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Journal No.: Journal No.:: Signature of Depositor Signature of Depositor

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FEE PAYMENT CHALLAN FOR

Employees State Insurance Corporation

FEE PAYMENT CHALLAN FOR


Employees State Insurance Corporation

Applicant's Copy
(To be retained by Applicant)
Deposit in any branch of State Bank of India

Bank copy
(To be retained by SBI Branch)
Deposit in any branch of State Bank of India

Post Applied for : UPPER DIVISION CLERK


Post Applied for : UPPER DIVISION CLERK
Challan can be deposited after minimum 24 hours of generation of
challan on any bank working day
Challan Generate
Date

Use CBS Screen No.

22/12/2015

Challan can be deposited after minimum 24 hours of generation of


challan on any bank working day
Challan Generate
Date

22/12/2015

Use CBS Screen No.

8888

Reg.Id/Ref.No.:
Date Of Birth:
Name of Candidate:
Mobile No.:
Email Id:

Fee Type: 265


4220824704
01/07/1989
RAJANNA C
8050957327

8888
Reg.Id/Ref.No.:

4220824704

Date Of Birth:

01/07/1989

Name of Candidate:

RAJANNA C

Mobile No.:

rajannac422@gmail.com
Email Id:

Category:

OBC

Amount(in Figures) (Fee+Bank Charges) Rs.300.00


1000x

Fee Type: 265

Category:

8050957327
rajannac422@gmail.com
OBC

Amount(in Figures) (Fee+Bank Charges) Rs.300.00


1000x

500x

500x

100x

100x

50x

50x

10x

10x

5x
Amount (in words)
ThreeHundred

5x
Amount (in words)
ThreeHundred

Signature of Depositor
Details below should be filled-in by the Bank

Signature of Depositor
Details below should be filled-in by the Bank

Journal No.:
Date of
Transaction:

Journal No.:
Date of
Transaction:

Branch Code
Signature of Bank's Official with Seal
Candidate can check the confirmation of fees payment after
minimum two working days (48 Hrs.)of depositing the fees.
There after candidate can Login for step-II for completion of
application.

Branch Code
Signature of Bank's Official with Seal
Candidate can check the confirmation of fees payment after
minimum two working days (48 Hrs.)of depositing the fees.
There after candidate can Login for step-II for completion of
application.

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