Depositor Copy Branch Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch Date: 26-03-2019 Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Benificiary/Remittance Details Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect
Date: 26-03-2019
State Bank MOPS Reference No. CPP5296974
Benificiary/Remittance Details
Beneficiary: RRB Patna
State Bank MOPS Reference No. CPP5296974
Merchant Reference No: 830116699
Beneficiary: RRB Patna
Rs P
Merchant Reference No: 830116699
Collection Amount 500 00
Comission 0 00 Rs P
Total ( Five HundredRupees Only) 500 00 Collection Amount 500 00
Comission 0 00
Details of Cash / Cheques Rs p Total ( Five HundredRupees Only) 500 00
Mode of Payment (Choose Either Cash / Cheque)
Cash

Total Rs Amount
Cash Notes Rs P
Instructions for Depositor: This is not an e-receipt.
*2000
(To be Filled in by the Bank) *500
*200
Journal No:
*100
*50
*20
Branch Name:
*10
Branch Code: Deposit Date:

Coins
Branch Stamp Total Rs

Cheque
Authorised Signatory Cheque No:
Cheque Date:
Drawee Bank & Branch: State Bank of India

Branch :

Signature of the Depositor

Space for Bank use

Branch Stamp