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Remuneration Form No 7

The document is a bill form for remuneration for paper setting and moderation. It collects information such as the name, subject, class, exam, number of sets, rates, and totals to calculate payment for these services.

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648 views3 pages

Remuneration Form No 7

The document is a bill form for remuneration for paper setting and moderation. It collects information such as the name, subject, class, exam, number of sets, rates, and totals to calculate payment for these services.

Uploaded by

No One
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PSP Bill ID: …………………… Form No.

7
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
REMUNERATION BILL FORM (Individual)
(For Paper-Setting and Paperset-Moderation only)

General Bill Register Sr. No. ……………………… Voucher No. ……………………………


Cheque No. ……………………………
Payment Register Page No. ……………………… Date of Dispatch: ………………………
……………………………… EXAMINATION First Half / Second Half of the year 20……
Note:
1) All entries in this form must be filled in by the person preferring the bill. Forms in which any entry is left blank will be
returned for completion to the person preferring the bill.
2) Payment of Remuneration will become due after six weeks from the date of the declaration of result of the
examination for which it is due.
3) Fill and attach Appendix "A" with this bill for payment by RTGS/NEFT. If Appendix "A" is not attached with this bill,
the Payment of the bill will be made by Cheque only.
4) Payment of this bill claimed one year after the date of the examination result will be considered as time barred for
payment.
5) The bill must be pre-receipted.

Name of Paperset-Moderator / Paper Setter: ………………………………………………………………………


in ……………………………………………………………………………………………………Marks………………
(Course/Subject/Class)

at the ……………………………………………………………………………………………………… Examination.


(Month & Year)

Subject Code Particulars (Set ID) Type* No. of Sets Marks Rate Total Rupees
A B C D E F G (D x F)
……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

……………………… …………………………………………………………………………………………………………………… ……… ………………… ………… ………… ……………………………

* Type: PS = Paper-setting; PM = Paperset-Moderation GRAND TOTAL (RS.):


(E.&O.E.)
Received payment (Signature & Date) (Pre-receipted)
One Rupee Signature of claimant: ………………………………………………
Revenue
Passed for Rs. ……………… Rupees (in words): ………………
stamp for
over …………………………………………………………………………
Rs.5,000/-
…………………………………………………………………………
…………………………………………………………………………
Checked Asst. Registrar Dy. Registrar, Date : ……/……/20……
App.UNIT Examinations

Asst. Registrar Dy. Registrar, Examinations


Controller of Examinations App.UNIT
Maharashtra University of Heatlh
Sciences, Nashik
Address for Correspondence: ……………………………………………
………………………………………………………………………………… Finance & Accounts Officer
…………………………………………………………………………………
…………………………………………………………………………………
……………………………………………………………Pincode…………
The Claimant are requested that not to specify GRAND TOTAL in the remuneration form.
Send duly filled, signed and scanned pdf file by email to "[email protected]"
PSP Bill ID : ____________
Confidential
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCE, NASHIK
| DECLARATION |
(TO BE SIGNED BY PAPER SETTER / MODERATOR)

I declare and have satisfied myself that :


1) The remnant unused copies and relevant material pertaining to manuscript of question
papers have been obliterated, shredded off and burnt into ashes under my personal
supervision, to prevent leakage of the question paper set by me.
2) I have read the instructions for paper-setters / moderators.
3) No question set by me is outside the scope of the syllabus for the examination.
4) Allotment of marks and numbering of the question are correct and are consistent with the
instructions at the top of paper.
5) I hereby assign the copyright of the questions to the University.
Work Type Subject code Paper-Set ID

Name : ____________________________________________ Signature : _________________

“Pre-sign” at above two + one place in both forms! Mention Full Name for cheques. Do not
specify AMOUNT in the remuneration form. (Send it to “The Controller of Examinations, MUHS,
Dindori Road, Mhasrul, Nashik – 422004” by post.)

Bill forwarded on / /201


Total Sets Total Amount

Checked by Name: Sign :


जोडपत्र- अ Appendix "A"
(सदस्य/मागणीदार/पुरवठादार/संलग्नित महाववघालय यांिी ववत्त व लेखा ववभागात माहहती सादर करण्यासाठीचा िमुिा)
१ आदात्याचे िाव/ फममचे िाव /संस्थेचे िाव
NAME OF CLAIMANT/
ORGANISATION
(आडिाव Surname) (स्वतःचे िाव Name) (वडडलांचे/पतीचे िाव
Father's/Husband's Name)
२ पॅि िंबर PAN NUMBER
३ आदात्याचा पत्ता
POSTAL ADDRESS

४ वपि कोड क्रमांक PIN CODE


५ बॅकेचे िाव NAME OF THE BANK

६ बॅकेच्या शाखेचे िाव व पत्ता


NAME OF BRANCH & ADDRESS

७ बॅक आय एफ एस संकेतांक
BANK IFSC CODE
८ बॅक खाते क्रमांक
BANK ACCOUNT NUMBER
९ बॅक खाते प्रकार [ ] SB [ ] CA [ ] CC
BANK ACCOUNT TYPE
१० बॅक एम आय सी आर सांकेतांक
BANK MICR CODE
इतर तपशील
११ आदात्याचा दरु ध्विी क्रमांक
CLAIMANT LAND LINE NUMBER
१२ आदात्याचा भ्रमणध्विी क्रमांक
CLAIMANT MOBILE NUMBER
१३ आदात्याचा र्म-मेल आयडी
CLAIMANT E-MAIL ID
१४ आधार ओळख पत्र क्रमांक (UID)/
िसल्यास आधार िोंदणी क्रमांक (EID)
या सोबत उपरोक्त खात्याचा रद्द कलेला धिादे श क्रमांक ................................जोडलेला आहे .

मागणीदाराचे प्रमाणपत्र
प्रमाणणत करण्यात येते की, वरील माहहती माझ्या समजूतीप्रमाणे अचूक आहे . माझ्या उपरोक्त बॅक खात्यात हस्तांतररत
करण्यात येणारी कोणतीही रक्कम मला प्राप्त झाल्याची कबूली दे त आहे .

_____________________________________________________
प्राग्निक / परीनिरीक्षकाची िाव व स्वाक्षरी
(Name and Signature of Paper-setter / Paperset-Moderator)

Send duly filled, signed and scanned pdf file by email to "[email protected]"

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