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GOVERNMENT OF KERALAGOVERNMENT OF KERALAGOVERNMENT OF KERALA
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 CHALAN ORIGINAL CHALAN DUPLICATE CHALAN TRIPLICATE
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FORM T.R. 12FORM T.R. 12FORM T.R. 12
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[See Rules 102(c) and 124 of Kerala Treasury Code]
Chalan for Payment of Money into the District Treasury/Sub
Treasury/State Bank of India/State Bank of Travancore		[See Rules 102(c) and 124 of Kerala Treasury Code]
Chalan for Payment of Money into the District Treasury/Sub
Treasury/State Bank of India/State Bank of Travancore		[See Rules 102(c) and 124 of Kerala Treasury Code]
Chalan for Payment of Money into the District Treasury/Sub
Treasury/State Bank of India/State Bank of Travancore
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at………………………………………………at…... ………………………………..at………………………………
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Computer Seq.Date:Computer Seq.Date:Computer Seq.Date:
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Head of Account
Head of Account
Head of Account
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MajSmj.Min.SubDet.Obj.S.ObjMajSmj.Min.SubDet.Obj.S.ObjMajSmj.Min.SubDet.Obj.S.Obj
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DDO Code:( Dept)(DDO)DDO Code:( Dept)(DDO)DDO Code:( Dept)(DDO)
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SDO Code:SDO Code:SDO Code:
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By whom paid and name and
address of the person on
whose behalf money is paid		Purpose of
remittance
and authority, if		Amount (in
Rs.)		Order to
the
Bank		By whom paid and name and
address of the person on
whose behalf money is paid		Purpose of
remittance
and authority, if		Amount (in
Rs.)		Order to
the
Bank		By whom paid and name and
address of the person on
whose behalf money is paid		Purpose of
remittance
and authority, if		Amount (in
Rs.)		Order to
the
Bank
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Signature& Designation of
the Departmental Officer
countersigning the remittance		Signature& Designation of
the Departmental Officer
countersigning the remittance		Signature& Designation of
the Departmental Officer
countersigning the remittance
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TotalTotalTotal
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Total in wordsTotal in wordsTotal in words
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Signature of Remitter
Signature of Remitter
Signature of Remitter
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Received Rs………………….
Received Rs………………….
Received Rs………………….
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(Rupees…………………………………………………………………………………………………...………. only)(Rupees…………………………………………………………………………………………………...………. only)(Rupees…………………………………………………………………………………………………...………. only)
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DateSealDateSealDateSeal
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Signature of Treasurer
/Cashier		Treasury Officer/
Bank Manager		Signature of Treasurer
/Cashier		Treasury Officer/
Bank Manager		Signature of Treasurer
/Cashier		Treasury Officer/
Bank Manager
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Note : 1. The seal/stamp of the Treasury/Bank of collection shall be
2. If remittance is in official capacity (*SDO/DDO), write corresponding code in the column provided.
3. If loan repayment of SDO, write instalment number in the purpose column		Note : 1. The seal/stamp of the Treasury/Bank of collection shall be
2. If remittance is in official capacity (*SDO/DDO), write corresponding code in the column provided.
3. If loan repayment of SDO, write instalment number in the purpose column		Note : 1. The seal/stamp of the Treasury/Bank of collection shall be
2. If remittance is in official capacity (*SDO/DDO), write corresponding code in the column provided.
3. If loan repayment of SDO, write instalment number in the purpose column
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