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Nirmal Darbar Punjab National Bank Payee Challan

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					    *Important Note (for Bank Official) Use PAYFEE menu option for data OF “TM”
  CAUTION : USE “PAYFEE” MENU :OPTION IN FINACLE INSTEAD entry in                                                                                             `Devotee Copy

                                                                        Bank Copy
                                                                                                                        Punjab National Bank                    DIST. NO.

                         Punjab National Bank                        DIST. NO.
                                                                                               Branch
                                                                                               Institute Name          NIRMAL DARBAR
 Branch
                                                                                               Institute ID            NIRDA
 Institute Name    NIRMAL DARBAR
                                                                                                                                     Date of Deposit
 Institute ID      NIRDA
                                                                                                                                          DD     MM     YY
                                      Date of Deposit                                           DETAILS OF THE DEVOTEE Roll/Mobile No……………………………………….
                                                    DD  MM  YY                                Devotee
  DETAILS OF THE DEVOTEE         Roll/Mobile No. ……………………………………                               Name
Devotee                                                                                       Course SMG PUJA  DONAT APONT PHAPN   DASND PURAN GRPAP CD PHOTO
Name                                                                                          Code
Course  SMG PUJA   DONAT      APONT    PHAPN     DASND     PURAN     GRPAP       CD   PHOTO
                                                                                              Fee     (City of
Code                                                                                          Code* Smagam)
Fee *   (City of
                                                                                               Cash Deposit:                    Cheque/DD Deposit:
Code    Smagam)
                                                                                                                                              Date of    Name of
 Cash Deposit:                  Cheque/DD Deposit:                                                               Rs.     Ps    Chq/DD No                              Rs.   Ps
                                                                                               Denomination                                   Chq/DD      Bank
                                            Date of        Name of                                                                                        PNB
                   Rs.   Ps   Chq/DD No                                    Rs.        Ps
 Denomination                               Chq/DD          Bank                                 1000 *
                                                            PNB                                   500 *
   1000 *                                                                                         100 *
    500 *                                                                                          50 *
    100 *                                                                                          20 *
     50 *                                                                                          10 *                          Total fee payable Rs.                -
     20 *                                                                                           5*                           Commission        Rs.         0 0 - 0 0
     10 *                          Total fee payable Rs.                -                       Coins *                          Total amount      Rs.                -
      5*                           Commission        Rs.         0 0 - 0 0                        Total
  Coins *                          Total amount      Rs.                -                      Amount (in words): Rs. ______________________________________________________
    Total                                                                                      __________________________________________________________________________
 Amount (in words): Rs. ______________________________________________________
 __________________________________________________________________________                    Name of the Depositor
                                                                                               Signature
 Name of the Depositor
                                                                                               Address for communication
 Signature
 Address for communication                                                                     Phone No.

 Phone No.                                                                                                                     For Bank use only
                                                                                               Acknowledgement                                          Cashier/Officer
                                For Bank use only
 Acknowledgement                                         Cashier/Officer
INSTITUTE ID   NIRDA                                              Instructions

CHARGES        Rs.00/- per transaction for    1) Mention “Pay Fee” category at the Bank.
               collection of fee              2) Fill both Bank copy and Devotee Copy.
                                              3)VERY IMPORTANT: Mobile Number, Name of
COURSE         Course Name         Course     Devotee & City of Samagam must be entered.
CODES                              Code       4) Checks or Demand Drafts should be made in
                                              the name of "Nirmal Darbar".
               SAMAGAM             SMG        5) Demand Draft should be made payable at
               PUJA                PUJA       "Punjab National Bank(Any Branch)".
               DONATION            DONAT      6) After Deposit is complete, send the devotee
               APPOINTMENT         APONT      copy of this form by courier to :
               DASWAND             DASND      Nirmal Darbar
               PURANMASHI          PURAN      1412A Chiranjiv Tower 43
                                              Nehru Place
               GROUP               GRPAP      New Delhi, ND 110019
               APPOINTMENT                    Ph: 011-40766400
               CD                  CD
               PHOTO               PHOTO      Description of each Item on the form
                                              Branch: Enter the name of PNB Branch.
FEE CODES      CITY OF             FEE CODE   Institute Name: "NIRMAL DARBAR" (Already filled
               SAMAGAM                        for you)
                                              Institute Id: “NIRDA” (Already filled)
               DELHI               DELHI      Date of Deposit: Enter date of deposit in DD MM
               AHMEDABAD           AHMED      YY format
               SURAT               SURAT      Details of Devotee
               BARODA              BAROD      Roll/Mobile No. : Mobile number of Devotee*
               GOA                 GOA
               BHUBNESHWAR         BHUBN      Devotee Name: Name of Devotee
               UDAIPUR             UDAIP      Course Code: The purpose for which this deposit is
               HYDERABAD           HYDER      being made. List of Codes and their purpose are
               BANGLORE            BANGL      mentioned on this page. Enter Course Code of
               MUMBAI              MUMBA      corresponding Course Name.
               PUNE                PUNE       Fee Code(City of Samagam)*: City of Samagam,
               RAIPUR              RAIPU      which you are registering. List of Station(Fee codes)
               NAGPUR              NAGPU      are given below. You can leave it blank if payment
               LUCKNOW             LUCKN      is not for Samagam.
               KANPUR              KANPU      Cash Deposit: Fill in the details if depositing cash.
               INDORE              INDOR      Check/DD deposit: Fill in details if payment is by
               PATNA               PATNA      Check or Demand Draft
               JAIPUR              JAIPU      Total Fee Payable: Enter Total amount
               CHENNAI             CHENN      Commission: This amount is 0 Rs/-. Not Applicable
               CHANDIGARH          CHAND      for devotees.
               LUDHIANA            LUDHI      Total Amount*: Same as Total Fee Payable.
               PATIALA             PATIA      Amount in Words: Write the total amount in
               SOLAN               SOLAN      words.
               SHIMLA              SHIML      Name of Depositor*: Write full name of depositor
               MANDI               MANDI      Signature: Sign in this section
               BHOPAL              BHOPA      Address for Communication: Enter your postal
               JULLUNDER           JULLU
                                              address.
               PATHANKOT           PATHA
                                              Phone No*: Enter your mobile phone number.
               KULU                KULU
                                              *These fields must be entered. (FIELDS
               JAMMU               JAMMU
                                              HIGLIGHTED IN RED ARE COMPULSORY TO
                                              FILL)

				
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