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)

               

 

Major Head

Sub Major Head

Minor Head

Sub Head

Amount

 

 

 

 

 

 

 

 

 

 

 

 

Rs. ________

 

 

 

 

 

 

 

 

(Head of Account)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rs. ________

 

Rs. ________

 

Rs. ________

 

Rs. ________

 

Rs. ________

 

 

(Signature of the Officer)

Ordering the money to paid in