Garima Capital Limited

Please fill in BLOCK LETTERS and tick boxes where applicable.

Name of the Applicant (As appearing in supporting identification document)

Birth of Place *

Maritial Status *

Single

Married

Divorced

Nationality *

Nepali

Foreigner

Status *

Resident

Non Resident Nepalese

Education *

Address Details

Correspondence Address

Country *

Province *

District *

VDC/Municipality *

Street name *

Ward No *

House No *

If on Rent, please specify

Owner's Name *

Owner's Telephone No *

Contact Details

Occupation Details *

Salaried-Govt

Retired

Student

Salaried-Private

Other(Please specify)

Associated Organization detail (Please fill the table below):

Name of Oraganization*

Designation*

Associated with other organization (Please fill the table below):

Name of Oraganization*

Financial Details

Estimated Annual Income *

Upto NPR 5 lakhs

NPR 500001 to NPR 1000000

Above NPR 10000000

Are you involved in any investment Company for securities *

Yes

In case of Minor

If yes, please fill all the fields below.

Guardian's Full Name*

Relationship with Applicant*

Address Detail of the Guardian

(Enter Corresponding Address if different)

Country*

Province*

District*

VDC/ Municipality*

Street Name*

Ward No*

House No*

Mobile No*

Telephone No*

Email Address*

PAN No.*

Client Details Form