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    Refund Form

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    rohit2607yt
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    Refund Form

    Uploaded by

    rohit2607yt
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    Gg

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    refundForm

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views1 page

    Refund Form

    Uploaded by

    rohit2607yt
    Gg

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    ALLEN Career Institute Pvt. Ltd.

    ONLINE REFUND APPLICATION FORM


    Corporate Office : "SANKALP" CP-6, Indra Vihar, Kota (Raj.) – 324005
    Tel. : +91-744-2757575 website: www.allen.ac.in | e-mail: info@allen.in SESSION: 2024-25

    I wish to discontinue my course due to HOME IS FAR FROM HOME, AND BACKLOG IS THERE, SO WANT TO SAVE TIME FOR
    TRAVELING AND SELF STUDY.
    DELHI, JANAKPURI
    Kindly arrange to Refund as per the rules. Details of my registration are as under.

    STUDENT DETAILS
    Student Name: ROHIT SINGH
    Father Name: SHAITAN SINGH
    Address:
    DELHI
    DELHI NORTH WEST DELHI
    Delhi 110056 Staple your Original I-Card
    Course Code: 105031 Course Start: 02 Apr &
    2024
    Attendance Card, Fee Receipt(s)
    Stream: JEE (MAIN + ADVANCED)
    Course: TALLENTPRO XII (JEE M+A) PHASE-I
    &
    Study Center: DELHI, JANAKPURI
    Cancelled Cheque / Bank
    1000598232
    Passbook First Page Copy
    Form Number:

    Attendance Card I-Card


    Issued Issued
    Fee Details
    Payment Mode: Total Fee Paid: Date of Fee Deposit:
    Installment ₹ 78000.00 04/12/2023
    Remark: ________________________________________________________
    Refund Details

    Application received upto Deductible Am ount(₹) Inclusive of Taxes


    ___________________________________________________
    First Refund - 16/04/2024 35,000 Approved by:
    Last Refund - 01/05/2024 70,000

    Please issue RTGS in Name (Favour) of


    as per the refund rules of the Institute.
    ( Father / Mother / Student )
    I have uploaded Cancelled Cheque / Bank Passbook First Page Copy .

    Place: ONLINE Date: 18/3/2024 Student Signature Father/Guardian Signature

    Office use only

    Refund Cheque No ________________________________ Date ___________________ Amount _________________________

    RTGS Details
    Beneficiary Name (Father/Mother/Self) SHAITAN SINGH
    Account No. 20037704982 IFSC Code SBIN0031999
    Bank Name STATE BANK OF INDIA Bank Branch City PATAN
    Receiver Name ______________________________________ Receiver Signature __________________________________

    The refund amount will be transfered to your Bank Account through RTGS within 2 weeks from the date of online submit of this Application Form.
    In case of query, please contact at Phone No. 8306100750; between 10AM to 7PM.

    Registered & Corporate Office : “SANKALP”, CP-6, Indra Vihar, Kota (Rajasthan) - 324005 CIN: - U80100RJ2021PTC077131
    18-Mar-2024 11:40:52 PM

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