GUJARAT TECHNOLOGICAL UNIVERSITY
EXAMINATION REMUNERATION BILL
B.E /B.PHARM/DIPLOMA__________ / PG ____________/ ___________EXAMINATION 20___
Surname
(In Block Letter)
Father’s Name
Name of Examiner
___________________________________________________________________
Institute Name: ________________________
Branch :_______________________
E-Mail ID : __________________________
Sr.
No
1
Particulars
Date of
Exam
Subject name No. of
Answer
(with code)
answer books book lot
assessed
Nos.
Examining
Answer books
(amount in words
Name
Mobile No: ______________________
Rate
(Rs.)
Amount
(Rs.)
) Grand total
Deductions if any
Net amount payable
: ___________________
Received
Address : ___________________
: ___________________
CERTIFICATE
I hereby certify that above details are correct and I am a resident of India and that the provision of the
Income tax-act 1961 is applicable to me and shall comply with it.
Bank information of receiver for Electronic fund transfer
Bank Name:______________Branch & Branch Code:_______________A/C Type (SB/CB)__________
A/c No.(Full digits)_______________________________________________IFSC Code:____________
The above information provided by me is correct.
Date :
Signature of Examiner ____________________
CERTIFICATE
This is to certify that Shri/Smt/Kum ____________________________received unassessed answerbooks
on dt._____________and returned assessed answerbooks on dt.___________(total days=_____). He/she
has completed assigned work within / not within time limit.
Date :
_____________________________
Name& Signature of GTU coordinator
FOR GTU USE ONLY
Passed for Rs.________________(in words_________________________________________)
Date:
Controller of Examination
Account officer
GUJARAT TECHNOLOGICAL UNIVERSITY
EXAMINATION REMUNERATION BILL FOR MANUSCRIPT
B.E /B.PHARM/DIPLOMA__________ / PG ____________/ ___________ EXAMINATION 20_______
Surname
Name of Examiner
Father’s Name
(In Block Letter)
________________________________________________________________________________
Institute Name: __________________________ Branch :__________________________________
E-Mail ID : __________________________ Mobile No: ____________________________________
Sr.No
1
Particulars
Manuscript
preparation charges
Subject name (with code)
Rate (Rs.)
Amount (Rs.)
Grand total
Deductions if any
Net amount payable
Name : ___________________
Address: ___________________
: ___________________
Received
CERTIFICATE


I hereby certify that above details are correct and I have read all instruction given in the Paper
setter order and also submitting paper solution of given order to me.
I am a resident of India and that the provision of the Income tax-act 1961 is applicable to me
and shall comply with it.
Bank information of receiver for Electronic fund transfer
Bank Name:___________ Branch & Branch Code: _______________A/C Type (SB/CB)__________ A/c
No.(Full digits)___________________________________________IFSC Code:___________________
The above information provided by me is correct
Date:
Signature of Examiner ______________________
FOR GTU USE ONLY
Passed for Rs.________________(in words_______________________________________________)
Date:
Controller of Examination
Account officer