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    28 views7 pages

    Form Scan Front

    Uploaded by

    trijya

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    © All Rights Reserved
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    NABIL BANK” CREDIT CARD APPLICATION FORM. To apply lor the ret Card, simply complete and return hs cpelcation frm. PEs PERN ou ve BLOCK CAATALLETTERS in blk ink end ensure you complet ll leant eons and akoched rerent documents MxTRA PRASAD TWINS Zin & | Mobile No: BBG 42.0 32.2 OF mail Adios: ikea kimaina 12.8469 malic Number Gitzenship/Passpert Nox_99 34 aie of bith (inBS|ASRG yuneaSin AD) Gondor Molo“ Female Othe FathersNeme: Brawans Prascd Thens\ndfthars Nome Qadti Prasod Timsit> spoudsNome wea Paknre’ Nocfdependeris:_2. Marit Sis Mwrerie4°D Account No [Nominee Account No: {in cave f FD Card PERIMANENT ADDRESS: Steet Name: LAXCNON RYT __HovseNo BY Word No. Municipal Karena Province 4. ___Couniry_D8@pa\ ‘TEIMPORARY ADDRESS: SrecNane: Ra\WMBA'ERAR’ HoeNo | Word No 4S Munich» Bia dra nA ean ovine county wena ghnaocmy cipal, 2 Bogenets _courin_weta\ Your Resident Shs: Owned ky me'" Owned by Parest Reed Loan Schome. Ful Name of Landlord: Landlord's Mobile no: EISEN ee dee ke ed Employed ot Nalgene: Yoo No? Crgrizen Name 2, Name of Main Employer/Company Name: D@Pal Rasivea Bane _ years of experience, AO Stoke (in %): PAN/VAT: Company Regisrotion Nos. Monthly expense thy Income: {solory/rentl business) Offce Ada SreoiName: BOW UDEKOX Howse No Wade) Muncy 1s Frovnce Bayonet County W9@ROA\ Wier et Sey Rupee [Volid in Nepol Jndio and Bhutan) VISA. ‘MosterCord SD Vall Wosevide xapin aio) * ‘Your Mein Prpose for applying Credit Cord: “\Z} POS IAT “7 Neds Inellnent <7 Ecommerce Gord Payment pions: 10% | 20% 25% 50% ~/100% Requested Cred Limit optional: oO OSD eee eee Address Reletonship to me: Mobile No: ail RAPE TEENA nae Poose use SIOCK CAPITAL LETTERS in blak nk and ensure you comple al relvant scion ond tached relvant documents CCizenahip/PosspodNo:____NocFdaponcdenss____ Date of inh_ | Fars Nema: Mothers Nome: Spouse's Nome: Relationship wth he Main Applicat. PERMANENT ADDRESS: ‘Soot Nome, Howse No Word No Municipality Provinge___ Contry ‘TEMPORARY ADDRESS: = ‘Steet Nome: House No Word No Muicipaliy irik __ Country. bile No: mal Aldous: PSU STEELS 200 i t re roqus yout ise Cred Cardo me/s. Tha undesgnad hore with to pay Cod Suburipion Feo of NPR [Nonehndabll which willbe paid in 4Equalkutellnens | orFul___ es preeribed bythe Bork Tenth ‘Signore of Main Applet i, Signature of Supplemeniary Aplican! Va NABIL BANK" a a 4 a 4 a a cl pcse Chen es on ibis ed cr cat ond expres port undar e Cares tell emtne oarue oder be pps cl clon and athens Ree ee ncpoymert de, be bint ray odd odteeechronh st Pome! bie Pace, sechr eas pymat fe Cot Bales ovtaning he Card Ary cde Spun Dee ut nce of any Soin Fs on te fo or Cob Fae eh pred cored oy ba ont Ssanet Aco he Bonk wil tafe rs rae Fee eee aes popman of ery amoent lt than he Caren oles then Se ea eee eel Poynt’ Sy am ba Crd mabe apes my See Ft cme pried in Sebo of Caras ore ork may ely om SRESESEG loci the Cord meron tlre be osendig i he Crd Fe es pln fl oe did inh Semen! of Acoma wich ch fu porn of lh Minn Pape nto of ease a peyey ur Bam alo eeosaig creat en dae and Peete Eled manter agar oe ae Foon Fee of on omc prin Fr Pci rte bank way apy om ine ie by wey ona ey Start il be tonal shar arom ppt {Foe Cd contr le py trina Poymet Br eS epojeen bees rin enon wos pots ark ee [Sted th Cord mere sel oy ee Br, medion paying oe splile Teme Smear he Cat Saumur ll oats a ty Mima ee ois ele pate, snd ol Sacyed paar, Cath Avro ROTEL cee ond lta oplecle css ed expr eeynen Due Die Steed ne Coren Seon Aco Pe ne CTinenercceods he ei Unt wiht Bon’ rien appre, MeCoE ether poy, ondonand sh vnoahrad eco ove Co nt egrh ‘kan ce ord wasn in ev, SESSLER Sed byte bank tom hr Cad menor maybe clin re owed sarees uapa fen Co Aone, Charo, abit ard ober coord pein rere cen tenet n cher ofa iw Bork oy dew Fete sepa Cord man le! be dered Bondo reed by, BS can pablo he Bark elo ogy, nl eddy bacame do Ses opo te cath reskony any of th Card enter ont Supsemaniy ERG Sete Cord member odor Spplonciry Crd mene hl imme CETTE TAE od heroin eworer recs, ee, tl arto be ark l Coch link fl pomen orga he Bork se Dn shal breed sacle dcrtn, to mand hn of he Card andor Tnmeie poyae! al ona ebnding unde he Cord Act ok ony he thet (pug toen ete and wht ny bye Bask RETEST’ si cay cde he Cand Asc wih vcd ores of 9 worcctn i orate wif enol pee fond hn he Bonk eae chord ‘ite con aacareaner ovr ie Cod mone net big ined cbr or (dcr ipndenanebyhe Barkan resun hohe ern econ beach fear sci opnomn he Cod mere sl weber bt larcs inetd, This ‘tna th din end sce wba oy econ or cheng, STENT ahts cn ftmoten hem Cordon, foreleg poy’ fr he ‘voap oncom inimun er caret Boonel vide © words Intcn/ anid ‘ica. Ife bonkncpgro, he Crd men my she Crd sn Ch Advonce phe riman nce i dae by theSk em in ie, prt Bk oma of Aids SRSA core nee en cath Cth Adan tom edt cf ach ath Avot l the dave Al peyote bate spied be Sched Cheam ox mood by he ek eth Coe ment Irednhe Cod man labo be blo py © Cosh Akane ar onan eos nh Shee Cor Fort bye Bon he Crd amber Sadia at ac fon lev by che pacing brs fant sion [ise hich ep he Bak Cor Hy rence bea bypohecce: oe darko cviig ail or oy ond ‘Chagueced shih ond ober met eto ond poche he Crd mento ‘nterendr el pce ond teh godt ood by Card arbor inci, were evtnn, lamer clr cn Pxnlld rn ign rep od “Desi, borhld nd ees fons, pm! ch tA codon, 1, Rod Herwentciguotr Compan, Car, Welder, Ch Shares end oer vals Hertel ronan he wt of om poymet by he Card mart fon ond ll Cree ani bles ener outs pylon pment bv Contos, ff bak nett repos eyed popny endo afc 2 he oe by vere gunner rpc scien, lr ch emount or emo nd ch pre owe os Ueto inns daceton {he ord manda es pay Banka cos al pres nd in onc ih ke cornmeal hl bbl fe Bonk fr the olor ire lesa of Sle il be dint a oe ete dof Donk The Crd mendes [Oeby inde hor om ony nd love, cai end doecge ig oo orn ipldon ih ony Bork mpeneaton ane sl tha ypaaesied rop FECEToenber heey comes ek 8 prep oe foro ements du ad pepe Bent by he Supenery Card rb irda erty ond alles Cre Ged ltt el her ete ed npnean pyle yh Sporty Crd renter te ork ‘Berd nanter urs he Bok tte Bork arbowed a tc he ere htns ewok tm eubered terse ofthe donk cv he tephoe. the tok arr da sgh ety heey of he Cord moma ovr be phon, To Career oy andl onotans made ares! ean oy Ihe brs curd repel. The Cord manta ao yest vee wpe re penn is Acad peeve maybe acral dcroft Bonk {eronypotaer poms. a err Sire spony Cardia pennant yf Cord mente ond ‘myrvedy te tk ot Spanair Cerca fa 1 rca elcand he Soplnenay Cor mae he Cord mnber lb cue Site ba Bork ev rine nb fr all Chega ond bis coher costs od ae taal orpyebl by he Bove Card mnbe! cdo the Speman Cord ee decd tnt ong w he Cord aha inde cf the Crt Unto te Teeny Cord wanker, end he Cord mane te Supple Card member S35 sa per he fel of he Chg ied urd or hrogh sir epee Cart ‘Azoisteacod ho sid Cie int Ce Eat in oN wh Crd rn ono Spanair Corder ose ot TE in cone ATI cel encase wl othe Cod 1) lantncy buco oder nan ber way te ron te Bonk Cord Inter ano Super Card mri thr )TeeGadinoter sje Soper ard men vested and gre hh sh ose pie ery pecan ad tl lla wr oom ecuson Yo pee “Tldbur fe PN ay poo oe Tslonenty Crd mark sal on any mart handover h Car oat be Cod led orden or PN sda iow ay ad a scar ete ars honda ovr hCard enero i pen Fe" Ean meme tl medal oy he seid lon odor dione wih al moe Fe ie tag Cond nanbors tebe Sk on eal apie he eit deck oh Eeemevc er eprops pct ls or ure errs, 1) Ha Cad mamta sl be abe fe bork al Cord Wrsion wade wih th PN vee wir whotne node of he Cord fh Weed oy Srplenenay Cardi mined yw pron wh cx! psn of re ere ott Coden s con Card meni b bla lnesncrg. oy TRICITSLN iho te sory ois Cond mob ef the Spon, Card Teetey le Cod ener separ tha Gard or tne here word no ruta mans: — RE rer meyer hi wigs We Bk f Ra/hr rons doe Fe Te STatn deter ne of Cady aring ol Cotto Berk. Te od SOSA ety te bork ry oer the recip of eCard on atl arom ot ae ts del endl cae oe oxpnss i don oo or Ac oy ee any nw tine eno spare eo by hing Tiong tum he let penny oi bebo acre Se ctiae' oman he oe bak rl Charge nd ii ond al oe a pcan risen ecm esnrdones wn Cees Un ee! Pea TEA cured by th Cord renber and oer Selene Card the fn cer he Boe cit he Spon Crs cg Ti Zeck we or eee by he Col pember oot Suplnartory Cor) mene Ac cpl he bak fa nen The Bk mya. frm, rea conc ree acting eny room, wih ar teat gg Oy pri ce he rd meni of Supe Cr en a STRSTR SRDae Siplenemay Cardmanbr shllinneioy rich ell ond Sie ain sack Carlee Sor i ewe card mabe sl be le Fr Sort cage! cetyl ako ol pore al Cher ndsbes nd Hae cae cd pees arson ew othe Bork Te avr enero Corder by monn alte ork oa echo oy AT of arate eer alow roman roca Cord cord nomen ol he Ga Sy nef nnd pve Ca Akane up th Cie imo fe Berks TICE SAS" sly ecco ty ttmvctons commoricand Hm fork vader ei Sas romecion Schyeitcmryng utorlare ot deoymearyg oon othe eres acon one eer nd eco, ty SEEni area atin eyo re lye quar, sdf, xy of pode cepenards neve! of pred bye in he Cad Car umber ory STeege tecol amcwel charged by. wernt ofr ony chor Bch or Roeolornance of oy worsen ta Maren cy eae Tatra any digo beet he Card mein nd ho Bok ny Mera! ro) ee eS monkey baby te a Bonk sl ral in oy ey b,c oF Ere ended uch dana ry abe come dam og ol wea whch he ‘Coenen hv ora uch Marcha oer pee, a SERUTTETATEAe i en coy be Cad merber or Spent Car pr foo Te UA Te ST shccre nae et or ran Fo any gn ie chs te Ar ln mang cnennestonsyanm or ext r dle roi 720% oF Coe ee tee ottoman naval or ow dap oy oe hing eee tepond be coal ce ek eee ee Teter ofeny lse/amplins/deneds/ deen olen Tee ee i comet wil oan ametinieendrovrd red othe Cord a te ee cn bara ond wes othe repre mde te Copa BURL os Soave Crt Cord rongumant hat he Bsk oy bore ened oo SRE ug eed hn fe Cod menbes, Se cpsemeey cod ren: heh conn “Tena pid ane cad pun tot Corns of are ere al ppc oc rps, uc oe cin er be TETUSg tet Nop! end xray be ced tom te Hie geering he ce ede rey dom he ork Hom any oe enor wages Fee To Sad by be Brkt et fence hin, ks ver le dhs by Card mab ear elmer Cor rere ot my I NABIL BANK’ pacer Nort ACCOUNT OPENING FORM (INDIVIDUAL - SINGLE) Please complete all details in CAPITAL leer ond strike out the non applicable fields/boxes ‘The Manager, . 214] [el4)(2[°] +13] Nabil Bank Limited vow: [ale] Lela]! SS Dear Sir/Madam, Please open my account with your bonk os follows Account Type" CIcurrent saving others Gurren? inex cy, VY $®: Purpose of Account Opening®: aw iog, and _troneastions Source of Funds" aa gesy___Anfcipated Volume of Transactions in 0 Year":__S7Q Exising Account No/s ni L [ Applicant/Customer Identification Perret Eley tile: Ei, ms, Es, other tev oe Nore’ (w(s]r[ela PIR[ATS [4] > a fa[m sa] af Al 1 dor" Aitole Li female Clother = =) Morita status: L]single Ettaried Nationality’ S22RO\\ oaecronae (121 (b[8] ale Tales. [a]s)(S[e}[2[8]2 6 Jao. esveaion —taptnit Fomily Size (Nunbe)__—¢______ Guardion’s Name (Ont for Minos) (Guardian's Relationship (On fr Mine Father's Nome: fulNenat” Qhauseany Prd other's Nome: fl Nond®@ —DOeWER DEN Grand Father's Nome: fulNene) ase, Px __ Grand Mother's Name: ful None} TUXBSA_DEV\ _Hysband/Wife’s Name: (ul None) Diga ParmrceA Permanent Address. House No_24, Tole/Steet_Laenon Sux __ Ward No*_f___ Municipality”, Karna\, Distrid”_HaRa Siti lag, Couniry* sepa\ Temporary/Current Address (IFDifferet than Permanent Address) House No. Tole/Strest Bol. ura \nans Word No*_AS___ Municipality* ws Sana tare Disriat__Kodtomern ds ste Dagmats —___Country_D9E RON #Office Address, if any House No. Tole/Strect RA\89QkAY __ Ward No*_—S — Municipality? —(CoXarman dA, __ Distiat_Karkman du state + ag ena ks count BRAN Web Address ‘Office Email #Contact information ‘Mobile No.1 RSAROFZIO Mobile No. 2 es Fax Number. aro Landline No. {Residence} Landline No. (Office) Email MiXPO LATAALUS 4524 G_gmai\- casn Social Madic Type and Username “Mandatory Information cc x6) For Nes Menton ib Dette of Guorlan @ ‘Applicant's Signoture oP nn ee eEEERRNE NABIL BANK* bE ay #Location Map - Sketch/Google Map (As per Current Address}: A “ a een a a Budhenitatanan teed Nore lendmaik BaNSUrQKAAsn EMD sO' and Distance to Ades (n Meters} SS #KYC Related Information/Declaration Please mention your postion/asseciation and insitlion name if you are a high profile inividuel or currently involved in or retired from politics, Bureaueraey or other high level postion Peslign/Asocion __Deguty Give ko ____ nsivion Nome _paesea\ _Rasrea Gans Additional Information. please mention the fllowing deol of your family membors or close ossoiates having high profile or currently involved in ox efirel rom poics, bureaucracy or other high level position. Perea | ne | ite eae a poker For Minar, Mention hee Delis of Goorin Applicant's Signature a LS ASSES SSS NABIL BANK” Other Services Required (PI |, Statement Frequency: = LI Monthly Clauartety C1 talf Yearly Cheque Book Ae: LINo ‘Statemsat Print [Nepali Calendar english calendar Mode of Delivery: LZ e-mail [Jpost Crim on Demand — special Delivery Ii, Debit Card (Aviso C1 scr visa Debit Card is Mondatory) [J Others IL, Online Banking es Eno third Perty Fund Transfer (Online Banking): LJ Yes LINo IV. Mobile Banking [Aes CINo Third Porty Fund Transfer {Mobile Bankingl: [1] Yes No Required Services sms sonking Amray 2 transocon Alert V. [hereby unreservedly authorize the bank to issue L] Nabilnet, Tpebit Cardin the name of... I hereby wish to pay Card Subscription Fee of NPR .... sues (Nonrefundable) in 4 Equol installments which will be paid ‘annually os preseribed by the Bank or Full 1 the undersigned hove understood and agreed that in case | request to close/ surrender the card(s) before making full poyment ofthe subscription fee atthe Bonk, I furthor agree fo undereke all the lilies to pay the remaining subscription fee before closure/surrender of the card] ot the Bonk. | hereby futher irevocably authorize the Bank to debit my ‘eccounts) by the subscription fee amount os requested by me vie this opplication form ‘hereby undertake that shal be liable for any act done bythe aforementioned person ond shal not am the bank againt his/her ac relaied othe use of LJNabinet L]Debit Card in future. any claim is made agains the bank by any means from, my part inthe future, the same dn Applicants Signature gas can be treated void wih this consont. Nome_Mikva Prasad “Tirastus Signore of Applica! ‘Thunb inpresion Right ond ah. Special Insrudion _ HY _ONe _Slqnakure ‘+ Guordin’s Photo in Cote of Minor NABIL BANK Decor Sirs In comideration of Nabil Bonk Lined (hereinafter refered 0. the “Bank”) mel) (herein veered to the “Accounls") ond providing banking ering endo contig he Cueran/Sevings/ Calor ony oer occurs) in my/our este mon, oe ‘he a Heel /.o5re0 fo be bound bythe tems end conditions set ut bslow ond reo thal th oxen wl e governed by and are sje to hese ems ond condins ferehofe refered cx he “Tera, We eo oes ell depot hater Svings, Core, Fixed or Foreign Currency hl may be ploed by ma/un rhe Ban re abe tha rving ls end vguaens Nepal Rese ene tnd ore gevorned moist win bon or ceo cr avg ‘Terms and Conditions Vier he count) the ‘ons ond abilties othe customers wit the bonk abl be aint and several ere 1. ep el bey dre ea ky [SaRSRISLSTS ROM ata anette kre © Sor lb are ir teeraemli tnt bet 5 Trgtinde ia fe ferhanty bok repeater esis 4. etl at neler pot dd ord cn Ohmi her orp fect ot he Sratepthsietct cobra merece bated ‘SSR doped ntpocel Sena costed ny wey) ado aytces {i roses at ro ce ego ak oer nen agrawal ee 7. Clgngenanlatfaikel a zs et on her snd ene Goepruean eaeeralta irish Pivemipeecree nate mnmaetast © heehee narrates Stee ee erence bee ave the Bonk aac Patna ib eal ll oe > eee ei ead emer ae ‘or Gaivery sel be considered gens of fhe accourt holders for ofl delivery of leer ‘mn, rms, and wo oper cb asp yh Bak 10, ne ciare of eo pray ee Sictermeu te eettee? reed beuncoescoa eit mandi ‘Serre poe oh dese pe wre 9 Sabi El srr a he, Behera uc. ho tal ba jl nd sol ea apoya) es pblonn in ony agentin ero thy oud lone th cour he Ee eee gr ha, ce cmb ol hiner rd hy outed "Mae sti Bt cide cicadas ssn 14 Th ek ee te a cl uth or pti ony gr ihn opens Pr gibasgercl setae chen Geeaio NTS aan SEES SUSE he cmon 15. ict unbagaloted w sa xpe whih od gpd in cl crnpandoce dds cet anche alg apa owas ‘6 eRe cay oe eS Ry ok =n Vb re rn Gt etn by prot h pretgn 16 ae Sets pala ee Sater eae tak 1. sel id woe em fp ma om 20 rkapsi she Poem ea ares 7 pee eee een eeeneeey aaa irc aoe 1 Yee dm cuca ener rin ace be 2 eg Reese eh Ng ed mano % Soren ote pon etsreempcney maasie 23 Sn ol mp ey dom, ey ca gle Sp iat econ alba ent ene eae ete Seer tall Th Soelal tio elena se Pk cl vy ri, nm} bag riod so ri of oor fo ie Sine pect lecte giained 2? ne Petes the low in elect fom time fo time. These fers shall apa to each ofthe ccoun's of whatarer nature hersaer opened wth, ovtnue wih Se opened by more thon one peri te word "7, *me or “ny shall read ot “wo, "vs" or “our in tha terms, The Tes shall bind each of sons nomad i the cczcunts(hersinaler clio referred lo cs He "Cuslomar)induelly or any one or mae o al ef hem ealletvey ond al agreements, bg Ped ae at ie cher supporting Soccan rom be min pe ek a oie ie get ocae eter rte gi gee ae Pema asin Secon een Loewe eee en aeein ches 25. Berk only naka pare abe poll derinan afr or cin wen hgh he ajc Katie fad cee det devo re 7 SOO a Ra elt rt a and Ca he Seeger om 28. Fhe 8 ewe pera deeded pd cone ce wb ce os ealesbn Tike sendy rs sad erect tbe dma 29. Bonk manag 0 cant th sing AVe whan in ot of sly A/a he Bork rs hs the ein Ae shar in cos slay Ae) ey Cae SSS acint Eehnls asta War Mine (8 poaced net beamaceinrcatate iat 1. Inte tre ced condos 1. "Tro Nb Bk inl! NABL| wh tone Vo acton eae tcc hte Raa Hho kta teaaii ames ee nea a gc ahioduiicteienitation iy Ertl pment niin eae ae re er etree thot Laer ep aan aee een eens: fae Lovtatrea ias aeiueieaas ahaa iat ary rir oe tae iene tapi Dete Capture Device (POS! whe displays Visa accoptoncs logo, bee orm a ee a mor ise fy ae in mg eee etn ged i ov fa tacee Seltat emel a or eae ‘Rrl'st’ar br enclid POS Terma, PR once peracid cic be -gererched and Sh eae bs Ufc pel betale lee aretie oiae iste sre orale cay Sees oe eee Fcohen rte rave! an th corgi fed ipeeteeniglangdlatya a Ateeplty a eine ed omtalle etree ts ‘pplication In Cove te cord los soen/ mis cobalt Pol be ice for Sees eee cae iv Tp tar regs ight w/c oad sod oy ool ‘Pestle By eet By Here ote Epeernaeert

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