APPLICATION FEE / INTIMATION CHARGES PAYMENT CHALLAN

BRANCH COPY

Application Fee / INTIMATION Charges Details

Recruitment Project – 1 / 2014

TO BE F I LL E D- I N BY TH E C A ND I DA TE

Registration No.

[to be filled after registration] :

Applicant’s Name : Mr. / Mrs. / Kum

Date of Birth [DD-MM-YYYY] :

Contact Phone No :

Category*

[Tick appropriate box] :

`̀̀̀ 100/- `̀̀̀ 500/-

SC ST PWD All Others

Post Applied for [write Post Name] :

Amount deposited :

`̀̀̀ _____/- [Rupees ____________________only]

Depositing Branch Name & City :

TO BE F IL L ED - IN BY THE B RA N CH O FF ICI A LS

D P Code of Branch where Fees /

Intimation Charges Paid :

Payee Branch Name : Canara Bank, Town Hall Welfare Centre, Bangalore

[DP Code-8693]

Name of the Account : Canara Bank Recruitment Project 1/2014

Account Number : 8693201000008

Transaction Sequence No. :

Date of Deposit [shall be between

08.02.2014 and 22.02.2014] :

Signature of Depositor

Authorized Signatory

SP No:___________ &

Branch Seal:__________

Note to the Branch: (1) Only Payment Challan containing full details of candidate should be

accepted. (2) Write Transaction Sequence No. & Branch DP Code No. above invariably, only after

the transaction is authorized & successful and then only copy should be given to Candidate. (3)

Transaction Sequence No. should not be prefixed or suffixed with any other numbers. (4) In

Narration field in CBS, name of the candidate should be entered.

APPLICATION FEE / INTIMATION CHARGES PAYMENT CHALLAN

CANDIDATE COPY

Application Fee / INTIMATION Charges Details

Recruitment Project – 1 / 2014

TO BE F IL L ED - IN BY THE C A N D ID A TE

Registration No.

[to be filled after registration] :

Applicant’s Name : Mr. / Mrs. / Kum

Date of Birth [DD-MM-YYYY] :

Contact Phone No :

Category*

[Tick appropriate box] :

`̀̀̀ 100/- `̀̀̀ 500/-

SC ST PWD All Others

Post Applied for [write Post Name] :

Amount deposited :

`̀̀̀ _____/- [Rupees ____________________only]

Depositing Branch Name & City :

TO BE F I LL ED - I N BY TH E B RAN CH OF FIC IA L S

D P Code of Branch where Fees /

Intimation Charges Paid :

Payee Branch Name : Canara Bank, Town Hall Welfare Centre, Bangalore

[DP Code-8693]

Name of the Account : Canara Bank Recruitment Project 1/2014

Account Number : 8693201000008

Transaction Sequence No. :

Date of Deposit [shall be between

08.02.2014 and 22.02.2014] :

Signature of Depositor

Authorized Signatory

SP No:___________ &

Branch Seal:__________

Note to the candidates: (1) Please check whether the Transaction Sequence No., Branch DP Code

No & Date of Deposit are entered properly & signed by the Branch Officials (2) Candidate has to

preserve this challan safely for submitting to the Bank whenever demanded.