Form S.T.R. 4
(See rule S.T.R. 2.7 & 2.20)
CHALLAN
(FOR USE IN TREASURY OFFICE )
Challan No. : ________________ Challan
Date : ___/____/
(TO BE
FILLED IN BY THE TENDERER)
Tendered By:
_________________________________________________________________________
_____________________________________________________________________________________
Particulars:
___________________________________________________________________________
_____________________________________________________________________________________
Amount Rs. _______________(in words)
Rupees _____________________________________________
(Signature
of Tenderer)
_____________________________________________________________________________________
(TO BE
FILLED BY THE DEPARTMENT OFFICER OR THE TREASURY)
Treasury Code
DDO Code (On
Whose behalf the money is tendered)
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Major Head |
Sub Major Head |
Minor Head |
Sub Head |
Amount |
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Rs. ________ |
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(Head of Account) |
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Rs. ________ Rs. ________ Rs. ________ Rs. ________ Rs. ________ |
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(Signature of the Officer)
Ordering the money to paid in