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BRANCH COPY                                                                          CANDIDATE COPY



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

                          For Recruitment of Officer in                                                         For Recruitment of Officer in
                        Baroda Uttar Pradesh Gramin Bank                                                      Baroda Uttar Pradesh Gramin Bank
                             (To be filled by candidate)                                                           (To be filled by candidate)
Name of Account              B.U.P.G.B. Recruitment Project - Group –‘A’              Name of Account              B.U.P.G.B. Recruitment Project - Group –‘A’
Account Number               00520200000638                                           Account Number               00520200000638

Application Fee/Postal Charges (Tick whichever is applicable)                         Application Fee/Postal Charges (Tick whichever is applicable)
      SC/ST/PWD             Rs. 20/- per candidate (Only Postage Charges)                   SC/ST/PWD             Rs. 20/- per candidate (Only Postage Charges)
      OTHERS                Rs. 100/- per candidate (including Postage charges)             OTHERS                Rs. 100/- per candidate (including Postage charges)

Applicant’s Name              :       ………………………………………..……………………                       Applicant’s Name              :       ………………………………………..……………………
Date of Birth                 :       …………………………………………………………….                        Date of Birth                 :       …………………………………………………………….
BOB Branch Name               :       ………………………………………..……………………                       BOB Branch Name               :       ………………………………………..……………………
Branch Code No*. (SOL ID)     :       ……………………………………………………………...                      Branch Code No*. (SOL ID)     :       ……………………………………………………………...

Transaction ID. * .               :   ………………………………………..……………………                       Transaction ID. * .               :   ………………………………………..……………………
Date of Deposit                   :   ………………………………………..……………………                       Date of Deposit                   :   ………………………………………..……………………
Application Fee / postage Rs. :       ………………………………………..……………………                       Application Fee / postage Rs. :       ………………………………………..……………………
                                      (Rupees …………………………………………….only)                                                       (Rupees …………………………………………….only)


Signature of Depositor                                        Authorised Signatory    Signature of Depositor                                        Authorised Signatory
Phone/Mobile No. ……………………..                                   Branch Stamp            Phone/Mobile No. ……………………..                                   Branch Stamp


*Fee receiving branch is advised to invariably write the BRANCH CODE NO. (SOL ID) &   *Fee receiving branch is advised to
                                                                                                                     invariably write the BRANCH CODE NO. (SOL ID) &
TRANSACTION ID as above. WILL BE REQ                                                  TRANSACTION ID as above. WILL BE REQ

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  • 1. BRANCH COPY CANDIDATE COPY CHALLAN FORM (CASH VOUCHER) CHALLAN FORM (CASH VOUCHER) For Recruitment of Officer in For Recruitment of Officer in Baroda Uttar Pradesh Gramin Bank Baroda Uttar Pradesh Gramin Bank (To be filled by candidate) (To be filled by candidate) Name of Account B.U.P.G.B. Recruitment Project - Group –‘A’ Name of Account B.U.P.G.B. Recruitment Project - Group –‘A’ Account Number 00520200000638 Account Number 00520200000638 Application Fee/Postal Charges (Tick whichever is applicable) Application Fee/Postal Charges (Tick whichever is applicable) SC/ST/PWD Rs. 20/- per candidate (Only Postage Charges) SC/ST/PWD Rs. 20/- per candidate (Only Postage Charges) OTHERS Rs. 100/- per candidate (including Postage charges) OTHERS Rs. 100/- per candidate (including Postage charges) Applicant’s Name : ………………………………………..…………………… Applicant’s Name : ………………………………………..…………………… Date of Birth : ……………………………………………………………. Date of Birth : ……………………………………………………………. BOB Branch Name : ………………………………………..…………………… BOB Branch Name : ………………………………………..…………………… Branch Code No*. (SOL ID) : ……………………………………………………………... Branch Code No*. (SOL ID) : ……………………………………………………………... Transaction ID. * . : ………………………………………..…………………… Transaction ID. * . : ………………………………………..…………………… Date of Deposit : ………………………………………..…………………… Date of Deposit : ………………………………………..…………………… Application Fee / postage Rs. : ………………………………………..…………………… Application Fee / postage Rs. : ………………………………………..…………………… (Rupees …………………………………………….only) (Rupees …………………………………………….only) Signature of Depositor Authorised Signatory Signature of Depositor Authorised Signatory Phone/Mobile No. …………………….. Branch Stamp Phone/Mobile No. …………………….. Branch Stamp *Fee receiving branch is advised to invariably write the BRANCH CODE NO. (SOL ID) & *Fee receiving branch is advised to invariably write the BRANCH CODE NO. (SOL ID) & TRANSACTION ID as above. WILL BE REQ TRANSACTION ID as above. WILL BE REQ