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
EAMCET-2010 (ADMISSIONS) EAMCET-2010 (ADMISSIONS) EAMCET-2010 (ADMISSIONS) EAMCET-2010 (ADMISSIONS)
ANDHRA BANK – ANDB0000533 ANDHRA BANK – ANDB0000533 ANDHRA BANK – ANDB0000533 ANDHRA BANK – ANDB0000533

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. 053310100010615 Account.No. 053310100010615 Account.No. 053310100010615 Account.No. 053310100010615

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 towards The following amount is paid The following amount is paid
The following amount is paid
Tuition Fee with regard to my admission towards Tuition Fee with regard to my towards Tuition Fee with regard to my
towards Tuition Fee with regard to my Rs……………… admission Rs……………… admission Rs………………
admission Rs………………
(In words (In words (In words (In words
Rupees……………………………………… Rupees………………………………………… Rupees……………………………………… Rupees………………………………………
……………..) …………..) ……………..) ……………..)

Signature of Payee Signature of Payee Signature of Payee Signature of Payee

Seal of Bank in Seal of Bank in Seal of Bank in Seal of Bank in

Receipt of Amount Receipt of Amount Receipt of Amount Receipt of Amount
Scroll. No. Scroll. No. Scroll. No. Scroll. No.

BANKER’S COPY CONVENER COPY CANDIDATE COPY

COLLEGE COPY