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BITS HD-2013 Print Challan Form .

This document is a print challan form for depositing fees for the BITS HD-2013 program. It contains fields for the applicant and institution names, application number, year, course details, fee amount, bank account details, denomination of cash deposited, transaction ID, and signature sections. The form is triplicated with copies for the applicant, institution, and bank.

Uploaded by

Naveen Kumar Sinha
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247 views1 page

BITS HD-2013 Print Challan Form .

This document is a print challan form for depositing fees for the BITS HD-2013 program. It contains fields for the applicant and institution names, application number, year, course details, fee amount, bank account details, denomination of cash deposited, transaction ID, and signature sections. The form is triplicated with copies for the applicant, institution, and bank.

Uploaded by

Naveen Kumar Sinha
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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:. BITS HD-2013 Print Challan Form .

http://www.bitsadmission.com/hd/BITSHDAPPLY/Challan.asp

(Applicant Copy) (TO BE HANDED OVER TO DEPOSITOR FOR RECORD)

(Institution Copy) (TO BE HANDED OVER TO DEPOSITOR FOR SENDING TO BITS)

(Bank's Copy) (TO BE RETAINED BY THE RECEIVING BRANCH)

Birla Institute of Technology & Science, Pilani PAN Number: AAATB2599R

Birla Institute of Technology & Science, Pilani PAN Number: AAATB2599R

Birla Institute of Technology & Science, Pilani PAN Number: AAATB2599R

Name of branch: Date of Deposit:

: _____________________ : ______________ (DD/MM/YY)

Name of branch: Date of Deposit:

: _____________________ : ______________ (DD/MM/YY)

Name of branch: Date of Deposit:

: _____________________ : ______________ (DD/MM/YY)

(to be treated by student as fee receipt) Account to be credited :

(to be treated by student as fee receipt) Account to be credited :

(to be treated by student as fee receipt) Account to be credited :

0036SLFEECOL

0036SLFEECOL

0036SLFEECOL

1. Institution Name

FCBITS Naveen Kumar 110665 2013 HD 1775/-

1. Institution Name

FCBITS Naveen Kumar 110665 2013 HD 1775/-

1. Institution Name

FCBITS Naveen Kumar 110665 2013 HD 1775/-

2. Student/ Applicant Name : 3. Roll no/ Application No. 4. Class/ Year (BITS HD) 5. Section/ Course 6. Amount (Rs.) 7. Amount in words : : : :

2. Student/ Applicant Name : 3. Roll no/ Application No. 4. Class/ Year (BITS HD) 5. Section/ Course 6. Amount (Rs.) 7. Amount in words : : : :

2. Student/ Applicant Name : 3. Roll no/ Application No. 4. Class/ Year (BITS HD) 5. Section/ Course 6. Amount (Rs.) 7. Amount in words : : : :

: Rs. One thousand Seven hundred and Seventy five only. Amount

: Rs. One thousand Seven hundred and Seventy five only. Amount

: Rs. One thousand Seven hundred and Seventy five only. Amount

Cash Details: Denomination 1000 * 500 * 100 * 50 * 20 * 10 * 5* Coins Total No. of notes/coins

Cash Details: Denomination 1000 * 500 * 100 * 50 * 20 * 10 * 5* Coins Total No. of notes/coins

Cash Details: Denomination 1000 * 500 * 100 * 50 * 20 * 10 * 5* Coins Total No. of notes/coins

Branch Transaction ID:____________________


(This field is Mandatory)

Branch Transaction ID:____________________


(This field is Mandatory)

Branch Transaction ID:____________________


(This field is Mandatory)

__________________ Signature & Stamp ICICI Bank Ltd

__________________ Signature of Depositor

__________________ Signature & Stamp ICICI Bank Ltd

__________________ Signature of Depositor

__________________ Signature & Stamp ICICI Bank Ltd

__________________ Signature of Depositor

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5/16/2013 11:34 PM

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