This document is a fees payment challan for applicants applying for administrative officer positions at United India Insurance Co. Ltd. It provides instructions for applicants to pay a fee of 525 rupees for general candidates and 125 rupees for reserved category candidates. The challan includes fields for the applicant's name, address, signature and bank details where the fee can be deposited at State Bank of India in Chennai by April 4, 2012.

1. BRANCH COPY APPLICANT’S COPY
FEES PAYMENTCHALLAN FEES PAYMENT CHALLAN
STATE BANK OF INDIA STATE BANK OF INDIA
Recruitment of Administrative Officers in Recruitment of Administrative Officers in
UNITED INDIA INSURANCE CO. LTD UNITED INDIA INSURANCE CO. LTD
Date: Date:
Account No. 32225814791 at Triplicane, Chennai – 600 005 Account No. 32225814791 at Triplicane, Chennai – 600 005
Name of the Applicant: Name of the Applicant:
Address: Address:
Fee Required:(`. 525/- for GEN/OBC and `. 125/- for SC/ST/PwD/Permanent
` Fee Required: (`. 525/- for GEN/OBC and `. 125/- for SC/ST/PwD/Permanent
`
Employees of UIIC including Rs.25/- for bank charges) Employees of UIIC including Rs.25/- for bank charges)
Signature of the Applicant: Signature of the Applicant:
(To be filled by the Bank) (To be filled by the Bank)
Branch Stamp Branch Stamp
SBI Branch Name :________________ SBI Branch Name :______________
Branch Code Deposit Date Branch Code Deposit Date
04 2012 04 2012
Journal No. Journal No.
Authorised Signatory Authorised Signatory
Instructions to Banker Instructions to Banker
1. Please note to write the Journal No. in both the copies of challan. 1. Please note to write the Journal No in both the copies of challan.
2. For clarification in filling up the challan please call 044-28441887/ 9444399331 2. For clarification in filling up the challan please call 044-28441887/ 9444399331