THE ORIENTAL INSURANCE CO. LTD.

HEAD OFFICE : NEW DELHI-110 002

CHALLAN FORM FOR PAYMENT OF APPLICATION FEE
Direct Recruitment of Administrative Officer (Scale I)
Candidates Name

: _______________________________

Date of payment

: ________________________________

Account & TXN Codes

: 3034 & 51-80

Fee paid

: Rs.500/-(Rupees five hundred only)

Mode of payment
(Cash/DD/Banker Cheque) : ________________________________
In case of DD/Banker
Cheque - Bank Name &
Branch with code No.

: ________________________________

Address

: ________________________________

________________________________

________________________________
E-mail ID

: ________________________________

Mobile No.

: ________________________________

Tel. No. (with STD Code) : ________________________________

Signature of the Applicant