CHALLAN FORM (CASH VOUCHER) - 01 BRANCH COPY* MAHARASHTRA GRAMIN BANK Application Fee Details Recruitment of Officers Grade

III, II & I GROUPA

CHALLAN FORM (CASH VOUCHER) 01 CANDIDATES COPY MAHARASHTRA GRAMIN BANK Application Fee Details Recruitment of Officers Grade III, II & I GROUPA

Account No

: 80007010584 At Maharashtra Gramin Bank, Branch Shivajinagar, Nanded (M.S.)

Account No

: 80007010584 At Maharashtra Gramin Bank, Branch Shivajinagar, Nanded (M.S.) Candidates Name: Mr./Mrs/Kum.____________________________ Category* SC/ST/PWD Only Postage Rs 20/Others - Application Fee & Postage Rs. 100/:

Candidates Name: Mr./Mrs/Kum.__________________________ Category* SC/ST/PWD Only Postage Rs 20/Others - Application Fee & Postage Rs. 100/Date of Birth Date of Birth : Maharashtra Gramin Bank Branch : Branch Code No# Branch Code No# Journal No # (7 to 10 digits) Deposit Date : Application Fee/Postage Rs........................ (Rupees..........................................................................................only) : : Journal No # (7 to 10 digits) Deposit Date : : :

Maharashtra Gramin Bank Branch :

Application Fee/Postage Rs........................ (Rupees......................................................................................only) Signature of Depositor Address:.................... ................................... Phone/Mobi. No. Authorized Signatory Stamp

Signature of Depositor Address:.................... ................................... Phone/Mobi. No.

Authorized Signatory Stamp

* Tick whichever is applicable. # Fee receiving branch is advised to write the Deposit Journal No. and branch code no. above invariably.

* Tick whichever is applicable. # Fee receiving branch is advised to write the Deposit Journal No. and branch code no. above invariably.

CHALLAN FORM (CASH VOUCHER) - 02 BRANCH COPY MAHARASHTRA GRAMIN BANK Application fee details Recruitment of Office Assistant (Multipurpose) GROUP B

CHALLAN FORM (CASH VOUCHER) - 02 CANDIDATES COPY MAHARASHTRA GRAMIN BANK Application fee details Recruitment of Office Assistant (Multipurpose) GROUP B

Account no

: 80007010618 At MAHARASHTRA GRAMIN BANK Branch Shivajinagar, Nanded (M.S.)

Account no

: 80007010618 At MAHARASHTRA GRAMIN BANK, Branch Shivajinagar, Nanded (M.S.)

Candidates name: Mr./Mrs/Kum. __________________________ Category* SC/ST/PWD/Ex-serviceman Only Postage Rs 20/Others - Application Fee & Postage Rs. 100/:

Candidates name: Mr./Mrs/Kum._____________________________ Category* SC/ST/PWD/Ex-serviceman Only Postage Rs 20/Others - Application Fee & Postage Rs. 100/Date of birth :

Date of birth

MAHARASHTRA GRAMIN BANK Branch : Branch code no# Journal no # (7 to 10 digits) Deposit date : : :

MAHARASHTRA GRAMIN BANK Branch : Branch code no# Journal no # (7 to 10 digits) Deposit date : : :

Application fee/postage Rs........................ (Rupees.....................................................................................only)

Application fee/postage Rs........................ (Rupees..........................................................................................only)

Signature of depositor Address:.................... ...................................

Phone/mobi. No.

authorized signatory Stamp

Signature of depositor Address:.................... ................................... Phone/mobi. No.

authorized signatory Stamp

* tick whichever is applicable. # Fee receiving branch is advised to write the deposit journal no. And branch code no. Above invariably.

* tick whichever is applicable. # Fee receiving branch is advised to write the deposit journal no. And branch code no. Above invariably.