G. P. Fund Debit/Credit cum withdrawl Statement of Sh/Smt..............................................................

A/C
No..........................
Name of Treasury
..................................................................................................................................Year..............................
S.
No.

Mont
h

Try.
Vr.No
.

Dat
e

G. Total

Nature
of the
bill

Gross
Amount of
the bill

Net
Amount of
the bill

Amount Pertaining to
subscriber
Monthl Ded.
Refun
Total
y
D
d
Subsc.
A Of Adv
15%

Total

Total
Amount of
the
Schedule

withdrawl if any with

Try,
Vr.No. & Date
Amou
nt

Try.Vr

Data

Signature of D D O