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 & Branch:   State Bank of India

Branch :

Space for Bank use

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

Beneficiary/Remittance Details

State Bank Collect Reference No. DU04557189

Beneficiary: INDIAN INSTITUTE OF MANAGEMENT TRICHY

Category: ADMISSION 2014-16 PAYMENT

Last Date of Payment: 26-05-2014

Remitter Akshay Gajghate

Rs

Collection Amount 50,000.00

Comission 50.00

Total (Rupees Fifty Thousand Fifty Only) 50,050.00

(To be Filled in by the Bank)

Branch Name:    

Date:   25-05-2014

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.

 

     DU04557189     Journal No:  

Deposit Date:Branch Code:         

Branch Stamp

Authorised Signatory

Branch Copy

Date:  25-05-2014

Beneficiary/Remittance Details

State Bank Collect Reference No. DU04557189

Beneficiary: INDIAN INSTITUTE OF MANAGEMENT TRICHY

Category: ADMISSION 2014-16 PAYMENT

Last Date of Payment: 26-05-2014

Remitter Akshay Gajghate

Rs

Collection Amount 50,000.00

Comission 50.00

Total (Rupees Fifty Thousand Fifty Only) 50,050.00

 Cheque

 Cash

  (Choose Either Cash / Cheque)Mode of Payment

Cash Notes Rs PAmount

*1000

*500

*100

*50

*20

*10

Coins

Total Rs

Signature of the Depositor

Branch Stamp