ldlt M

>L =================================a}+s lnld6]8

dfkm{t M >L PgcfO{laPn P; Soflk6n lnld6]8 ,nflhDkf6, sf7df08f} .

laifo M ==================================a}+s ln= sf] z]o/ cef}lts ?kdf k|bfg ul/ lbg] af/] .

dxf]bo,

pk/f]Qm ;DaGwdf ;fljssf] ================================================ln= sf] hDdf =============lsQf z]o/ sfod

/x]sf]df ;f] sDkgL =============================================================a}+s ln= ;Fu dh{ kZrft d]/f]÷xfd|f] gfddf
sfod x'g cfpg] ==================================================a}+s ln= sf] z]o/ tn pNn]lvt lxtu|fxL vftfdf
k|fKt ug{ cfjZos Joj:yf ldnfO{lbg'x'g cg'/f]w ub{5'÷5f}+ .
Zf]o/wgLsf] gfd÷y/ M
Share Holder’s Name :
a'afsf] gfd÷y/ M
Father’s Name :
Affh]sf] gfd÷y/M
Grand Father’s Name :

klt÷kTgLsf] gfd÷y/M
Spouse Name :

z]o/wgL g+= M
Holder No. :

6]lnkmf]g÷df]afOn g+= M
Contact No. :

lxtu|fxL vftf gDa/ M DP ID CLIENT ID

Beneficial Ownership No.:

ejbLo,

=================================
z]o/wgLsf] b:tvt
dfly pNn]v u/]sf] ljj/0f l7s ;fFrf] xf] .

;+nUg M
!= z]o/wgLsf] lxtu|fxL vftf ?h' k|of]hgfy{ lxtu|fxL vftf vf]Nbf lgIf]k ;b:on] k|bfg u/]sf] lxtu|fxL vftf
vf]n]sf] k|df0fsf] ! k|lt .
@= ===============================================a}+s lnld6]8sf] ;Ssn k|df0fkq — yfg .