BRANCH OFFICIALS TO CAREFULLY ENTER DETAILS AS BRANCHES ARE NOT PERMITTED TO DEBIT THE ACCOUNT

(Original To Be Produced Along With The Call Letter for Interview) PHOTOCOPY MAY BE RETAINED

FEE PAYMENT CHALLAN

BRANCH COPY

FEE PAYMENT CHALLAN

APPLICANTS COUTERFOIL

(USE SEPARATE CHALLANS FOR EACH POST)

KARNATAKA VIKAS GRAMEEN BANK : DHARWAD

(USE SEPARATE CHALLANS FOR EACH POST)

KARNATAKA VIKAS GRAMEEN BANK : DHARWAD

DIRECT RECRUITMENT PROJECT - 2012

INTERVIEW APPLICATION FEES PAYMENT CHALLAN For Officer Scale- I / Office Asst (Multipurpose)*

DIRECT RECRUITMENT PROJECT - 2012

INTERVIEW APPLICATION FEES PAYMENT CHALLAN For Officer Scale- I / Office Asst (Multipurpose)*

To be filled in by KVG BANK'S BRANCH Branch Name DPD Code Credit To A/C No. 1. 89016771475 (for Officer Scale-I)* 2. 89016773766 (for Office Assistant (Multipurpose)*

To be filled in by KVG BANK'S BRANCH Branch Name DPD Code Credit To A/C No. 1. 89016771475 (for Officer Scale-I)* 2. 89016773766 (for Office Assistant (Multipurpose)*

PAYMENT DATE

PAYMENT DATE

Scroll Journal No. TO BE FILLED BY THE CANDIDATE

POST APPLIED:

Scroll Journal No. TO BE FILLED BY THE CANDIDATE

POST APPLIED:

Category: SC/ST/ PWD/EXSM*

Category: SC/ST/ PWD/EXSM* `

FEES PAID

FEES PAID

CANDIDATE'S FULL NAME IN BLOCK LETTERS:

* *Mr. / Mrs. / Ms. _____________________________________________________________

CANDIDATE'S FULL NAME IN BLOCK LETTERS:

* *Mr. / Mrs. / Ms. _____________________________________________________________

** Applicant's Name on this Payment Challan & on the Application Form SHOULD BE IDENTICAL.
Candidate's Signature :

** Applicant's Name on this Payment Challan & on the Application Form SHOULD BE IDENTICAL.
Candidate's Signature :

Mobile /Telephone No.(With STD Code) : Branch Seal/CASH RECEIVED Stamp

Mobile / Telephone No. (With STD Code) :

Branch Seal/CASH RECEIVED Stamp BANK'S AUTHORISED SIGNATORY

BANK'S AUTHORISED SIGNATORY 1). BRANCH TO ENSURE THAT BRANCH NAME, DPD No., AMOUNTPAYMENT DATE, and TRANSACTION ID & APPLICANT'S NAME ARE CORRECTLY & LEGIBLY NOTED IN THIS CHALLAN. 2) BRANCH TO CUT THIS PAYMENT CHALLAN INTO HALF ALONG MID LINE, & HAND OVER APPLICANT'S COUNTERFOIL TO APPLICANT. RETAIN THE BANK'SVOUCHER PORTION FOR BRANCH RECORDS. ( Fee accepted between 11.12.2012 and 26.12.2012 only)

1). BRANCH TO ENSURE THAT BRANCH NAME, DPD No., AMOUNTPAYMENT DATE, and TRANSACTION ID & APPLICANT'S NAME ARE CORRECTLY & LEGIBLY NOTED IN THIS CHALLAN. 2) BRANCH TO CUT THIS PAYMENT CHALLAN INTO HALF ALONG MID LINE, & HAND OVER APPLICANT'S COUNTERFOIL TO APPLICANT. RETAIN THE BANK'SVOUCHER PORTION FOR BRANCH RECORDS. ( Fee accepted between 11.12.2012 and 26.12.2012 only)

*STRIKE OUT NOT APPLICABLE