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Annexure RECEIPT CHALLAN Form PTR 16 Rule 107 of PTR Volume For use of Treasury only Date Serial No. To be filled in by the tenderer By Whom Tendered Purpose of Deposit Amount in figures Rs. in words Rs. Treasury / Sub Treasury Code Name of the Treasury/ Sub Treasury DDO Code whose behalf Money deposited Plan/ Non Plan/CSS Major Head Designation of the DDO P for Plan N for Non-Plan S for CSS Minor Head Sub Head Complete Head of Account Signature of Tenderer ------------------------------------------------------------------------------------------ For use of Department of Treasury Only Order to the Bank Correct Receipts and Gross Receipt Department Officer or DTO/ TO With Seal Authorised Signatory of the Bank Details of the Money Deposited Drawee Bank Notes Branch Cheque/ Draft No* Dated Cash Details Rupees Paise Rs. 1000 X Rs. 50 X 20 X 10 X 5X 2X 1X Coins TOTAL A Separate Challan may be used for every complete Head of Account. Incomplete / Incorrect Challan or Challan not verified by the Department are liable to be rejected by the Bank. in words Rs. Treasury / Sub Treasury Code Name of the Treasury/ Sub Treasury DDO Code whose behalf Money deposited Plan/ Non Plan/CSS Major Head Designation of the DDO P for Plan N for Non-Plan S for CSS Minor Head Sub Head Complete Head of Account Signature of Tenderer ------------------------------------------------------------------------------------------ For use of Department of Treasury Only Order to the Bank Correct Receipts and Gross Receipt Department Officer or DTO/ TO With Seal Authorised Signatory of the Bank Details of the Money Deposited Drawee Bank Notes Branch Cheque/ Draft No* Dated Cash Details Rupees Paise Rs. 1000 X Rs. 50 X 20 X 10 X 5X 2X 1X Coins TOTAL A Separate Challan may be used for every complete Head of Account. 1000 X Rs. 50 X 20 X 10 X 5X 2X 1X Coins TOTAL A Separate Challan may be used for every complete Head of Account. Incomplete / Incorrect Challan or Challan not verified by the Department are liable to be rejected by the Bank. in words Rs. Treasury / Sub Treasury Code Name of the Treasury/ Sub Treasury DDO Code whose behalf Money deposited Plan/ Non Plan/CSS Major Head Designation of the DDO P for Plan N for Non-Plan S for CSS Minor Head Sub Head Complete Head of Account Signature of Tenderer ------------------------------------------------------------------------------------------ For use of Department of Treasury Only Order to the Bank Correct Receipts and Gross Receipt Department Officer or DTO/ TO With Seal Authorised Signatory of the Bank Details of the Money Deposited Drawee Bank Notes Branch Cheque/ Draft No* Dated Cash Details Rupees Paise Rs. 1000 X Rs. 50 X 20 X 10 X 5X 2X 1X Coins TOTAL A Separate Challan may be used for every complete Head of Account. Incomplete / Incorrect Challan or Challan not verified by the Department are liable to be rejected by the Bank. .

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