West Bengal Joint Entrance Examinations Board
AQ-13/1, Salt Lake City, Sector-V, Kolkata- 700 091
PRE-RECEIPT BILL
(FOR BOARD OBSERVER)
Centre Code __________________
B.O. ID No __________________
Name of the Examination _____________________________________________________________________________________
Name of the Examinations Centre____________________________________________________________________________
Name of Board Observer______________________________________________________________________________________
Institution Designation :_______________________________Institution (full Name) _____________________________
__________________________________________________________________________________________________________________
Mailing Address________________________________________________________________________________________________
____________________________________________________________Mobile No___________________________________________
Office Telephone No._________________________________ Telephone No. ®_____________________________________
A. Honorarium ( as per annexed guideline) : ______________________________________________
Performed duty as Period of Performance Rate of remuneration / Total amount (Rs.)
honorarium
B. Travelling allowance (as per annexed guideline) :
Name of the place Date(s) and Time No. of days engaged Total (Rs.)
From (Station of
starting) :
To. (Reporting
station for duty)
:
Return to
starting sation :
Total-Rs.
Grand Total (A+B)= Rs.
Bank Details: (for money transfer though RTGS/ NEFT)
Name of the Bank Name of the Branch Bank A/C. No. IFS Code No
Declared that I have obtained/ applied for permission from the competent authority for performing
the above mentioned duty.
___________________________________
(Signature in full with date)
Received from the office of the West Bengal Joint Entrance Examination Board a Sum of Rs___________________
Rupees ) only.
Revenue.
Stamp (Signature in full with date)