CHINMAYA VIDYALAYA, B S CITY
Application for Transferring Caution Money/Other Amount in Student/Parent ‘s Bank A/C
Reg. No. ___________ (XII) ______________ Class : ____ Section: ______ BSL ____ Non-BSL ______
Student’s Name :
Father’s Name :
Mother’s Name :
Email-ID : Mobile No.:
Caution Money/other Amount : Rs - - - - - - - - -- - - - - - - - - -- - - -- - Words - - - - -- - - -- -- -- - -- - - -- --- -- - - - - - - -
Bank A/C No.: Name of A/c Holder: (i) First Holder
Bank Name : (ii) Second Holder
Branch : (iii) Other Holder
Branch Code :
IFSC Code:
I do here by confirm that I have collected the caution money of my ward from the school and state that there is no other amount/receivable
from Chinmaya Vidyalaya. All the dues have been settled and I will not have any claim Whatsoever from the school.
We request & authorize Chinmaya Vidyalaya to transfer above mentioned amount paid as the Caution Money/Other head at
the time of my admission in Chinmaya Vidyalaya in above Bank A/C .
NOTE : Please attached a CANCELLED CHEQUE
Signature of Student Signature of Parent.