State Bank Collect

SB Collect

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NAME OF PARTTY/VENDOR/STAFF *

ADDRESS WITH PIN CODE

CONTACT/MOBILE NO. *

EMAIL ID

PURPOSE OF PAYMENT *

DETAILS OF PAYMENT *

REFERENCE/SANCTION ORDER NO.

AMOUNT OF ADVANCE DRAWN

REMARKS *

AMOUNT *

Remarks :

PLEASE SUBMIT A COPY OF THE ONLINE PAYMENT RECEIPT TO ACCOUNT SECTION, ICAR,UMIAM

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Individual

Organisation / Corporate

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Date of Birth * :

Mobile No * :

On successful completion of payment,you will receive the transaction reference number on this mobile number

Email ID :

On successful completion of payment, you will receive the transaction reference number on this email ID

Your Name * :

Organisation Name * :

Date of Incorporation * :

Mobile No * :

On successful completion of payment,you will receive the transaction reference number on this mobile number

Email Id :

On successful completion of payment, you will receive the transaction reference number on this email ID

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