|
TO BE FILLED IN BY THE REMITTER |
To be filled in by the Department
officer of the Treasury |
|
By whom tendered |
Name (or designation) &
address of the person on
whose behalf money is paid |
Full particulars of the
remittance and of authority
(if any) |
Amount |
Head of Account |
Order to the Bank |
|
|
|
|
Rs. |
Ps. |
|
Date
Correct Receive and grant
receipt
(Signature and full designation
of the officer ordering
the money to be paid in) |
|
|
|
|
Signature |
|
Total:- |
|
|
|
(in words) Rupees. |
To be used only in the case remittance
to the Bank throughDepartment Officer,Treasury Officer |
|
Received payment (in words)
Rupees |
|
Treasurer |
|
Accountant |
Date |
Treasury Officer |
