fee pay in slip
TRANSCRIPT
-
8/3/2019 Fee pay in slip
1/1
Name of branch: Name of branch: Name of branch:
Date of Deposit: valid up to 01 January 2012 Date of Deposit: valid up to 01 January 2012 Date of Deposit: valid up to 01 January 2012
1 Institution Name : D A I I C T 1 Institution Name : D A I I C T 1 Institution Name : D A I I C T
2 : 2 : 2 :
3 Roll no/student ID : 3 Roll no/student ID : 3 Roll no/student ID :
4 : 4 : 4 :
5Section /
Course/Programme: 5
Section /
Course/Programme: 5
Section /
Course/Programme:
6 Amount( RS.) : 6 Amount( RS.) : 6 Amount( RS.) :
School Fee/Tution fee School Fee/Tution fee School Fee/Tution feeHostel fee Hostel fee Hostel fee
Registration fees Registration fees Registration fees
Medical Insurance Medical Insurance Medical Insurance
Electricity chrgs Electricity chrgs Electricity chrgs
7 Amount in words : 7 Amount in words : 7 Amount in words :
Cash Details: Cash Details: Cash Details:
Denomination Denomination Denomination
1000* 1000* 1000*
500* 500* 500*
100* 100* 100*
50* 50* 50*
20* 20* 20*
10* 10* 10*
5* 5* 5*
Coins Coins Coins
Total Total Total
Cheque/PO no. _______________________ Cheque/PO no. _______________________ Cheque/PO no. _______________________
Drawn on b ank _______________________ b ranch __________________ Drawn o n bank _______________________ b ranch __________________ Drawn o n bank _______________________ branch __________________
at city ________________________ at city ________________________ at city ________________________
Trans id : Trans id : Trans id :
Singature/ Stamp Signature of Depositor Singature/ Stamp Signature of Depositor Singature/ Stamp Signature of Depositor
ICICI Bank Ltd ICICI Bank Ltd ICICI Bank Ltd
I.e outstation instruments not acceptableI.e outstation instruments not acceptable I.e outstation instruments not acceptable
* must be drawn payable at the centre of deposit of the instrument * must be drawn payable at the centre of deposit of the instrument * must be drawn payable at the centre of deposit of the instrument
(Bank's Copy) (Student Copy) (Institution Copy)
DA-IICT DA-IICT DA-IICT
Student Name
Pan No.:- AAAJT1203A Pan No.:- AAAJT1203A Pan No.:- AAAJT1203A
D D/M M/Y Y D D/M M/Y Y D D/M M/Y Y
( to be treated by student as fee receipt) ( to be treated by student as fee receipt) ( to be treated by student as fee receipt)
Student Name Student Name
class/year/Semester class/year/Semester class/year/Semester
No. of notes/coins Amount
Rs. ______________
No. of notes/coins Amount
Rs. ______________ Rs. ______________
No. of notes/coins Amount