Payment Receive

Ticket Number :

Division:

Sub-Division:

Section:

Address:

Consumer Name:

Demand Note Number:

Receipt Number:

Material Cost:

Storage Charge (2%) On A:

Erection Charge (15%) On (A):

Other Chrges:

Transportation Chrges:

Supervision Charge (10%)

Contingency Charge (3%)

Anticipated Higher Cost:

Add GST Charge (18%):

Sub Total:

Meter Cost:

Service Connection Charge:

Connection Fee:

Total To Pay:

Payment Modes :*

Bank Name:

Cheque Number/DD Number/RTGS Number:

Cheque Number/DD Number/RTGS Date: