a}+s ckm sf7df08" lnld6]8

BANK OF KATHMANDU LTD.

Detail of Board of Directors (BoD), Chief Executive Officer (CEO) and A/c Operator
Date/ldlt Account No.
vftf g+=
Branch/zfvf

BoD CEO A/c Operator

Full Name Mr./Mrs./Ms. Desgnation

Account
k"/f gfd >Ldfg\÷>LdtL÷;'>L kb Holder's
Marital Stauts: Married Unmarried Gender: Male Female Others Photograph

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Nationality Date of Birth / / Religion

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Identification Document and Number Issued from Issued Date

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Passport (if availed) Issued from Issued Date

/fxbfgL hf/L u/]sf] 7fp“ hf/L ldlt

Permanent Account Number (If availed)

:yfoL n]vf gDa/

Residential/correspondence Address Self Family Owned Rented

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House No. Ward No. Street/Tole

3/ g+= j8f g+= 6f]n

VDC/Municipality District Zone Phone Mobile

uf=lj=;=÷gu/kflnsf lhNnf c~rn kmf]g df]jfO{n

P.O.Box.No./kf]=a=g+= E-mail/Od]n Country/d'n's

If tenant Name of Landlord Address Phone No.

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Permnent Address House No. Ward No. Street/Tole

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VDC/Municipality District Zone Phone

uf=lj=;=÷gu/kflnsf lhNnf c~rn kmf]g

P.O.Box.No./kf]=a=g+= Country/d'n's

Details of Family Member -kl/jf/ ;b:o ;DaGwdf_

S.No./qm=;+= Relation/gftf Name, Surname/gfd, y/
1 Husband/Wife/ klt÷klTg

2 Father/a'af

3 Mother/cfdf
4 Grand Father/afh]
5 Father in law/;;'/f

Note: In case of married woman, please provide the details of father in law /ljjflxtf dlxnfsf] xsdf s[kof ;;'/fsf] ljj/0f pNn]v ug'{xf]nf_

Signature/b:tvt

*Ploitically Exposed Person: Yes No

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If Yes, Please menton details
s[kof xf] eg] ljj/0f v'nfpg'xf];\
DE 022 D (Details)

* Politically exposed persons are individuals who have been entrusted with prominent public functions in Nepal and a foregn country including Heads of State or of Government, Ministers, First class officer and civil officials above that Post of Nepal
Government or Government's institutions, leaders of political parties, high portfolio holders of provate and social sector Officials. The term aslo means the closse family members, close associates of such people themselves.
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kl/jf/sf ;b:o tyf glhssf ;xof]uL ;d]tnfO{ hgfp“5 .