Year of Admission
20 ·-·······-··-··
KARNATAKA STATE OPEN UNIVERSITY
MUKTHAGANGOTRI, MYSORE 570 006
APPLICATION FOR EXAMINATION
Group I 1-:--::-lf---+----f--____,
First I SECOND I THIRD YEAR B.Com. of MAY ·JUNE IOCTOBEIUNOVEMBER 20. .. Lang L2
Mobile No: .................................................. . . REGULATION
Landline No: ..... .... .... ..... ......................... ..... .. Rl I R2
Email ID: ........................................................ Tick( whichever is applicable
1. Name of the Examination Centre:
(Mention City, not College)
2. Name of the Candidate (in block letters):
(as in qualifying examination records)
S. Permanent Postal Address
with pin code
(In block letters)
Pin Code:
4. Marl< 1;1) to which you belong:
I
sc I ST I CT I I CAT
UB
Kamataka State Open University, Mysoro
Nu1e of the 8111nLr: &
Place of Rt>mitt1nce ...................................................... .
I
l'lime of the Course B.Com Cta.a . 1/ 11 I Ill \ur
Roll No:
KSOU-500-EXAMJNATION FUND
SBM-54035420128 SBI-31106997538

SBM. Mukthcnaotri, Myaono · 05
SRI, Ntw S yyajl Rao Road, Myaore-01
Name and Address of the Studtnt
mnatoon Fee ..S..,
PenliFee
Change of Centre Fee r"'
Total \...)
Amount (tn words) Rupees . 4 ,
CAT
IIlA
Note Fees once pa1d Y.dl not ccd
Dale: Signatw-eor the Remitt"
For the use of the Dank
The Amount of Rupees (m words) ..
has been received I
Challan No
Date&
Bank Seal
SitlJ'Biure of the Officer
rtcei\'1ng the money
UNlVERSITY COPY
I CAT
IUB I GM I
Group
Ill
Option
Os
AI 0.
0.
0.
A2 o.
0.
o,
AS o,
o,
Affix Group II I CURES
Stamp Size
Photo here 01
Group
lli 02
Optional OS
BPP
Second Year Elcamination
AlP Sui:Wea
Group I
Ll
Lang
L2
Group II FCA
OJ
Gro..,
m 00
Optiooal <XI
Third Year Examination
Month & AlP Title of the Paper Year
Mooth
&Year
__ .a.G- Jtbe..era:::_Lh.:.- _ __ - ______ _ _ _ _ _ _ _ - __ ----------..)G.--
Kunatalca State Open University, Mysore X Kamataka State Open University, Mysore T Kamatakt Stale Open University, Mysoro
Name of the Bank & I Name of the Bank & Y Namc of the Bank&:
Place or Re mitllnC't ....................................................... I Place or Rcmitcance ....................................................... I Place of RcmltfllldC'C ..................................................... ..
Name or the Cou re B.Com Oass: 1/ 11 / 111 Yer IName or the CourK B.Com Oau : 1/ 11 / 111 \ 'ur I Name or the Coune B. Com Oau: 1/ u / Ill Year
Roll No: I Roll No I Roll No:
---------------- 1 I ----------------
KSOU-500-EXAMJNATION FUND I KSOU-500-EXAMJNATION FUND I KSOU-500-EXAMJNATION FUND
SBM-54035420i28 SBI-J 1106997538ISBM-54035420i28 SBI-3 1i7 8 I SBM-54035420128 SBI-31106997538
llmh.om Iru>liu1< " SBM, Mulilhaaanaotri, Mysore . 0$ ISBM, Mulithaanaotri, Mysore . .. r I SBM, Muklbaaanaotrl, Mystn . ..
SBI, New Sayyaji Rao Road, 1\fysore-01 ISBI, New Sayyaji Rae Road, Myson--01 \.,.) I SBI, New Sanaji Ru Road, Mysore-01 ......._"\
Name and Address or the Student s. I Name ond Address or the Student I Name and Address oflhe Student 'S,......,.
GC c,C t GC
l:oll<.& &nollnl...llo. I dtnotlni..I.L I .l.mlIDl.I.\L
501 Examination Fee lsot. Exam1nauon Fee I sot Examination Fee ·
Penal F I Penal Fee : I Penal Fee
.:·3, ... .. :Amou:h(:8 . ... .. .. :An»uth:g:d .. .... .. ....
Note Fees on"' paod "''II not be Rerunded I Note· F#"Jid "'II not be Rerundod I Note Fe<S onll not be Rel'unded
Ptc" StWJI[S gf 1hs Rsmmer :D S'NDDIBrA gf 1hp Rsm,uq : Qa1e Simpm'l' of the Rmutts;r
For the use of the Bank For the use of the Bank For the use of the Bank
The Amount or Rupees (In words) . I The mount of Rupees (1n \Ao'Ords) . . I The Amount of Rupees (1n v.ords) ... ....... ....... .
has hem receiVed I I has been recci'oltd I I has been received
Chlan No. lchalln No I Chtan No.
Date & SignaiUreoftheOfficer I Date & SiKJlalureoftheOfficer I Dte & SignalureortheOfficer
Bank Seal rcc:ci"nJ the money Bank Seal receiving the money Bank Seal receiving the money
To be rdamed With lhc reccivin& bank Recci'oltng Banlr. should send thLS copy to the Finance Officer, Sc:udenl copy to be retained by the student No upenue rectipc
KSOU, Mukthagangotri. Mysorc-06 Wi ll be issued