ABCDEFGHIJUVWXYZ
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CHALAN NO.
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 ચલણ નંબર ઓરીજનલ
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Chalan of Cash paid into the Treasury / Sub treasury / State / Reserve Bank of India at JAMJODHPUR
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5
To be filled in by the remmitterTo be filled in by the Departmental Officer
of the Treasure
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By Whom rended (Name)લગ્ન નોંધણી અધિકારી
Head of Account
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8
Name (or designation) andકરશનપરમુખ્ય સદર :-
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address of the person onગૌણ સદર :-
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whose behalf money is paidપેટા સદર :-
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14
Full particulars of the remittance and the authority if anyAmount
Order of the Bank
15
વર્ષ
Correct Receive and grant receipt
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Date/03/2017
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Signature and full designation of the officer
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Ordering the money to be paid in.
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Signature Total
To be used only in the case of remittance Bank
20
(in words) Rupees
એકસો પચાસ પુરા
through an officer of the Government
21
Received Payment
Date
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23
24
25
Treasure
Accountant
Treasury Officer/Agent -
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27
28
29
30
31
CHALAN NO.
32
 ચલણ નંબર ડુપ્લીકેટ
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Chalan of Cash paid into the Treasury / Sub treasury / State / Reserve Bank of India at JAMJODHPUR
34
35
To be filled in by the remmitterTo be filled in by the Departmental Officer
of the Treasure
36
By Whom rended (Name)લગ્ન નોંધણી અધિકારી
Head of Account
37
38
Name (or designation) andકરશનપરમુખ્ય સદર :-
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40
address of the person on ગૌણ સદર :-
41
42
whose behalf money is paid પેટા સદર :-
43
44
Full particulars of the remittance and the authority if anyAmount
Order of the Bank
45
વર્ષ
Correct Receive and grant receipt
46
 Date/03/2017
47
Signature and full designation of the officer
48
Ordering the money to be paid in.
49
Signature Total
To be used only in the case of remittance Bank
50
(in words) Rupees
એકસો પચાસ પુરા
through an officer of the Government
51
Received Payment
Date
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53
54
55
Treasure
Accountant
Treasury Officer/Agent -
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57
CHALAN NO.
58
 ચલણ નંબર ટ્રીપ્લીકેટ
59
Chalan of Cash paid into the Treasury / Sub treasury / State / Reserve Bank of India at JAMJODHPUR
60
61
To be filled in by the remmitterTo be filled in by the Departmental Officer
of the Treasure
62
By Whom rended (Name)લગ્ન નોંધણી અધિકારી
Head of Account
63
64
Name (or designation) andકરશનપરમુખ્ય સદર :-
65
66
address of the person onગૌણ સદર :-
67
68
whose behalf money is paidપેટા સદર :-
69
70
Full particulars of the remittance and the authority if anyAmount
Order of the Bank
71
વર્ષ
Correct Receive and grant receipt
72
 Date/03/2017
73
Signature and full designation of the officer
74
Ordering the money to be paid in.
75
Signature Total
To be used only in the case of remittance Bank
76
(in words) Rupees
એકસો પચાસ પુરા
through an officer of the Government
77
Received Payment
Date
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79
80
81
Treasure
Accountant
Treasury Officer/Agent -
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83
84
85
86
87
CHALAN NO.
88
 ચલણ નંબર ક્વા.ડુપ્લીકેટ
89
Chalan of Cash paid into the Treasury / Sub treasury / State / Reserve Bank of India at JAMJODHPUR
90
91
To be filled in by the remmitterTo be filled in by the Departmental Officer
of the Treasure
92
By Whom rended (Name)લગ્ન નોંધણી અધિકારી
Head of Account
93
94
Name (or designation) andકરશનપરમુખ્ય સદર :-
95
96
address of the person onગૌણ સદર :-
97
98
whose behalf money is paidપેટા સદર :-
99
100
Full particulars of the remittance and the authority if anyAmount
Order of the Bank