Contact Tel. No.

: Office 1 Residence Statement: To be POSTED To be COLLECTED To be E-MAILED

;Dks{ kmf]g M sfof{no lgjf; vftfsf] ljj/0f k7fpg] t/Lsf M x'nfsaf6 k7fpg' kg]{ cfkm}n] lng cfpg] O{dn
] ug'k{ g]{
2
GENERAL CONDITIONS GOVERNING ACCOUNT:
1 vftf ;~rfng ;DaGwL lgodx¿M
Mobile Nationality: 1 _______________
df]afOn /fli6«otf M • THE LAWS AND REGULATIONS OF THE KINGDOM OF NEPAL AND CUSTOMS AND PROCEDURES COMMON TO BANKS IN THE
2 2 KINGDOM WILL APPLY TO AND GOVERN THE CONDUCT OF ACCOUNTS OPENED WITH THE BANK.
• o; a}s
+ df vf]lnPsf] vftfsf] ;~rfng g]kfn clw/fHodf k|rlnt P]g lgod tyf a}l+ s· If]qdf k|rlnt k/Dk/f / rng
Date of Birth: 1 Citizenship/P.P. No. 1 ______________ Place of Issue 1_____________
cg';f/ x'g5
] .
• THE BANK RESERVES THE RIGHT TO AMEND THESE RULES AT ANY TIME AND IN ANY MANNER WHICH THE BANK DEEMS
hGd ldlt M gful/stf÷/fxbfgL g+= 2 hf/L u/]sf] 7fp“ 2 NECESSARY WITH OR WITHOUT NOTICE TO THE APPLICANTS OR THE PUBLIC.
2
Year Month Day
• a}s
+ n] cfgf] :jljj]sdf s'g} klg j]nf k"j{ ;"rgf ;lxt jf a]u/ klg vftf ;~rfng ;DaGwL oL lgodx¿ kl/jt{g ug{
jif{ dlxgf lbg ;Sg]5.
• THE BANK IS ENTITLED TO CLOSE THE ACCOUNT WITHOUT NOTICE IF THE CONDUCT OF THE ACCOUNT IS IN THE OPINION OF
THE BANK UNSATISFACTORY OR FOR ANY OTHER REASONS WHATSOEVER.
(APPLICABLE TO ALL TYPES OF ACCOUNT) • a}s
+ nfO{ s'g} vftf ;~rfng ug{ lbg cg'ko'Qm nfu]df cfgf] :jljj]sdf lagf ;"rgf g} pQm vftf aGb ug{ ;Sg]5.
NOMINEES: • COMMISSIONS AND/OR SERVICE CHARGE WILL BE LEVIED BY THE BANK AS APPLICABLE.
PHOTO • a}s
+ n] vftf ;~rfng ug{ lbP afkt cfgf] cfGtl/s lgod cg';f/sf] sldzg /÷jf ;]jf z'MNs nufpg ;Sg]5.
OR5\ofPsf] JolQm M
I …………………………………………… maintaining Current/Saving/E-ZEE account No. …………………
kmf]6f] • THE FUNDS IN AN ACCOUNT WOULD BE CONSIDERED BY THE BANK TO BE SECURITY FOR ALL THE OBLIGATIONS PRESENT OR
FUTURE OF THE ACCOUNT HOLDER TO THE BANK AND IN THE EVENT OF THE DISHONOUR OF SUCH OBLIGATIONS THE BANK IS
with your Bank, hereby give details of the nominee(s) to receive any sum of amount which may be ENTITLED TO UTILIZE SUCH FUNDS AGAINST THE OBLIGATIONS OF THE ACCOUNT HOLDER TO THE BANK WITHOUT NOTICE TO THE
ACCOUNT HOLDER.
due to me from Nepal Investment Bank Limited in the event of my death.
• vftfdf /x]sf] ;Dk"0f{ /sd vftfjfnfsf] a}s
+ pk/ /x]sf] x/]s k|sf/sf] bfloTjsf] -jt{dfg jf eljiodf l;h{gf x'g_] ;'/If0f
g]kfn OGe]i6d]06 a}+sdf d]/f] gfp“df /x]sf] rNtL÷art÷O{hL vftf g+= ………………………………………………… df af“sL /x]sf] ;Dk"0f{ ;/x dflgg] 5 / vftfjfnfsf] pQm /sdx¿ a}s + n] vftfjfnfnfO{ s'g} ;"rgf glbO{ To:tf] bfloTj afkt s§L u/L ldnfg
/sd d]/f] z]if kl5 k|fKt ug{ lgDg Joxf]/f ePsf JolQmnfO{ OR5ØfPsf] cg'/f]w ub{5' . ug{ ;Sg]5.
• THE ACCOUNT HOLDER MUST MAINTAIN THE PRESCRIBED MINIMUM BALANCE AS SET BY THE BANK FROM TIME TO TIME AND
IF THE BALANCE FALLS BELOW THE PRESCRIBED MINIMUM BALANCE A MONTHLY LEDGER FEE WILL BE CHARGED, AS PER
Mr./Mrs./Miss: ______________________________________________________________________ Relation to me: _________________ RULE OF THE BANK.
>Ldfg\÷>LdtL÷;'>L ???????????????????????????????????????????????d ;+usf] gftf • vftfdf a}s
+ n] ;do–;dodf tf]s] cg';f/sf] Go"gtd df}Hbft /x]sf] x'gk' b{5. olb vftfdf a}s
+ n] tf]ss
] f] Go"gtd df}Hbft
Son/Wife/Daughter of: ______________________________________________________________________________________________ eGbf sd /sd ePdf a}s+ n] cfgf] cfGtl/s lgodfg';f/ dfl;s n]vfaxL z'MNs nufpg] 5.
????????????????????????????????????????????sf] 5f]/f÷>LdtL÷5f]/L • STATEMENT OF ACCOUNT WILL BE PROVIDED ON DEMAND.

Date of Birth: ________________________ Age: ______ Citizenship/P.P. No. ___________________ Place of Issue ________________ • vftfsf] ljj/0f dfu u/] adf]lhd pknAw u/fOg] 5.
hGd ldlt pd]/ gful/stf÷/fxbfgL g+=????????????? hf/L u/]sf] 7fp“ • IF THERE IS NO TRANSACTION IN THE ACCOUNT FOR A PERIOD OF 6 MONTHS OR MORE, THE ACCOUNT BECOMES
INOPERATIVE. THE ACCOUNT HOLDER HAS TO BE SELF PRESENT TO MAKE THE ACCOUNT OPERATIVE.
Permanent Address: ________________________________________________________________________________________________ • ^ dlxgf jf ;f] eGbf a9L cjlw;Dd vftfdf s'g} sf/f]af/ gePdf pQm vftf lgis[o x'g5
] . To;kl5 ;f] vftf ;+rfng
:yfoL 7]ufgf ug{ vftfjfnf :jo+ pkl:yt x'gk' g]5
{ .
Contact Address: ___________________________________________________________________________________________________ I/We have read the above GENERAL CONDITIONS GOVERNING ACCOUNT and hereby agree to be abiding by and be bound by them.
kqfrf/ ug]{ 7]ufgf My/Our specimen signature/s is/are as given below and will be operated by
Tel. No.: ________________ and in the event of my death during the minority of the above nominee(s). I appoint d}n÷] xfdLn] dflysf vftf ;~rfng ;DaGwL ;fdfGo lgdox¿ cWoog u/]+ / pQm lgodx¿ dfGg k"0f{ ¿kdf d~h"/ ub{5' ÷ ub{5f}
+ .
kmf]g g+= dfly pNn]lvt d}n] OR5fPsf] JolQm gfafns} 5“bf d]/f] d[To' ePdf d lgDg JolQmnfO{ pNn]lvt OR5fPsf] d]/f]÷xfd|f] gd"gf b:tvt÷x¿ tn lbOPsf]÷sf 5÷5g\÷ vftf ;~rfng lgDgcg';f/sf] b:tvtaf6 x'g5 ] .
JolQmsf] tkm{af6 d]/f] vftfdf /x]sf] /sd sfg"g adf]lhd k|fKt ug{ lgo'Qm ub{5' . Single Any One of us Any Two of us Other/Special
Mr./Mrs./Miss: ______________________________________________________________________ Relation to me: _________________ Psn xfdLdWo] s'g} Ps xfdLdWo] s'g} b'O{ cGo÷ljz]if
>Ldfg\÷>LdtL÷;'>L ???????????????????????????????????????????????d ;+usf] gftf
Son/Wife/Daughter of: ______________________________________________________________________________________________ 1. Name: 2. Name:
sf] 5f]/f÷>LdtL÷5f]/L != gfdM @= gfdM
Date of Birth: _________________________________________ Age: ________ Citizenship/P.P. No. ______________________________
hGd ldlt ?pd]/ gful/stf÷/fxbfgL g+=
Permanent Address: ________________________________________________________________________________________________
:yfoL 7]ufgf
Temporary Address: _________________________________________________________________________________________________
c:yfoL 7]ufgf 3. Name: 4. Name:
Tel. No.: ________________ to receive all monies due to me on behalf of nominee(s). #= gfdM $=gfdM
kmf]g g+=
PHOTO
(Signature of Account holder) kmf]6f]
vftfjfnfsf] ;xL
WITNESS -;fIfL_ M
1. Signature -;xL_ ________________________________________________________ Signature of Applicant/s
lgj]bssf] b:tvt M
Name -gfd_: ___________________________________________________________ A/C No.:
Signature Verified: Date:
Address -7]ufgf_ ________________________________________________________
vftf g+= ldlt M
x:tfIf/ k|dfl0ft ug]M{
INTRODUCER’S DECLARATION
kl/ro u/fpg]sf] 3f]if0ff PHOTO PHOTO PHOTO
_______________________ Branch kmf]6f] kmf]6f] kmf]6f]
zfvf
I/We ………………………………………………………………………… of ………………………………………………………………… Date: 20 / /
……………………………………………………………………………………………………………………………………………………
ldlt
declare that I/We know the applicant(s) and he/she/they is/are fit and proper person(s) to open an account with you. OPENING OF SAVING/CURRENT ACCOUNT Saving E-Z EE ESA Current
art O{hL O{hL ljBfyL{ rNtL
lgj]bs÷x¿ nfO{ d÷xfdL /fd|/L lrGb5'÷5f}+ . p÷pgLx¿ To; a}+sdf vftf vf]Ngsf nflu pko'Qm JolQm÷x¿ x'g\ egL art÷rlNt vftf vf]Ng] kmf/fd
…………………………………………… a:g] d÷xfdL ……………………………………………………… n] Mr. Mrs. Ms. Minor
k|dfl0ft ub{5'÷ub{5f}+ . >Ldfg\ >LdtL ;'>L gfafns
Name: (in BLOCK letters)
gfd M
Father’s Name:
(Introducer’s Signature/s) (Signature verified by)
kl/ro u/fpg]sf] b:tvt -x:tfIf/ k|dfl0ft ug]{_ lktfsf] gfd M
Grandfather’s Name:
afh]sf] gfd M
Husband/Wife’s Name:
Name: ________________________________________________________________ klt÷klTgsf] gfd M
gfd M
Permanent Address:
A/C No.: :yfoL 7]ufgf M
vftf g+= M Temporary Address:
c:yfoL 7]ufgf M
Correspondence Address:
Date: _____________________
kqfrf/ ug]{ 7]ufgf M
ldlt M
Contact Tel. No.: Office Residence
;Dks{ kmf]g M sfof{no lgjf;
Mobile Nationality:
df]afOn ?????????????????????????????????????/fli6«otf M
ONLY FOR BANK USE Date of Birth: Citizenship No./PP No. Place of Issue
a}+s k|of]hgsf] nflu dfq hGd ldlt M Year Month Day

jif{ dlxgf
gful/stf g+=÷/fxbfgL g+=
lbg
hf/L u/]sf] 7fp“

FOR JOINT ACCOUNT

Saving E-Z EE Current
ACCOUNT NO.: ;+o'Qm vftfsf] nflu art O{hLrNtL

ACCOUNT TITLE: Mr. Mrs. Ms. Minor

>Ldfg\ >LdtL ;'>L gfafns

Name: 1 (in BLOCK letters)

gfd M
2
ACCOUNT TYPE: CCY CODE: CUSTOMER TYPE:
Father’s Name: 1
lktfsf] gfd M
2

Grandfather’s Name: 1
afh]sf] gfd M
2

Husband/Wife’s Name: 1
Prepared by: Checked by: Approved by: Opened by: klt÷klTgsf] gfd M
2

Permanent Address: 1

Date: _______________ Date: _______________ Date: _______________ Date: _______________ :yfoL 7]ufgf M 2
Temporary Address:
1
c:yfoL 7]ufgf M
2