vafictt a1 ait Details of Nominee strep (Gi / seh) = Registered (Yes/Ne anit af at ister a: IfYes, Reg. No, (atwf&e5) Optional) 7. ahd of wfoarg eA we Contact Branen manager case o dicutios/ Value added sonics. 7ST-F-VTYER STREET NEAR BROADWAY POLICE Phone No + 25217199¢¢58 CHENNAL : 600001 Branch : IFSC Code + TDTBOOOKOIG MIC Code + sogo{9027 PERSONAL DETAILS PPO Numbet: CIF : 0146864045 Name : P SUGUNA & P ASHOK = /\ PAN NO zl : Mobile No Node of EITHER OR SURVIY. QR D.O.B. ( nor): M/A Date of A/C Opening : 21/09/2001 Nom.Reg No : Nominee Indian Bank KOMESIEEERPRART 2) trait 4 skothavalbazaaeOLndiantank.co-in "Account Nd : 446859613 18 MMIAPPA STREET KONDITHOPE, CHENNAI 79 sons vA Date of Taian any Chdngé (R°VaU AddreS$ of Phone Number 10, gar sd er ar mtr / Fee AH a OT TES Tat TARE / eH Fey ra eee ang ae yee arate Please do not disclose your Account di Fem ac Books BUSIRGSS -HOUTS am DUPLICATE continuity PB.No : 1 \ to the branch for updation. © scanned with OKEN Scanner