Detail Of Beneficial Owner
Correspondence Address
Permanent Address
Bank Detail
Occupation
Nominee
Gaurdian
Document
Branch To Visit
*
---Select Branch ---
Jyoti Bikash Bank Ltd.- Head Office Branch
Jyoti Bikash Bank Ltd.- Pathari Branch
Jyoti Bikash Bank Ltd.- Jhamsikhel
Jyoti Bikash Bank Ltd.- Sitapaila
Jyoti Bikash Bank Ltd.- Itahari
Jyoti Bikash Bank Ltd.- Beni Branch
Jyoti Bikash Bank Ltd.- Baglung Branch
Jyoti Bikash Bank Ltd.- Phutung Branch
Jyoti Bikash Bank Ltd.- Saraswatinagar Branch
Jyoti Bikash Bank Ltd.- Birgunj Branch
Jyoti Bikash Bank Ltd.- Chyamasingh (Bhaktapur) Br
Jyoti Bikash Bank Ltd.- Diktel Branch
Jyoti Bikash Bank Ltd.- Bharatpur Branch
Jyoti Bikash Bank Ltd.- Biratnagar Branch
Jyoti Bikash Bank Ltd.- Sundhara Branch
Jyoti Bikash Bank Ltd.- Pokhara Branch
Jyoti Bikash Bank Ltd.- Nepalgunj Branch
Jyoti Bikash Bank Ltd.- Butwal Branch
Jyoti Bikash Bank Ltd.- Jajarkot Branch
Jyoti Bikash Bank Ltd.- Baneshwor Branch
Jyoti Bikash Bank Ltd.- Balaju Branch
Jyoti Bikash Bank Ltd.- Kohalpur Branch
Jyoti Bikash Bank Ltd.- New Road Branch
Jyoti Bikash Bank Ltd.- Bagdula Branch
Jyoti Bikash Bank Ltd.- Bhingri Branch
Jyoti Bikash Bank Ltd.- Machhi Branch
Jyoti Bikash Bank Ltd.- Darvan Branch
Jyoti Bikash Bank Ltd.- Kwadi Branch
Jyoti Bikash Bank Ltd.- Bardibas Branch
Jyoti Bikash Bank Ltd.- Jhumka Branch
Jyoti Bikash Bank Ltd.- Surkhet Branch
Jyoti Bikash Bank Ltd.- Ghorahi Branch
Jyoti Bikash Bank Ltd.- Tharpu Branch
Jyoti Bikash Bank Ltd.- Hetauda Branch
Jyoti Bikash Bank Ltd.- Maurighat Branch
Jyoti Bikash Bank Ltd.- Dhangadi Branch
Jyoti Bikash Bank Ltd.- Devghat Branch
Jyoti Bikash Bank Ltd.- Ramgopalpur Branch
Jyoti Bikash Bank Ltd.- Phaparbari Branch
Jyoti Bikash Bank Ltd.- Koteshwor Branch
Jyoti Bikash Bank Ltd.- Nepaltar Branch
Jyoti Bikash Bank Ltd.- Puspalalchowk Branch
Jyoti Bikash Bank Ltd.- Tulsipur Branch
Jyoti Bikash Bank Ltd.- Gulariya Branch
Jyoti Bikash Bank Ltd.- Rajapur Branch
Jyoti Bikash Bank Ltd.- Gadhawa Branch
Jyoti Bikash Bank Ltd.- Shamsergunj Branch
Jyoti Bikash Bank Ltd.- Damak Branch
Jyoti Bikash Bank Ltd.- Pepsicola Branch
Jyoti Bikash Bank Ltd.- Thamel Branch
Jyoti Bikash Bank Ltd.- Jorpati Branch
Jyoti Bikash Bank Ltd.- Kalimati Branch
Jyoti Bikash Bank Ltd.- Galchhi Branch
Jyoti Bikash Bank Ltd.- Tokha Branch
Jyoti Bikash Bank Ltd.- Chapagaun Branch
Jyoti Bikash Bank Ltd.- Khorsane Branch
Jyoti Bikash Bank Ltd.- Birtamod Branch
Jyoti Bikash Bank Ltd.- Bardaghat Branch
Jyoti Bikash Bank Ltd.- Parsa Branch
Jyoti Bikash Bank Ltd.- Janakpur Branch
Jyoti Bikash Bank Ltd.- Narayangadh Branch
Jyoti Bikash Bank Ltd.- Simara Branch
Jyoti Bikash Bank Ltd.- Golbazar Branch
Jyoti Bikash Bank Ltd.- Hasulaya Branch
Jyoti Bikash Bank Ltd.- Kapurkot Branch
Jyoti Bikash Bank Ltd.- Rupani Branch
Jyoti Bikash Bank Ltd.- Parwanipur Branch
Jyoti Bikash Bank Ltd.- Amuwa Branch
Jyoti Bikash Bank Ltd.- Padsari Branch
Jyoti Bikash Bank Ltd.- Abukhaireni Branch
Jyoti Bikash Bank Ltd.- Nijgadh Branch
Jyoti Bikash Bank Ltd.- Hariwon Branch
Jyoti Bikash Bank Ltd.- Ason Branch
Jyoti Bikash Bank Ltd.- Sindhuli Branch
Jyoti Bikash Bank Ltd.- Bhairahawa Branch
Jyoti Bikash Bank Ltd.- Jeetpur Branch
Jyoti Bikash Bank Ltd.- Mahendranagar Branch
Jyoti Bikash Bank Ltd.- Kawasoti Branch
Jyoti Bikash Bank Ltd.- Gaighat Branch
Jyoti Bikash Bank Ltd.- Waling Branch
Jyoti Bikash Bank Ltd.- Tansen Branch
Jyoti Bikash Bank Ltd.- Ghandruk Branch
Jyoti Bikash Bank Ltd.- Kirtipur Branch
Jyoti Bikash Bank Ltd.- Chandranigahpur Branch
Jyoti Bikash Bank Ltd.- Bode Branch
Jyoti Bikash Bank Ltd.- Balambu Branch
Jyoti Bikash Bank Ltd.- Banepa Branch
Jyoti Bikash Bank Ltd.- Sankhu Branch
Jyoti Bikash Bank Ltd.- Talchowk Branch
Jyoti Bikash Bank Ltd.- Dharan Branch
Jyoti Bikash Bank Ltd.- Satdobato Branch
Jyoti Bikash Bank Ltd.- Lakeside Branch
Jyoti Bikash Bank Ltd.- Maharajgunj Branch
Jyoti Bikash Bank Ltd.- Gongabu Branch
Jyoti Bikash Bank Ltd.- Prayagpokhari Branch
Jyoti Bikash Bank Ltd.- Sinamangal branch
Jyoti Bikash Bank Ltd.- Battar Branch
Jyoti Bikash Bank Ltd.- Trishuli Branch
Jyoti Bikash Bank Ltd.- Chhahare Branch
Jyoti Bikash Bank Ltd.- Ratmate Branch
Jyoti Bikash Bank Ltd.- Ranipauwa Branch
Jyoti Bikash Bank Ltd.- Samundratar Branch
Jyoti Bikash Bank Ltd.- Deurali Branch
Jyoti Bikash Bank Ltd.- Samari Branch
Jyoti Bikash Bank Ltd.- Ratopul
Jyoti Bikash Bank Ltd.- Tamghas
Jyoti Bikash Bank Ltd.- Murgiya
Jyoti Bikash Bank Ltd.- Tandi
Jyoti Bikash Bank Ltd.- Manigram
Jyoti Bikash Bank Ltd.- Lahan Branch
Jyoti Bikash Bank Ltd.- Katari Branch
Jyoti Bikash Bank Ltd.- Attariya Branch
Jyoti Bikash Bank Ltd.- Ilam Branch
Jyoti Bikash Bank Ltd.- Parasi Branch
Jyoti Bikash Bank Ltd.- Besishahar Branch
Jyoti Bikash Bank Ltd.- Kanchanbari Branch
Jyoti Bikash Bank Ltd.- Dhulabari Branch
Jyoti Bikash Bank Ltd.- Corporate Branch
Jyoti Bikash Bank Ltd.- Trishuli Colony Extension
Jyoti Bikash Bank Ltd.- Jaharsingpauwa Extension C
Jyoti Bikash Bank Ltd.- Tikathali
Jyoti Bikash Bank Ltd.- Dallu
Jyoti Bikash Bank Ltd.- Gokarna Branch
Jyoti Bikash Bank Ltd.- Nakhu
Jyoti Capital Ltd.
Type Of Account / खाताको प्रकार
*
Individual / व्यक्तिगत
Foreign Employement
Minor / नाबालक
*
YES / हो
NO / होईन
Mero Share Service / मेरो सेयर सेवा
*
YES / हो
NO / होईन
Maritial Status / वैवाहिक स्थिति
*
Married / विवाहित
Unmarried / अविवाहित
Gender / लिङ्ग
*
Male
Female
Title / शीर्षक
*
Mr.
Mrs.
Miss.
Minor
First Name / आवेदकको पहिलो नाम
*
Middle Name / आवेदकको बीचको नाम
Last Name / आवेदकको थर
*
Father's Name / बुवाको नाम
*
Grandfather's Name / हजुरबुबाको नाम
*
Mother's Name आमाको नाम
*
Spouse's Name / जीवनसाथीको नाम
*
Son's Name/ छोराको नाम
Daughter's Name / छोरीको नाम
Daughter In Law's Name / बुहारीको नाम
Father In Law
*
Citizenship No. / नागरिकता नम्बर
*
Citizen Issue District / नागरिकता जारी जिल्ला
*
-- Select --
Achham
Arghakhanchi
Baglung
Baitidi
Bajhang
Bajura
Banke
Bara
Bardiya
Bhaktapur
Bhojpur
Chitwan
Dadeldhura
Dailekh
Dang
Darchula
Dhading
Dhankuta
Dhanusa
Dolkha
Dolpa
Doti
Gorkha
Gulmi
Humla
Ilam
Jajarkot
Jhapa
Jumla
Kailali
Kalikot
Kanchanpur
Kapilvastu
Kaski
Kathmandu
Kavrepalanchowk
Khotang
Lalitpur
Lamjung
Mahottari
Makwanpur
Manang
Morang
Mugu
Mustang
Myagdi
Nawalparasi (Pashchim)
Nawalparasi (Purba)
Nuwakot
Okhaldhunga
Palpa
Panchthar
Parbat
Parsa
Pyuthan
Ramechhap
Rasuwa
Rautahat
Rolpa
Rukum (Pashchim)
Rukum (Purba)
Rupandehi
Salyan
Sankhuwasabha
Saptari
Sarlahi
Sindhuli
Sindhupalchok
Siraha
Solukhumbu
Sunsari
Surketh
Syangja
Tanahu
Taplejung
Terathum
Udayapur
Citizenship Issue Date (BS) / नागरिकता जारी मिति ( वि . सं )
*
Citizen Issue Date (AD) / नागरिकता जारी मिति ( इस्वी सम्बतमा )
*
DOB (BS) / जन्म मिति ( वि . सं )
*
DOB (AD) / जन्म मिति ( इस्वी सम्बतमा )
*
PAN No. / प्यान नम्बर
Next
Province
*
-- Select --
Province No. 1
Province No. 2
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudurpashchim Province
District / जिल्ला
*
-- Select --
Achham
Arghakhanchi
Baglung
Baitidi
Bajhang
Bajura
Banke
Bara
Bardiya
Bhaktapur
Bhojpur
Chitwan
Dadeldhura
Dailekh
Dang
Darchula
Dhading
Dhankuta
Dhanusa
Dolkha
Dolpa
Doti
Gorkha
Gulmi
Humla
Ilam
Jajarkot
Jhapa
Jumla
Kailali
Kalikot
Kanchanpur
Kapilvastu
Kaski
Kathmandu
Kavrepalanchowk
Khotang
Lalitpur
Lamjung
Mahottari
Makwanpur
Manang
Morang
Mugu
Mustang
Myagdi
Nawalparasi (Pashchim)
Nawalparasi (Purba)
Nuwakot
Okhaldhunga
Palpa
Panchthar
Parbat
Parsa
Pyuthan
Ramechhap
Rasuwa
Rautahat
Rolpa
Rukum (Pashchim)
Rukum (Purba)
Rupandehi
Salyan
Sankhuwasabha
Saptari
Sarlahi
Sindhuli
Sindhupalchok
Siraha
Solukhumbu
Sunsari
Surketh
Syangja
Tanahu
Taplejung
Terathum
Udayapur
Zone
*
-- Select --
Bagmati
Bheri
Dhawalagiri
Gandaki
Janakpur
Karnali
Koshi
Lumbini
Mahakali
Mechi
Narayani
Rapti
Sagarmatha
Seti
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
*
-- Select --
Province No. 1
Province No. 2
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudurpashchim Province
District / जिल्ला
*
-- Select --
Achham
Arghakhanchi
Baglung
Baitidi
Bajhang
Bajura
Banke
Bara
Bardiya
Bhaktapur
Bhojpur
Chitwan
Dadeldhura
Dailekh
Dang
Darchula
Dhading
Dhankuta
Dhanusa
Dolkha
Dolpa
Doti
Gorkha
Gulmi
Humla
Ilam
Jajarkot
Jhapa
Jumla
Kailali
Kalikot
Kanchanpur
Kapilvastu
Kaski
Kathmandu
Kavrepalanchowk
Khotang
Lalitpur
Lamjung
Mahottari
Makwanpur
Manang
Morang
Mugu
Mustang
Myagdi
Nawalparasi (Pashchim)
Nawalparasi (Purba)
Nuwakot
Okhaldhunga
Palpa
Panchthar
Parbat
Parsa
Pyuthan
Ramechhap
Rasuwa
Rautahat
Rolpa
Rukum (Pashchim)
Rukum (Purba)
Rupandehi
Salyan
Sankhuwasabha
Saptari
Sarlahi
Sindhuli
Sindhupalchok
Siraha
Solukhumbu
Sunsari
Surketh
Syangja
Tanahu
Taplejung
Terathum
Udayapur
Zone
*
-- Select --
Bagmati
Bheri
Dhawalagiri
Gandaki
Janakpur
Karnali
Koshi
Lumbini
Mahakali
Mechi
Narayani
Rapti
Sagarmatha
Seti
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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Next
Types Of Bank Account / बैंक खाताका प्रकारहरू
*
-- Select --
Saving Account
Current Account
Bank Account Number / बैँक खाता नम्बर (20 digits)
*
Name Of Bank
*
No Selected
Nepal Bank Ltd.
Rastriya Banijya Bank Ltd.
Agriculture Development Bank Ltd.
Global IME Capital Ltd.
Nabil Bank Ltd.
Nepal Investment Bank Ltd.
Standard Chartered Bank Nepal Ltd.
National Cooperative Bank Ltd.
Himalayan Bank Ltd.
Nepal SBI Bank Ltd.
Nepal Bangladesh Bank Ltd.
Everest Bank Ltd.
Bank of Kathmandu Lumbini Ltd.
Nepal Credit & Commerce Bank Ltd.
Lumbini Bank Ltd.
Nepal Industrial & Commercial Bank Ltd.
Machhapuchhre Bank Ltd.
Kumari Bank Ltd.
Laxmi Bank Ltd.
Siddhartha Bank Ltd.
Global IME Bank Ltd.
Citizens Bank International Ltd.
Prime Commercial Bank Ltd.
Sunrise Bank Ltd.
NIC Asia Bank Ltd.
Grand Bank Nepal Ltd.
NMB Bank Ltd.
Prabhu Bank Ltd.
Janata Bank Nepal Ltd.
Mega Bank Ltd.
Commerz and Trust Bank Nepal Ltd.
CIVIL Bank Ltd.
Century Commercial Bank Ltd.
NIDC Development Bank Ltd.
Siddhartha Development Bank Ltd.
Yeti Development Bank Ltd.
Axis Development Bank Ltd.
Supreme Development Bank Ltd.
Sanima Bank Ltd.
Bageshwori Development Bank Ltd.
Infrastructure Development Bank Ltd.
Society Development Bank Ltd.
Araniko Development Bank Ltd.
Deva Bikas Bank Ltd.
Clean Energy Development Bank Ltd.
Public Development Bank Ltd.
Ace Development Bank Ltd.
Lumbini Bikas Bank Ltd.
Professional Diyalo Bikas Bank Ltd.
Country Develpment Bank Ltd.
Kasthamandap Development Bank Ltd.
Alpine Development Bank Ltd.
Saptakoshi Development Bank Ltd.
Jyoti Bikash Bank Ltd.
International Development Bank Ltd.
Tourism Development Bank Ltd.
Sindhu Bikash Bank Ltd.
Social Development Bank Ltd.
Garima Bikas Bank Ltd.
OM Development Bank Ltd.
Kamana Sewa Bikas Bank Ltd.
Gandaki Bikas Bank Ltd.
Gandaki Bikas Bank Limited.
Paschimanchal Development Bank Ltd.
Muktinath Bikas Bank Ltd.
Shangri-la Development Bank Ltd.
Tinau Bikas Bank Ltd.
Metro Development Bank Ltd.
Excel Development Bank Ltd.
Sajha Bikas Bank Ltd.
Nepal Consumer Development Bank Ltd.
Sahayogi Vikas Bank Ltd.
Manaslu Bikas Bank Ltd.
Kankrebihar Bikash Bank Ltd.
Cosmos Development Bank Ltd.
Miteri Development Bank Ltd.
Ekata Bikas Bank Ltd.
Kabeli Bikas Bank Ltd.
Mahakali Bikas Bank Ltd.
Western Development Bank Ltd.
Hamro Bikas Bank Ltd.
Kankai Bikas Bank Ltd.
Best Finance Company Ltd.
Green Development Bank Ltd.
Nepal Infrastructure Bank Ltd.
City Express Finance Company Ltd.
Nepal Aawas Finance Co. Ltd.
Nepal Community Development Bank Ltd.
Hathway Finance Company Limited.
Janaki Finance Company Ltd.
Sahara Bikas Bank Limited.
Nepal Finance Ltd.
NIDC Capital Markets Ltd.
Narayani National Finance Ltd.
Kailash Bikas Bank Ltd.
Shine Resunga Development Bank Ltd.
Srijana Finance Ltd.
Gurkhas Finance Ltd.
Bhargav Bikash Bank Ltd.
Union Finance Ltd.
Bhrikutee Development Bank Ltd.
Pashchimanchal Finance Co. Ltd.
Business Universal Development Bank Ltd.
Goodwill Finance Ltd.
Raptiveri Bikash Bank Ltd.
Shree Investment & Finance Co. Ltd.
Lumbini Finance & Leasing Co. Ltd.
Yeti Finance Ltd.
International Leasing & Finance Co. Ltd.
Mahalaxmi Finance Ltd.
Lalitpur Finance Co. Ltd.
United Finance Ltd.
Sewa Bikas Bank Ltd.
Progressive Finance Co. Ltd.
Synergy Finance Ltd.
Nava Durga Finance Co. Ltd.
Pokhara Finance Ltd.
Central Finance Ltd.
Premier Finance Co. Ltd.
Corporate Development Bank Ltd.
Om Finance Ltd.
Triveni Bikas Bank Ltd.
World Merchant Banking & Finance Ltd.
Purnima Bikas Bank Ltd.
Innovative Development Bank Ltd.
Apex Development Bank Ltd.
Guheshwori Merchant Banking Finance Ltd.
Everest Finance Ltd.
Fewa Finance Ltd.
Prudential Finance Co. Ltd.
ICFC Finance Ltd.
Subhechha Bikas Bank Ltd.
Sagarmatha Finance Ltd.
Civil Merchant Bittiya Sanstha Ltd.
Siddhartha Finance Ltd.
Pathibhara Bikas Bank Ltd.
Nepal Express Finance Ltd.
Valley Finance Ltd.
Karnali Bikas Bank Ltd.
Reliable Development Bank Ltd.
Mahalaxmi Bikas Bank Ltd.
Biratlaxmi Bikas Bank Ltd.
Zenith Finance Ltd.
Unique Finance Ltd.
Manjushree Finance Ltd.
Mission Development Bank Ltd.
Subhalaxmi Finance Ltd.
Jebils Finance Ltd.
Reliance Finance Ltd.
Lotus Investment Finance Ltd.
Bhaktapur Finance Ltd.
Kaski Finance Ltd.
Kanchan Development Bank Ltd.
Nepal Rastra Bank.
Name Of Branch
*
No Selected
Debit Authority
*
Yes
Debit Authority
*
I hereby authorize Jyoti Bikash Bank Ltd to deduct all the De-mat and Mero share service-related charges from the account maintained at the bank.
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Next
Occupation Type / व्यवसायको प्रकार
*
--- Select Occupation ---
Business Person
Farmer
Government Services
House Wife
Others
Private Sector
Public Sector
Retired
Service
Student
Type Of Business / व्यापारको प्रकार
--- Select BusinessType ---
Manufacturing
Service Oriented
Organization Name / संस्थाको नाम
Address / ठेगाना
Designation / पद
Financial Details / Annual Income
Up to Rs.1,00,000
From Rs.1,00,001 to Rs.2,00,000
From Rs.2,00,001 to Rs.5,00,000
Above Rs.5,00,000
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YES
No
Name English / नाम
*
Father Name
*
Relationship / सम्बन्ध
*
Reference Document Type / कागजात प्रकार
*
-- Select --
Citizenship
Passport
Birth Certificate
Citizenship / Passport / Birth Certificate
*
Place of Issue / जारी को स्थान
*
Issue Year
*
Province
*
-- Select --
Province No. 1
Province No. 2
Bagmati Province
Gandaki Province
Lumbini Province
Karnali Province
Sudurpashchim Province
District / जिल्ला
*
-- Select --
Achham
Arghakhanchi
Baglung
Baitidi
Bajhang
Bajura
Banke
Bara
Bardiya
Bhaktapur
Bhojpur
Chitwan
Dadeldhura
Dailekh
Dang
Darchula
Dhading
Dhankuta
Dhanusa
Dolkha
Dolpa
Doti
Gorkha
Gulmi
Humla
Ilam
Jajarkot
Jhapa
Jumla
Kailali
Kalikot
Kanchanpur
Kapilvastu
Kaski
Kathmandu
Kavrepalanchowk
Khotang
Lalitpur
Lamjung
Mahottari
Makwanpur
Manang
Morang
Mugu
Mustang
Myagdi
Nawalparasi (Pashchim)
Nawalparasi (Purba)
Nuwakot
Okhaldhunga
Palpa
Panchthar
Parbat
Parsa
Pyuthan
Ramechhap
Rasuwa
Rautahat
Rolpa
Rukum (Pashchim)
Rukum (Purba)
Rupandehi
Salyan
Sankhuwasabha
Saptari
Sarlahi
Sindhuli
Sindhupalchok
Siraha
Solukhumbu
Sunsari
Surketh
Syangja
Tanahu
Taplejung
Terathum
Udayapur
Phone No / फोन नम्बर
Mobile No / मोबाइल नम्बर
*
Email / ईमेल
Pan No / प्यान नम्बर
Nominee Photo
फोटो
*
Nominee Thumb Prints
थम्ब प्रिन्ट
*
Nominee Signature
हस्ताक्षर
*
Nominee Birth Certificate / Citizenship (Front)
जन्म प्रमाणपत्र वा नागरिकता (अगाडि)
*
Nominee Birth Certificate / Citizenship (Back)
जन्म प्रमाणपत्र वा नागरिकता (पछाडि)
*
Back
Next
Next
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
*
-- Select --
Achham
Arghakhanchi
Baglung
Baitidi
Bajhang
Bajura
Banke
Bara
Bardiya
Bhaktapur
Bhojpur
Chitwan
Dadeldhura
Dailekh
Dang
Darchula
Dhading
Dhankuta
Dhanusa
Dolkha
Dolpa
Doti
Gorkha
Gulmi
Humla
Ilam
Jajarkot
Jhapa
Jumla
Kailali
Kalikot
Kanchanpur
Kapilvastu
Kaski
Kathmandu
Kavrepalanchowk
Khotang
Lalitpur
Lamjung
Mahottari
Makwanpur
Manang
Morang
Mugu
Mustang
Myagdi
Nawalparasi (Pashchim)
Nawalparasi (Purba)
Nuwakot
Okhaldhunga
Palpa
Panchthar
Parbat
Parsa
Pyuthan
Ramechhap
Rasuwa
Rautahat
Rolpa
Rukum (Pashchim)
Rukum (Purba)
Rupandehi
Salyan
Sankhuwasabha
Saptari
Sarlahi
Sindhuli
Sindhupalchok
Siraha
Solukhumbu
Sunsari
Surketh
Syangja
Tanahu
Taplejung
Terathum
Udayapur
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
*
Achham
Arghakhanchi
Baglung
Baitidi
Bajhang
Bajura
Banke
Bara
Bardiya
Bhaktapur
Bhojpur
Chitwan
Dadeldhura
Dailekh
Dang
Darchula
Dhading
Dhankuta
Dhanusa
Dolkha
Dolpa
Doti
Gorkha
Gulmi
Humla
Ilam
Jajarkot
Jhapa
Jumla
Kailali
Kalikot
Kanchanpur
Kapilvastu
Kaski
Kathmandu
Kavrepalanchowk
Khotang
Lalitpur
Lamjung
Mahottari
Makwanpur
Manang
Morang
Mugu
Mustang
Myagdi
Nawalparasi (Pashchim)
Nawalparasi (Purba)
Nuwakot
Okhaldhunga
Palpa
Panchthar
Parbat
Parsa
Pyuthan
Ramechhap
Rasuwa
Rautahat
Rolpa
Rukum (Pashchim)
Rukum (Purba)
Rupandehi
Salyan
Sankhuwasabha
Saptari
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Sindhupalchok
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Terathum
Udayapur
Citizenship Issue Date(BS) / नागरिकता जारी मिति ( वि . सं )
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Citizenship Issue Date(AD) / नागरिकता जारी मिति ( इस्वी सम्बतमा )
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DOB(BS) / जन्म मिति ( वि . सं )
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DOB(AD) / जन्म मिति ( इस्वी सम्बतमा )
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Applicant Photo
आवेदकको फोटो
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Citizenship of Applicant (Front)
नागरिकता (अगाडि)
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Citizenship of Applicant (Back)
नागरिकता (पछाडि)
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Location Map of Applicant Residence
आवेदकको घरको स्थानीय नक्शा
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Applicant Signature
आवेदक हस्ताक्षर
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Applicant Thumb Print
आवेदकको ल्याप्चे
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Applicant with Citizenship
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Sample Image
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Guardian Photo
फोटो
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Guardian Citizenship (Front)
नागरिकता (अगाडि)
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Guardian Citizenship (Back)
नागरिकता (पछाडि)
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