NTechPoultry

Hagradi, Shikaripara, Nawabganj, Dhaka-1322, Bangladesh

Phone: 01836699270, 01836699350; Email: ntechpoultry@gmail.com

Investor’s Information Form

Code: 2 4 1 1 0 1 2 0 2

Name of the Investor: ……………………………………………………….. One copy

photograph
Father’s/Husband’s Name: …………………..………………………………

Mother’s Name: ……………………………………………………………...

Present Address: ………………………………………………………………

…………………………………………………………………………………

Permanent Address: ……………………………………………………………………………

………………………………………………………………………………….

Email Address: ………………………………………. Phone: ………………………….

Gender: Male Female Age: ……… years

Nationality: ………………………. Resident Non-Resident

Nominee Info
SL Name Age Relation % share
1
2
3

Bank Account Info (Please provide an active local bank account information)
Bank & Branch A/C Title A/C Type A/C Number

Other Payment Method: BKash …………………………. Rocket ……………………………

(Please provide personal BKash/Rocket number)

Investment Amount (BDT)

Amount: …………….. (in word ………………………………………..……………………..)

Date: ………………………. …………………………………

Signature of the Investor