State Bank of India :: Branch ______________________

State Bank of India :: Branch ______________________

RECRUITMENT IN THE CHITTOOR DISTRICT CO-OP CENTRAL BANK LTD., CHITTOOR STAFF ASSISTANTS/CLERKS 2011 APPLICATION FEE PAYMENT CHALLAN (Branch copy) A/c No : 31772203365

RECRUITMENT IN THE CHITTOOR DISTRICT CO-OP CENTRAL BANK LTD., CHITTOOR STAFF ASSISTANTS/CLERKS 2011
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APPLICATION FEE PAYMENT CHALLAN (Applicants copy to be produced at the written test centre) A/c No : 31772203365

(Only for payment in State Bank of India branches )

TO BE FILLED IN BY THE CANDIDATE

(Only for payment in State Bank of India branches )

TO BE FILLED IN BY THE CANDIDATE

Applicants Name(Block letters) (Please note: Applicants Name in this challan and on the On-Line (Please note: Applicants Name in this challan and on the On-Line application should be the same) application should be the same) Direct Recruitment Candidates hailing from Direct Recruitment Candidates hailing PACS affiliated to from PACS affiliated to Application fee Application fee CHITTOOR DCCB CHITTOOR DCCB Rs.300 Rs.100 Rs.150 Rs.50 Rs.300 Rs.100 Rs.150 Rs.50 OC BC SC ST PC Ex- OC BC SC ST PC Ex- Category (Tick OC BC SC ST PC Ex- OC BC SC ST PC Ex-Ser Category (Tick [ ] Ser Ser [ ] whichever Ser whichever is applicable) is applicable) For Branch Use For Branch Use Applicants Name(Block letters) Branch Code & Name Date of payment Transaction Id (From 12.09.2011 to 03.10.2011 only) Branch Code & Name Date of payment Transaction Id (From 12.09.2011 to 03.10.2011 only)

Authorised Signatory with Signature No & Br.Seal

Applicants/Remitters Signature

Authorised Signatory with Signature No & Br.Seal

Applicants/Remitters Signature