CHALLAN FORM (CASH VOUCHER) CHALLAN FORM (CASH VOUCHER)

BRANCH COPY CANDIDATE’S COPY

SAURASHTRA GRAMIN BANK-02 SAURASHTRA GRAMIN BANK - 02
Application Fee Details Application Fee Details Affix Pass port
Recruitment of Officer Scale-I,II,III Recruitment of Officer Scale-I,II,III size Photograph
in Saurashtra Gramin Bank in Saurashtra Gramin Bank

Account No : 78001352805 ** Account No : 78001352805

At SGB Dhebar Road Branch, Rajkot ( code-182) At SGB Dhebar Road Branch, Rajkot ( code-182)

Candidate’s Name : Mr./Mrs/Kum. Candidate’s Name : Mr./Mrs/Kum.

Category* SC/ST/PC/EXS – Only Postage Rs 75/- Category* SC/ST/PC/EXS – Only Postage Rs 75/-
OBC/GEN - Application Fee & Postage Rs.300/- OBC/GEN - Application Fee & Postage Rs.300/-
Date of Birth Date of Birth

SGB Branch Name SGB Branch Name

Branch Code No# Branch Code No#

Journal No # (7 to 10 digits) Journal No # (7 to 10 digits)

Deposit Date Deposit Date

Application Fee/Postage Rs........................ Application Fee/Postage Rs........................

(Rupees..........................................................................................only) (Rupees..........................................................................................only)

Signature of Depositor Authorized Signatory Signature of Depositor Authorized Signatory

Address:.................... Stamp Address:.................... Stamp
................................... ...................................
Phone/Mob. No. Phone/Mob. No.
* Tick whichever is applicable. * Tick whichever is applicable.
# Fee receiving branch is advised to write the Deposit Journal No. and branch # Fee receiving branch is advised to write the Deposit Journal No. and branch
code no. above invariably. If the Journal Number shown by the system is code no. above invariably. If the Journal Number shown by the system is
less than seven digits, the Journal Number must be prefixed by adequate less than seven digits, the Journal Number must be prefixed by adequate
zeros. Example: If journal No. is 4444 then it should be written as 0004444. zeros. Example: If journal No. is 4444 then it should be written as 0004444.
**This is a fees collection account no fund transfer charges may be recovered (This part of the challan will be required to be submitted by the candidate
from the candidate. at the time of written test along with a photograph, otherwise the
candidate will not be allowed to appear at the examination.)
 CHALLAN FORM (CASH VOUCHER) CHALLAN FORM (CASH VOUCHER)
BRANCH COPY CANDIDATE’S COPY
SAURASHTRA GRAMIN BANK-02 SAURASHTRA GRAMIN BANK - 02
Application Fee Details Application Fee Details Affix Pass port
Office Assistant(Multi Purpose) Office Assistant(Multi Purpose) size Photograph
in Saurashtra Gramin Bank in Saurashtra Gramin Bank

Account No : 78001352805 ** Account No : 78001352805

At SGB Dhebar Road Branch, Rajkot ( code-182) At SGB Dhebar Road Branch, Rajkot ( code-182)

Candidate’s Name : Mr./Mrs/Kum. Candidate’s Name : Mr./Mrs/Kum.

Category* SC/ST/PC/EXS – Only Postage Rs 75/- Category* SC/ST/PC/EXS – Only Postage Rs 75/-
OBC/GEN - Application Fee & Postage Rs.300/- OBC/GEN - Application Fee & Postage Rs.300/-
Date of Birth Date of Birth

SGB Branch Name SGB Branch Name

Branch Code No# Branch Code No#

Journal No # (7 to 10 digits) Journal No # (7 to 10 digits)

Deposit Date Deposit Date

Application Fee/Postage Rs........................

Application Fee/Postage Rs........................ (Rupees..........................................................................................only)
(Rupees..........................................................................................only)

Signature of Depositor Authorized Signatory Signature of Depositor Authorized Signatory

Address:.................... Stamp Address:.................... Stamp
................................... ...................................
Phone/Mob. No. Phone/Mob. No.
* Tick whichever is applicable. * Tick whichever is applicable.
# Fee receiving branch is advised to write the Deposit Journal No. and branch # Fee receiving branch is advised to write the Deposit Journal No. and branch
code no. above invariably. If the Journal Number shown by the system is code no. above invariably. If the Journal Number shown by the system is
less than seven digits, the Journal Number must be prefixed by adequate less than seven digits, the Journal Number must be prefixed by adequate
zeros. Example: If journal No. is 4444 then it should be written as 0004444. zeros. Example: If journal No. is 4444 then it should be written as 0004444.
**This is a fees collection account no fund transfer charges may be recovered (This part of the challan will be required to be submitted by the candidate
from candidate. at the time of written test along with a photograph, otherwise the
candidate will not be allowed to appear at the examination.)