Pathivara Holding
Group of Companies
Founder Share Purchase Call
Please complete all steps carefully
Step
of 4
Account & Share Details
Referred By (Phone Number)
*
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Investor found ✓
Date
*
DP ID
*
Client ID
*
Bank Account No
*
Bank Name
*
Total Kittas
*
Price per Kitta
*
Total
*
Total in Words
*
Payment Type
*
Cheque
Online
Bank Transfer
Cheque Number
*
Cheque Bank Name
*
Cheque Amount
*
Cheque Photo
*
Paid Amount
*
Transaction / Reference ID
*
Payment Screenshot
*
Transferred Amount
*
Sender Bank Name
*
Transaction / Voucher Number
*
Transfer Receipt
*
Personal Details
Applicant Name (English)
*
Applicant Name (Nepali)
*
Mobile
*
Email
(Optional)
PAN
*
NID
*
Citizenship No
*
Issued District
*
Issue Date
*
Permanent Address
*
Current Address
*
Citizenship Documents
(Upload front/back, multiple files allowed)
Applicant Photo
*
Family Details
Husband's / Wife's Name
(Optional)
Father's Name
*
Mother's Name
*
Grandfather's Name
*
Son's Name
(Optional)
Daughter's Name
(Optional)
Daughter-in-law's Name
(Optional)
Father-in-law's Name
(Optional)
Mother-in-law's Name
(Optional)
Nominee Details
Nominee Name
*
Relationship
*
Nominee Address
*
Nominee Citizenship No
*
Nominee Citizenship Issue Date
*
Nominee Citizenship Issue District
*
Nominee Citizenship
(Upload front/back, multiple files allowed)
Nominee Signature
*
Applicant Signature
*
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