ORIGINAL DUPLICATE TRIPLICATE QUADRUPLICATE

ANDHRA PRADESH STATE COUNCIL OF ANDHRA PRADESH STATE COUNCIL OF ANDHRA PRADESH STATE COUNCIL OF ANDHRA PRADESH STATE COUNCIL OF
HIGHER EDUCATION HIGHER EDUCATION HIGHER EDUCATION HIGHER EDUCATION
ICET-2010 (ADMISSIONS) ICET-2010 (ADMISSIONS) ICET-2010 (ADMISSIONS) ICET-2010 (ADMISSIONS)
INDIAN BANK – IDIB000NO15 INDIAN BANK – IDIB000NO15 INDIAN BANK – IDIB000NO15 INDIAN BANK – IDIB000NO15

Bank authorities please enter HTNO & Bank authorities please enter HTNO & Bank authorities please enter HTNO & Bank authorities please enter HTNO &
Rank while entering in the system Rank while entering in the system Rank while entering in the system Rank while entering in the system

Account.No. 902061334 Account.No 902061334 Account.No 902061334 Account.No . 902061334

Date:-……………… Date:-……………….. Date:-……………….. Date:-………………..

Name: ………..…………………………. Name: ………..…………………………….. Name: ………..…………………………….. Name: ………..……………………………..

Hall Ticket Number……………………… Hall Ticket Number……………………….…

Hall Ticket Number………………………. Hall Ticket Number…………………………
Rank……………………………………… Rank…………………………………………
Rank………………………………………… Rank…………………………………………
The following amount is paid
The following amount is paid towards The following amount is paid
towards Tuition Fee with regard to my The following amount is paid
Tuition Fee with regard to my admission towards Tuition Fee with regard to my
admission Rs……………… towards Tuition Fee with regard to my
Rs……………… admission Rs………………
admission Rs………………
(In words
Rupees………………………………………
……………..) (In words
(In words (In words
Rupees………………………………………
Rupees………………………………………… Rupees………………………………………
Signature of Payee ……………..)
…………..) ……………..)
Signature of Payee
Seal of Bank in Signature of Payee Signature of Payee
Receipt of Amount Seal of Bank in
Scroll. No. Seal of Bank in Seal of Bank in
Receipt of Amount
Receipt of Amount Receipt of Amount
Scroll. No.
BANKER’S COPY Scroll. No. Scroll. No.
CONVENER COPY COLLEGE COPY
CANDIDATE COPY