12/31/12 NEET-UG- 2013

Central Board of Secondary Education Central Board of Secondary Education Central Board of Secondary Education
(Candidate Copy) (CBSE Copy) (Canara Bank Copy)

Canara Bank Canara Bank Canara Bank

NEET(UG )- 2013 NEET(UG )- 2013

NEET(UG )- 2013
Cash can be tendered at any CBS Branch of Canara Bank Cash can be tendered at any CBS Branch of Canara Bank
Cash can be tendered at any CBS Branch of Canara Bank
Canara Bank A/C No: 0388101021399 Canara Bank A/C No: 0388101021399
Canara Bank A/C No: 0388101021399
Registration No.: 1737340 Registration No. : 1737340
Registration No.: 1737340
Name : DEEPTI RAJPUT Name : DEEPTI RAJPUT
Name : DEEPTI RAJPUT
Date of Birth : 15/07/1994 Date of Birth : 15/07/1994
Date of Birth : 15/07/1994
Contact No. : +91-8171036946 Contact No.: +91-8171036946
Contact No.: +91-8171036946
Email Id : bhartinderrajput@ymail.com Email Id : bhartinderrajput@ymail.com
Email Id : bhartinderrajput@ymail.com
Fee: Rs. ____________________(To be filled by Candidate) Fee: Rs. ____________________(To be filled by Candidate)
Fee: Rs. ____________________(To be filled by Candidate)
__________________________________________________ (In Words) __________________________________________________ (In Words)
Fees: Rs. 1000 /if remitted on or before 31.12.2012. __________________________________________________ (In Words)
Fees: Rs. 1000 /-if remitted on or before 31.12.2012.
Fees: Rs. 2000 /-during 01.01.2013 to 31.01.2013. Fees: Rs. 1000 /-if remitted on or before 31.12.2012.
Fees: Rs. 2000 /-during 01.01.2013 to 31.01.2013.
Fee will not be accepted by the Bank after 31.01.2013. Fees: Rs. 2000 /-during 01.01.2013 to 31.01.2013.
Fee will not be accepted by the Bank after 31.01.2013.
Printed on: 31/12/2012 Fee will not be accepted by the Bank after 31.01.2013.
Printed on: 31/12/2012
Signature of the Candidate
Printed on: 31/12/2012 Signature of the Candidate
Signature of the Candidate

(To be filled by the bank)

(To be filled by the bank)
Canara Bank : (To be filled by the bank)
Canara Bank :
Branch Name: ___________________________ Canara Bank :
Branch Name: ___________________________
Branch Code: ___________________________ Branch Name: ___________________________
Branch Code: ___________________________
Transaction ID: ___________________________ Branch Code: ___________________________
Transaction ID: ___________________________
Deposit Date: _____/______/______ Transaction ID: ___________________________
Deposit Date: _____/______/______
Authorized Signatory Deposit Date: _____/______/______
Authorized Signatory
Branch Stamp Authorized Signatory
Branch Stamp
Branch Stamp
* *Candidate should login to the website again and complete part II * Bank Official is requested to enter Registration No. followed by
of the on line application after remittance of Fee. name of Candidate in the CBS database.

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