Nepal Bank Limited

Type Of Account *

Individual /
Non Resident Nepalese

Minor*

YES
NO

CASBA *

YES

Mero Share Service*

YES

Maritial Status*

Married
Unmarried

Gender *

Title *

First Name [English] *

Middle Name [English]

Last Name [English] *

First Name [Nepali] *

Middle Name [Nepali]

Last Name [Nepali] *

Grandfather First Name [English]*

Grandfather Middle Name [English]

Grandfather Last Name [English]*

Grandfather First Name [Nepali] *

Grandfather Middle Name [Nepali]

Grandfather Last Name [Nepali] *

Father First Name [English]*

Father Middle Name [English]

Father Last Name [English]*

Father First Name [Nepali] *

Father Middle Name [Nepali]

Father Last Name [Nepali] *

Mother First Name [English]*

Mother Middle Name [English]

Mother Last Name [English]*

Mother First Name [Nepali] *

Mother Middle Name [Nepali]

Mother Last Name [Nepali] *

Citizenship No. *

Citizen Issue District *

Citizenship Issue Date (BS) *

Citizen Issue Date (AD) *

DOB (BS) *

DOB (AD) *

PAN No.

Province *

District / जिल्ला *

Zone *

VDC-Municipality / गाविस -नगरपालिका*

Tole / टोल *

Ward No / वार्ड न*

Block No / ब्लक नं

Phone No / फोन नम्बर

Mobile No / मोबाइल नम्बर(10 digits) *

Email / ईमेल *

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Same as Correspondence Address / पत्राचार ठेगाना जस्तै

Province *

District / जिल्ला *

Zone *

VDC-Municipality / गाविस -नगरपालिका *

Tole / टोल *

Ward No / वार्ड न *

Block No / ब्लक नं

Phone No / फोन नम्बर

Mobile No / मोबाइल नम्बर(10 digits) *

Email / ईमेल

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Types Of Bank Account / बैंक खाताका प्रकारहरू*

Bank Account Number / बैँक खाता नम्बर (20 digits)*

Name Of Bank / बैंकको नाम*

Demat Account Debit Authority*

I/We, having a Demat Account at Nepal Bank Limited, hereby authorize you to debit my account maintained with Nepal Bank Limited for the purpose of opening a DEMAT and MeroShare account along with an Annual Operating Fee for Demat account and Annual Maintenance Charge for Mero Share Account. I/We understand that this authorization is valid until I/we revoke it in writing, and that I/we shall be responsible for any charges or fees associated with this transaction. I/We hereby declare that the above information is true and accurate to the best of my/our knowledge and belief.

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Occupation Type / व्यवसायको प्रकार *

Type Of Business / व्यापारको प्रकार

Organization Name / संस्थाको नाम

Address / ठेगाना

Designation / पद

Financial Details / Annual Income

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Relationship / सम्बन्ध *

Full Name / नाम*

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First Name / नाम *

Middle Name / अभिभावक नाम

Last Name / अभिभावक थर *

Relation With Applicant *

Father Name*

Grandfather Name *

Spouse Name

Citizenship No./ नागरिकता नम्बर *

Address / पत्राचार गर्ने ठेगाना

District / जिल्ला *

VDC-Municipality/ गाविस - नगरपालिका *

Block No / ब्लक नं *

Ward / वार्ड न *

Phone No / फोन नम्बर

Mobile No / मोबाइल नम्बर*

PAN No / प्यान नम्बर

Email / ईमेल *

Citizenship Issued District/नागरिकता जारी जिल्ला *

Citizenship Issue Date(BS) / नागरिकता जारी मिति ( वि . सं )*

Citizenship Issue Date(AD) / नागरिकता जारी मिति ( इस्वी सम्बतमा )*

DOB(BS) / जन्म मिति ( वि . सं ) *

DOB(AD) / जन्म मिति ( इस्वी सम्बतमा ) *

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Applicant Photo
uploadphoto *

Citizenship of Applicant (Front)
*

Citizenship of Applicant (Back)
*

Location Map of Applicant Residence
uploadphoto uploadphoto? *

Applicant Signature
*

Applicant Thumb Print Left
*

Applicant Right Thumb [20KB] [20KB] *

Applicant with Citizenship *

Sample Image*

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