Amount of renewal fee deposited Rs. _______________ dated ________________ vide T.C.R No. __________________ at State Bank of India, Old Sectt. Delhi.
(Original Challan Receipt Should Be Attached )
I hereby declare that the above information furnished by me is true and correct.
PLACE
:
____________________________
____________________________
DATED
:
____________________________
(SIGNATURE OF THE APPLICANT)
(TO BE FILLED BY THE OFFICE)
The renewal fee Rs._____________ at page No. _______________ in order. Licence renewed from ________________ to ________________ is submitted for Signature please.