Du 0455718k;lwd9
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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