BANK COPY /

APPLICANT COPY /

BHEL COPY / ....

BHARAT HEAVY ELECTRICALS LIMITED

BHARAT HEAVY ELECTRICALS LIMITED

RANIPUR, HARIDWAR

RANIPUR, HARIDWAR

BHARAT HEAVY ELECTRICALS LIMITED

RANIPUR, HARIDWAR

STATE BANK OF INDIA

STATE BANK OF INDIA

STATE BANK OF INDIA

POWER JYOTI ACCOUNT NO / :

POWER JYOTI ACCOUNT NO / :

POWER JYOTI ACCOUNT NO / :

30989466064

30989466064

30989466064

SBI, RANIPUR, BHEL

SEC 5A, CODE NO - 0586

SBI, RANIPUR, BHEL

SEC 5A, CODE NO - 0586

SBI, RANIPUR, BHEL

SEC 5A, CODE NO - 0586

(TO BE FILLED BY APPLICANT) / ( )

(TO BE FILLED BY APPLICANT) / ( )

(TO BE FILLED BY APPLICANT) / ( )

DISCIPLINE / :

DISCIPLINE / :

DISCIPLINE / :

APPLICANT NAME /
:

APPLICANT NAME /
:

APPLICANT NAME /
:

FATHER'S NAME /
:

FATHER'S NAME /
:

FATHER'S NAME /
:

DATE OF BIRTH /
:

DATE OF BIRTH /
:

DATE OF BIRTH /
:

SBI BRANCH NAME /

:

SBI BRANCH NAME /

:

SBI BRANCH NAME /

:

SBI BRANCH CODE /

:

SBI BRANCH CODE /

:

SBI BRANCH CODE /

:

DATE OF DEPOSIT /
:

DATE OF DEPOSIT /
:

DATE OF DEPOSIT /
:

FEE DETAILS (IN Rs) / ( )

FEE DETAILS (IN Rs) / ( )

FEE DETAILS (IN Rs) / ( )

Rs. 100/BANK CHARGES / : Rs. 25 /TOTAL / : Rs. 125/PROCESSING FEE / :

TOTAL AMOUNT (In Words): One Hundred & Twenty Five RUPEES Only

Rs. 100/BANK CHARGES / : Rs. 25/TOTAL / : Rs. 125/PROCESSING FEE / :

TOTAL AMOUNT (In Words): One Hundred & Twenty Five RUPEES Only

(SIGNATURE OF THE REMITTER)

( )

DATE / :
PLACE / :

(SIGNATURE OF THE AUTHORIZED

OFFICIAL WITH BANK SEAL)
( )

BANK CHARGES / :
TOTAL / : Rs.

(SIGNATURE OF THE REMITTER)

( )

(TO BE FILLED BY BANK) / ( )

JOURNAL NUMBER /
(HOST TRACE NUMBER) /( ):

DATE / :
PLACE / :

(SIGNATURE OF THE AUTHORIZED

OFFICIAL WITH BANK SEAL)
( )

125/-

TOTAL AMOUNT (In Words): One Hundred & Twenty Five RUPEES Only

(SIGNATURE OF THE REMITTER)

( )

(TO BE FILLED BY BANK) / ( )

JOURNAL NUMBER /
(HOST TRACE NUMBER) /( ):

Rs. 100/Rs. 25/-

PROCESSING FEE / :

(TO BE FILLED BY BANK) / ( )

JOURNAL NUMBER /
(HOST TRACE NUMBER) /( ):

DATE / :
PLACE / :

(SIGNATURE OF THE AUTHORIZED

OFFICIAL WITH BANK SEAL)
( )

IMPORTANT INSTRUCTIONS / :
1. Candidate should send BHEL copy of this challan form along with Acknowledgement
Slip to BHEL & keep Applicant copy of this challan form for future reference. /
.... ...

2. Candidate should ensure that the Journal No. (Host Trace No.) is allotted by Bank for
this payment. /
( )

IMPORTANT INSTRUCTIONS / :
1. Candidate should send BHEL copy of this challan form along with Acknowledgement
Slip to BHEL & keep Applicant copy of this challan form for future reference. /
.... ...

2. Candidate should ensure that the Journal No. (Host Trace No.) is allotted by Bank for
this payment. /
( )

IMPORTANT INSTRUCTIONS / :
1. Candidate should send BHEL copy of this challan form along with Acknowledgement Slip
to BHEL & keep Applicant copy of this challan form for future reference. /
.... ...

2. Candidate should ensure that the Journal No. (Host Trace No.) is allotted by Bank for this
payment. / (
)

3. The Bank shall not do bench posting or trickle feed. Journal Number (Host Trace No.)
should be entered by the Bank. /
( )

3. The Bank shall not do bench posting or trickle feed. Journal Number (Host Trace No.)
should be entered by the Bank. /
( )

3. The Bank shall not do bench posting or trickle feed. Journal Number (Host Trace No.)
should be entered by the Bank. /
( )