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

Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect

Cheque No:

Cheque Date:

Drawee Bank: State Bank of India (other bank cheques not accepted under PAP)

Branch:

Space for Bank use

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

Beneficiary/Remittance Details

State Bank Collect Reference No. DU13057977

Beneficiary: UP SUBORDINATE SERVICES SELECTION COMMISSION

Category: APPLICATION FEE

Last Date of Payment: 20-03-2015 23:45

Remitter Pradip kumar

Rs

Collection Amount 160.00

Comission 0.00

Total (Rupees One Hundred Sixty Only) 160.00

(To be Filled in by the Bank)

Branch Name:

Date: 13-03-2015

Depositor Copy

pRsDetails of Cash / Cheques

Total Rs

Instructions for Depositor: This is not an e-receipt. After payment , please visit > 'State Bankwww.onlinesbi.comCollect' and click on the hyperlink at the bottom of the page to generate the e-receipt.

DU13057977 Journal No:

Deposit Date:Branch Code:

Branch Stamp

Authorised Signatory

Branch Copy

Date: 13-03-2015

Beneficiary/Remittance Details

State Bank Collect Reference No. DU13057977

Beneficiary: UP SUBORDINATE SERVICES SELECTION COMMISSION

Category: APPLICATION FEE

Last Date of Payment: 20-03-2015 23:45

Remitter Pradip kumar

Rs

Collection Amount 160.00

Comission 0.00

Total (Rupees One Hundred Sixty Only) 160.00

Cheque

Cash

(Choose Either Cash / Cheque)Mode of Payment

PAN:

Please quote your PAN for Cash remittance >= Rs. 50,000

Cash Notes Rs PAmount

*1000

*500

*100

*50

*20

*10

Coins

Total Rs

Signature of the Depositor

Branch Stamp