Bank Challan Form

Company Name(s): 
Documents: 

STATE BANK OF INDIA
STATE BANK OF INDIA
STATE BANK OF INDIA
STATE BANK OF INDIA
Branch Name Branch Code Date Branch Name Branch Code Date Branch Name Branch Code Date Branch Name Branch Code Date
Fee Code Fee Particulars Rs. Fee Code Fee Particulars Rs. Fee Code Fee Particulars Rs. Fee Code Fee Particulars Rs.
A Admission Fee A Admission Fee A Admission Fee A Admission Fee
B Enrolment Fee B Enrolment Fee B Enrolment Fee B Enrolment Fee
C Hostel Admn Fee C Hostel Admn Fee C Hostel Admn Fee C Hostel Admn Fee
D Caution Deposit D Caution Deposit D Caution Deposit D Caution Deposit
E Others E Others E Others E Others
J Late Fine J Late Fine J Late Fine J Late Fine
Total Total Total Total
Nature of payment Nature of payment Nature of payment Nature of payment
SBI Power Jyoti Account SBI Power Jyoti Account SBI Power Jyoti Account SBI Power Jyoti Account
Note: Fee Collection Charges of Rs. 30/per
challan is to be paid
additionally
Note: Fee Collection Charges of Rs. 30/per
challan is to be paid
additionally
Note: Fee Collection Charges of Rs. 30/per
challan is to be paid
additionally
Note: Fee Collection Charges of Rs. 30/per
challan is to be paid
additionally
Tezpur University, Tezpur 784028 Tezpur University, Tezpur 784028 Tezpur University, Tezpur 784028 Tezpur University, Tezpur 784028
Fee Payment Challan Fee Payment Challan Fee Payment Challan Fee Payment Challan
STUDENT'S COPY ACADEMIC'S COPY FINANCE'S COPY BANK'S COPY
Tezpur University Fee Collection Account Number Tezpur University Fee Collection Account Number Tezpur University Fee Collection Account Number Tezpur University Fee Collection Account Number
31223174021 31223174021 31223174021 31223174021
(Please key in the number correctly)
Roll No.
(Please key in the number correctly)
Roll No.
(Please key in the number correctly)
Roll No.
(Please key in the number correctly)
Students Name Student Name Student Name Student Name
Roll No.
Progm./Dept./Sem
Amount in words Amount in words Amount in words Amount in words
Progm./Dept./Sem Progm./Dept./Sem Progm./Dept./Sem
Journal No: Journal No:
Signature of the candidate/Remitter Signature of the candidate/Remitter Signature of the candidate/Remitter Signature of the candidate/Remitter
Seal/Date Authorized Signatory Seal/Date Authorized Signatory Seal/Date Authorized Signatory Seal/Date Authorized Signatory
For Bank use only Rs. For Bank use only Rs. For Bank use only Rs. For Bank use only Rs.
Journal No: Journal No:
NOTE: Hand over the University Copy to Tezpur University NOTE: Hand over the University NOTE: Hand over the University Copy to Tezpur University NOTE: Hand over the University Copy to Tezpur University Copy to Tezpur University