Depositor Copy Branch Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Date: 13-07-2017 Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect
Date: 13-07-2017
Beneficiary/Remittance Details
Beneficiary/Remittance Details
State Bank Collect Reference No. DU70575801
State Bank Collect Reference No. DU70575801
Beneficiary: BLESSED SACRAMENT HIGH SCHOOL
Beneficiary: BLESSED SACRAMENT HIGH SCHOOL
Category: School Fees
Category: School Fees
Last Date of Payment: 25-07-2017 23:45
Last Date of Payment: 25-07-2017 23:45
Remitter Rudra Narayan Rout
Remitter Rudra Narayan Rout
Rs
Collection Amount 7,330.00 Rs
Comission 59.00 Collection Amount 7,330.00
Total (Rupees Seven Thousand Three Hundred Eighty Nine Only) 7,389.00 Comission 59.00
Total (Rupees Seven Thousand Three Hundred Eighty Nine Only) 7,389.00
Details of Cash / Cheques Rs p Mode of Payment (Choose Either Cash / Cheque)

Cash PAN:

Please quote your PAN for Cash remittance >= Rs. 50,000
Total Rs
Amount
Instructions for Depositor: This is not an e-receipt. After payment , please visit www.onlinesbi.com > 'State Bank Cash Notes Rs P
Collect' and click on the hyperlink at the bottom of the page to generate the e-receipt. *2000
*500
(To be Filled in by the Bank)
*100
Journal No: DU70575801 *50
*20
*10
Branch Name:
Coins
Branch Code: Deposit Date:
Total Rs

Branch Stamp Cheque

Cheque No: Cheque Date:
Drawee Bank: State Bank of India (other bank cheques not accepted under PAP)
Authorised Signatory
Branch:

Signature of the Depositor

Space for Bank use

Branch Stamp