CHALLAN NO.

CHALLAN OF CASH PAID INTO THE Treasury/ Sub- Treasury

To be filled in by the remitter To be filled in by the Departmental Officer or the Treasury
By whom Tendered Name	Name or Designation & address of the person on whose behalf money is paid	Full particulars of the remittance & authority (if any)	Amount		Head of Account
			Rs.	P.

( In words)

Signature:

Date :

Received Payment Date……….. Treasury Officer/Agent

Treasurer Accountant