Page 175 - ENGLISH 8

APPLICATION TO ALL TYPES OF ACCOUNT

NOMINEE(S)

I/We Anupa Gaire maintaining Current/Saving/Sambridhi/Ba-Ama/Other account
No (A/c No.) 020001000300 with your Bank hereby give details of the nominee(s)
to receive any sum of amount which may be due to me from Agriculture Development
Bank Limited in the case of my/our death.

Mr/Mrs/Miss: Mani Kumar K.C. Relation to me: Husband Date of Birth: 1975/ 10/12
Age: 38 years Citizenship/P.P. No 2267 Place of Issue: Palpa Date of Issue: 1986/
11/15 Permanent Address: Lumbini Zone Palpa District Tansen
Municipality/VDC 2 Ward No. Badigyan Street/Tole
Contact Address: Tansen-2, Palpa Tel No: 9849233462

And in the event of my death during the minority of the following nominee(s), I appoint to
receive all money due to me on behalf of nominee(s).

Mr/Mrs/Miss:............................. Relation to me:

........................................

Son/Wife/Daughter/of
................................../.......................................

Date of Birth: .......................................... Age: .............. Citizenship/P.P. No.
...............................

Place of Issue: ..................................................... Date of Issue:
.....................................................

Permanent Address: .....................................................................................................

Contact Address: ...........................................................................................................
Anupa Gaire

Signature of Account Holder

Statement Calendar: English Nepali

Statement Delivery: To be POSTED To be COLLECTED

To be E-MAILED

Grade 8/English Book 173