Member Registration Form || Pabitra Lumbini Saving and Credit Cooperative Ltd

Pabitra Lumbini Saving & Credit Cooperative Ltd. Kathmandu 28 Bagbazar ,Nepal

Online Member Application Form

Respected Sir/Maa'm,

I request you for membership in the cooperative with the membership charge of Rs. and share of stock at the rate of Rs.100 that amounts to Rs. ,membership security fund as Rs. so, I would monthly deposit Rs. which totals to Rs. by agreeing with the Terms & Conditions of the cooperative

Pabitra Lumbini Saving & Credit Cooperative Members Form

Personal Information

Applicant Name *

Grand Father Name

Grand Mother Name

Father Name *

Mother Name *

Permanent Address *

Province *

District *

Municipality

Ward No. *

Area

House No.

Temporary Address *

Copy Permanent Address

Province *

District *

Municipality

Ward No. *

Area

House No.

Personal Details

Birth Date * [as per Citizenship Card ID]

Mobile No. *

Email

Gendar *

Male Female Other

Occupation

Total estimated annual income

Marital Status *

Singal Married Divorce

Spouse

Citizenship Card [Front and Back]

Upload Front Id

Upload Back Id

Citizenship No. *

Issued Place *

Issued Date *

If you are the member of any other SACOOS, please enter the name and address of the SACOOS

SAACOS's Name

SAACOS's Address

Relation

Family details of the applicant

Fillup any of them below:

Relation *

Grandfather Father in Law Father Mother Husband Wife

Nominee

Nominee details of the applicant

Fillup any of them below:

Nominee

Nominee Name

Nominee Address

Nominee Contact No

Nominee Email

Nominee Citizenship No.

Issued Date

Issued Placed

Upload Front Citizenship

Upload Back Citizenship

Personal Information

Family details of the applicant

Nominee details of the applicant

Our Services

Download