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Cash Only (NSEIT’s Copy) Cash Only (Candidate's Copy) Cash Only (Bank Copy)

Challan for remittance of Examination fee for Challan for remittance of Examination fee for Challan for remittance of Examination fee for
Test Test Test
PAN NO. AABCN0159P PAN NO. AABCN0159P PAN NO. AABCN0159P
PowerJyothi Account No: 33029715480 at PowerJyothi Account No: 33029715480 at PowerJyothi Account No: 33029715480 at
SBI, Mumbai Main Branch (CODE:00300) SBI, Mumbai Main Branch (CODE:00300) SBI, Mumbai Main Branch (CODE:00300)

Name : Mr. raj shaw Name : Mr. raj shaw Name : Mr. raj shaw

Date Of Birth : 10-May-1981 Date Of Birth : 10-May-1981 Date Of Birth : 10-May-1981

Mobile No : 9038826899 Mobile No : 9038826899 Mobile No : 9038826899

Examination Opted For( Tick mark) Examination Opted For( Tick mark) Examination Opted For( Tick mark)

UIDAI Certification for Operator - Supervisor UIDAI Certification for Operator - Supervisor UIDAI Certification for Operator - Supervisor

Operator Child Enrollment Lite Client Operator Child Enrollment Lite Client Operator Child Enrollment Lite Client

To be filled by the Bank: To be filled by the Bank: To be filled by the Bank:

Branch Name:………………………….......... Branch Name:………………………….......... Branch Name:…………………………..........


Branch Code:…………………………............ Branch Code:…………………………............ Branch Code:…………………………............
Journal Number: Journal Number: Journal Number:

Date of Deposit:………………………............. Date of Deposit:………………………............. Date of Deposit:……………………….............

Examination Fee : Rs.345 Examination Fee : Rs.345 Examination Fee : Rs.345

Bank Charges : Rs. 20 Bank Charges : Rs. 20 Bank Charges : Rs. 20

Examination Fee : Rs.365 Examination Fee : Rs.365 Examination Fee : Rs.365

(Rs. Three Hundred and Sixty five only.) (Rs. Three Hundred and Sixty five only.) (Rs. Three Hundred and Sixty five only.)

Signature of the Signature of the Authorized Signature of the Signature of the Authorized Signature of the Signature of the Authorized
Remitter Official with branch seal Remitter Official with branch seal Remitter Official with branch seal

* Pl. credit Rs 20/- to your Bank commission * Pl. credit Rs 20/- to your Bank commission * Pl. credit Rs 20/- to your Bank commission
A/c No. 98353XXXXXX . A/c No. 98353XXXXXX . A/c No. 98353XXXXXX .
* Branch should write the branch name, Br * Branch should write the branch name, Br * Branch should write the branch name, Br
Code, Journal No.& Date of remittance Code, Journal No.& Date of remittance Code, Journal No.& Date of remittance
invariably and hand over both the NSEIT’s copy invariably and hand over both the NSEIT’s copy invariably and hand over both the NSEIT’s copy
and applicant’s copy to the remitter, duly and applicant’s copy to the remitter, duly and applicant’s copy to the remitter, duly
signed. signed. signed.

Asst.Manager, SBI, Mumbai Main Branch. Asst.Manager, SBI, Mumbai Main Branch. Asst.Manager, SBI, Mumbai Main Branch.
POWER JYOTI SECTION POWER JYOTI SECTION POWER JYOTI SECTION
22661467, 22661765 Extn.244 22661467, 22661765 Extn.244 22661467, 22661765 Extn.244

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