Date: 2023/02/01

Personal Information
Full Name rabina dhungana
Contact No. 9841168321
Alternative Contact No. 9801845824
Email rawbeen.dhungana8@gmail.com
Date of Birth 1995/10/14 AD
2052/06/28 BS
Gender Female
Nationality Nepali
Citizenship No. 30017003164
Citizenship Issued From Kavrepalanchowk
Citizenship Issued Date 2013/07/03 AD
2070/03/19 BS
Passport No.
Passport Issued From
Passport Issued Date
Passport Expiry Date
Beneficiary No. 1301120001505140
PAN No. 114091725
Is Minor Account? NO
Are you Residing Outside Nepal? NO

Family Information
Grandfather's Name Chod Prasad Dhungana
Father's Name Tanka Prasad Dhungana
Mother's Name Naina Kala Rai
Marital Status Single

Permanent Address

Country Nepal
Province Province 3 ﴾Bagmati﴿
District Kavrepalanchowk
Municipality Dhulikhel
Ward No. 2
Tole dhunganagaun
House/Block Number
Phone Number 0
Fax

Current Address

Country Nepal
 Fax

Current Address

Country Nepal
Province Province 3 ﴾Bagmati﴿
District Kathmandu
Municipality Kathmandu
Ward No. 29
Tole ghattekulo
House/Block Number
Phone Number 0
Fax

Bank Account Details

Type of Bank Account Saving Account
Bank Account No. 3207010002925
Name of Bank Global IME Bank Ltd.
Address of Bank Dillibazar 2 Branch

Occupation

Occupation Type Student

Business Type

Organization's Name

Address

Designation

ID no. of Employee

Estimated Annual Income UpTo 500000

Involvement in NO
Investment Companies

Are You A Politician Or A High‐Ranking Official? False

Are You Related To A Politician Or A High‐ False

Ranking Official?

Do You Have A Beneficiary? False

Have You Been Convicted Of A Felony In The False

Past?

Naasa Securities Branch Kathmandu

I consent to open my online account and have provided all the genuine information to Naasa Securities Company
Limited by filling this form. I will be responsible solely for all the documents and details provided by me. Also, I will
provide further verification if required and comply with Terms & Conditions.

* I have read and understood the condition above and agree to create Online Trading Account.
* I have read and understood the condition above and agree to proceed forward.

Applicant's Name rabina dhungana

Referred By None
 Involvement in NO
Investment Companies

Are You A Politician Or A High‐Ranking Official? False

Are You Related To A Politician Or A High‐ False

Ranking Official?

Do You Have A Beneficiary? False

Have You Been Convicted Of A Felony In The False

Past?

Naasa Securities Branch Kathmandu

I consent to open my online account and have provided all the genuine information to Naasa Securities Company
Limited by filling this form. I will be responsible solely for all the documents and details provided by me. Also, I will
provide further verification if required and comply with Terms & Conditions.

* I have read and understood the condition above and agree to create Online Trading Account.
* I have read and understood the condition above and agree to proceed forward.

Applicant's Name rabina dhungana

Referred By None

Selfie carrying your National Identity Card

Citizenship Front
Citizenship Front

Citizenship Back

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Signature Image

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Location Image
Location Image