Annexure
RECEIPT CHALLAN
(Form PTR 16, Rule 107 of PTR Volume)
(For use of Treasury only)
Serial No.: __________
Date:___________
(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)
(Designation of the DDO)
Plan/ Non
Plan/CSS
(“P” for Plan, “N” for Non-Plan , “S” for CSS)
Major Head
Sub-Major Head
Minor Head
Sub Head
(Complete Head of Account)
(Signature of Tenderer)
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(For use of Department of Treasury Only)
Order to the Bank
Correct
Receipts and Gross Receipt
Department Officer or DTO/ TO (With Seal)
-------------------------------------------------------------------------------------------
Received Rs. _______________ (in words) ___________________________________
Authorised Signatory of the Bank
(Details of the Money Deposited)
Drawee Bank
Branch
Cheque/ Draft
No.
Dated
Cash Details
Rupees
Paise
1.
Rs. 1000 X
2.
Rs.
500 X
3.
Rs.
100 X
4.
Rs.
50 X
5.
Rs.
20 X
6.
Rs.
10 X
7.
Rs.
5 X
8.
Rs.
2 X
9.
Rs.
1 X
10.
Coins
TOTAL
Notes
1. A Separate Challan may be used for every complete Head of Account.
2.
Incomplete / Incorrect Challan or Challan not verified by the Department are liable to be
rejected by the Bank.