatory Signature of Depositor Authorized Signatory
Address:_______________________ Branch Stamp Address:_______________________ Branch Stamp
_______________________________ _______________________________
Phone/Mobi. No._________________ Phone/Mobi. No._________________

* Tick whichever is applicable. * Tick whichever is applicable.

# Fee receiving branch is advised to write the Transaction No. and Branch Code No.
above invariably.
# Fee receiving branch is advised to write the Transaction 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 written test along with a photograph, otherwise the candidate will not be
allowed to appear at the examination.)