PAY-IN-SLIP
BANK’S COPY
PAY-IN-SLIP
CANDIDATES’S COPY
KVPY – 2009 INDIAN INSTITUTE OF SCIENCE BANGALORE – 560 012
TO BE ENCLOSED WITH THE APPLICATION
PAY-IN-SLIP
KVPY – 2009 INDIAN INSTITUTE OF SCIENCE BANGALORE – 560 012
KVPY – 2009 INDIAN INSTITUTE OF SCIENCE BANGALORE – 560 012
State Bank of India
State Bank of India
State Bank of India
Payable at all Branches of SBI in India
Payable at all Branches of SBI in India
Payable at all Branches of SBI in India
Branch Name and Address:
Branch Name and Address:
Branch Name and Address:
Paid into the credit of Administrative Executive, KVPY, IISc., Bangalore – 560 012
Paid into the credit of Administrative Executive, KVPY, IISc., Bangalore – 560 012
Paid into the credit of Administrative Executive, KVPY, IISc., Bangalore – 560 012
SB A/C No. 10270577392
SB A/C No. 10270577392
SB A/C No. 10270577392
Rupees…………………………
Rs.
Rupees…………………………
Rs.
Rupees…………………………
Rs.
Application No.
Application No.
Application No.
………………………………. ………………………………. Name and ………………………………. address of the candidate ………………………………. ………………………………. ………………Pin……………
………………………………. ………………………………. Name and ………………………………. address of the candidate ………………………………. ………………………………. ………………Pin……………
Application Processing fee: Tick as applicable (last date to remit the money – 10/09/09) General Category SC/ST Category (a) Rs. 200/- □ (a) Rs. 100/- □ (b) Bank charges if (b) Bank charges if any any
Application Processing fee: Tick as applicable (last date to remit the money – 10/09/09) General Category SC/ST Category (a) Rs. 200/- □ (a) Rs. 100/- □ (b) Bank charges if (b) Bank charges if any any
Application Processing fee: Tick as applicable (last date to remit the money – 10/09/09) General Category SC/ST Category (a) Rs. 200/- □ (a) Rs. 100/- □ (b) (b) Bank charges (b) (b) Bank charges if any if any
Signature of the Depositor
Signature of the Depositor
Signature of the Depositor
Signature of the Cashier
Signature of the Cashier
Signature of the Cashier
Bank Stamp with date
Bank Stamp with date
Bank Stamp with date
Name and address of the candidate
………………………………. ………………………………. ………………………………. ………………………………. ………………………………. ………………Pin……………