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Fee Payment Form - 28650

This document is a fee payment receipt from Tata Institute of Social Sciences (TISS) to a State Bank of India branch. It contains payment details for a student including their name, enrollment number, program, semester, and itemized fees paid. The receipt is made in triplicate with copies for the bank, TISS, and student. It also notes an additional Rs. 50 bank charge and spells out the total payment amount in words.

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Saswat Mousam Nayak
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194 views

Fee Payment Form - 28650

This document is a fee payment receipt from Tata Institute of Social Sciences (TISS) to a State Bank of India branch. It contains payment details for a student including their name, enrollment number, program, semester, and itemized fees paid. The receipt is made in triplicate with copies for the bank, TISS, and student. It also notes an additional Rs. 50 bank charge and spells out the total payment amount in words.

Uploaded by

Saswat Mousam Nayak
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BANK COPY TISS COPY STUDENT COPY

Date:____/___/20___ Bank Journal No. _________ Date:____/___/20___ Bank Journal No._________ Date:____/___/20___ Bank Journal No. _________

TATA INSTITUTE OF SOCIAL SCIENCES TATA INSTITUTE OF SOCIAL SCIENCES TATA INSTITUTE OF SOCIAL SCIENCES
MUMBAI – 400 088 MUMBAI – 400 088 MUMBAI – 400 088
STATE BANK OF INDIA (Deonar Branch) STATE BANK OF INDIA (Deonar Branch) STATE BANK OF INDIA (Deonar Branch)
Branch Code 3109 Branch Code 3109 Branch Code 3109
TISS — Fees A/c 31134925071 TISS — Fees A/c 31134925071 TISS — Fees A/c 31134925071

Student Name: ______________________________ Student Name: ______________________________ Student Name: ______________________________

Enrol. No./Reg. No.__________ Sem. No. I / II / III / IV Enrol. No./Reg. No. _________ Sem. No. I / II / III / IV Enrol. No./Reg. No. __________Sem. No. I / II / III / IV

Programme: ________________________________ Programme: ________________________________ Programme:_________________________________

Sl. Particulars Amount Sl. Particulars Amount Sl. Particulars Amount


No. Rs. No. Rs. No. Rs.
1. Fees 1. Fees 1. Fees
2. Insurance 2. Insurance 2. Insurance
3. Development Fee 3. Development Fee 3. Development Fee
4. Study Tour/Rural Camp 4. Study Tour/Rural Camp 4. Study Tour/Rural Camp
5. Deposits 5. Deposits 5. Deposits
6. Hostel Charges 6. Hostel Charges 6. Hostel Charges
7. Dining Hall Advance 7. Dining Hall Advance 7. Dining Hall Advance
8. 8. 8.
9. 9. 9.
10. 10. 10.
Total Rs. Total Rs. Total Rs.
Note: Additional Bank Charges Rs. 50/- Note: Additional Bank Charges Rs. 50/- Note: Additional Bank Charges Rs. 50/-

Amount in Words (Rupees _____________________ Amount in Words (Rupees ____________________ Amount in Words (Rupees _____________________

_________________________________________ ) __________________________________________) _________________________________________ )

__________________ _____________________ ___________________ ____________________ __________________ _____________________


Student’s Signature Bank Seal with Student’s Signature Bank Seal with Student’s Signature Bank Seal with
Signature Signature Signature

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