NOOR MULTIPURPOSE COOPERATIVE

Depositor Photo:

Name of Depositor:

Permanent Address:

Temporary Address:

Date of Birth Nepali (YYYY-MM-DD) B.S.:

Marital Status:

Gender:

Name of Father/Husband:

Name of Guardian (in case of minor):

Resident Number:

Mobile Number:

Office Number:

Citizenship Number:

Passport Number:

Driving License Number:

Type of Account:

Period:

Nominee Name:

Relation:

Nominee Address:

Name of Minor:

Age of Minor:

Name of Minor Guardian:

Relation With Minor:

Address of Minor Guardian:

Contact Number of Guardian:

Name of Nominee:

Relation With Nominee:

Name of Nominee's Father/Mother/Husband:

Date of Birth of Nominee:

Contact Number of Nominee:

Nominee Citizenship:

Nominee Citizenship Issued Date:

Nominee Citizenship Issue Place:

Nominee Address:

form