CHALLAN FORM (CASH VOUCHER) - 01 CHALLAN FORM (CASH VOUCHER) - 01

BRANCH COPY CANDIDATE’S COPY

STATE BANK OF INDIA STATE BANK OF INDIA
Application Fee Details Application Fee Details
Recruitment of Officer Scale-I Recruitment of Officer Scale-I
in Samastipur Kshetriya Gramin Bank in Samastipur Kshetriya Gramin Bank
Account No :
3 1 6 8 4 7 5 5 8 9 4 Account No :
at ADB, Samastipur (Code No. 1953) 3 1 6 8 4 7 5 5 8 9 4
at ADB, Samastipur (Code No. 1953)
Candidate’s Name : Mr./Mrs/Kum................................................
Candidate’s Name : Mr./Mrs/Kum..............................................
Category* For SC/ST – Application Fee & Postage Rs 125/-
For All others - Application Fee & Postage Rs. 500/- Category* For SC/ST – Application Fee & Postage Rs 125/-
Date of Birth : For All others - Application Fee & Postage Rs. 500/-
Date of Birth :
Bank’s Branch Name : STATE BANK OF INDIA
Branch............................................ Bank’s Branch Name : STATE BANK OF INDIA
Branch Code No# : Branch............................................

Journal No # : Branch Code No# :

(7 to 10 digits)
Journal No # :
Deposit Date : (7 to 10 digits)
Deposit Date :
Application Fee/Postage Rs........................ Application Fee/Postage Rs........................
(Rupees..........................................................................................only) (Rupees..........................................................................................only)

Signature of Depositor Authorized Signatory

Signature of Depositor Authorized Signatory Address:............................. Stamp
Address:................................. Stamp ...........................................
................................................ Phone/Mobi. No.
* Tick whichever is applicable.
Phone/Mobi. No. # Fee receiving branch is advised to write the Deposit Journal No. and branch code no. above
* Tick whichever is applicable. invariably.
# Fee receiving branch is advised to write the Deposit Journal No. and
(This part of the challan will be required to be submitted by the candidate at the time of
branch code no. above invariably. written test along with a photograph, otherwise the candidate will not be allowed to appear
at the examination.)
 CHALLAN FORM (CASH VOUCHER)- 02 CHALLAN FORM (CASH VOUCHER)- 02
BRANCH COPY CANDIDATE’S COPY
STATE BANK OF INDIA STATE BANK OF INDIA
Application Fee Details Application Fee Details
Recruitment of Office Assistant (Multipurpose) Recruitment of Office Assistant (Multipurpose)
in Samastipur Kshetriya Gramin Bank in Samastipur Kshetriya Gramin Bank
Account No :
3 1 6 8 4 7 5 6 9 2 2 Account No :
3 1 6 8 4 7 5 6 9 2 2
at ADB, Samastipur (Code No. 1953)
Candidate’s Name : Mr./Mrs/Kum................................................
at ADB, Samastipur (Code No. 1953)
Category* For SC/ST – Application Fee & Postage Rs 100/- Candidate’s Name : Mr./Mrs/Kum..............................................
For All others - Application Fee & Postage Rs. 400/-
Date of Birth : Category* For SC/ST – Application Fee & Postage Rs 100/-
For All others - Application Fee & Postage Rs. 400/-
Bank’s Branch Name : STATE BANK OF INDIA Date of Birth :
Branch............................................
Branch Code No# : Bank’s Branch Name : STATE BANK OF INDIA
Branch............................................
Journal No # : Branch Code No# :
(7 to 10 digits)
Journal No # :
Deposit Date : (7 to 10 digits)
Deposit Date :
Application Fee/Postage Rs........................ Application Fee/Postage Rs........................
(Rupees..........................................................................................only) (Rupees..........................................................................................only)

Signature of Depositor Authorized Signatory

Signature of Depositor Authorized Signatory Address:............................. Stamp
Address:................................. Stamp ...........................................
................................................ Phone/Mobi. No.
* Tick whichever is applicable.
Phone/Mobi. No. # Fee receiving branch is advised to write the Deposit Journal No. and branch code no. above
* Tick whichever is applicable. invariably.
# Fee receiving branch is advised to write the Deposit Journal No. and
(This part of the challan will be required to be submitted by the candidate at the time of
branch code no. above invariably. written test along with a photograph, otherwise the candidate will not be allowed to appear
at the examination.)