KYC - Individual

Basic Details

Person's Details

First Name ^*

Middle Name

Last Name ^*

Mobile No. ^*

10 digit mobile number

Email ^*

Date of Birth (in B.S.) ^*

Date of Birth (in A.D.) ^*

Recent passport sized photo ^*

Upload

Gender ^*

Male

Female

Others

Is this a Minor's Account? ^*

Yes

Guardian's Details (in case of Minor only)

Name of Guardian

Full Address of Guardian

Relationship with Applicant

Contact No. of Guardian

PAN No. of Guardian

Recent Photo of Guardian

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Official Documents

Citizenship Details

Citizenship Front Side Scanned Image ^*

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Citizenship No. ^*

Citizenship Issued From ^*

Citizenship Issued Date (in B.S.) ^*

Citizenship Issued Date (in A.D.) ^*

Grandfather's Name ^*

Father's Name ^*

Mother's Name ^*

Citizenship Back Side Scanned Image ^*

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Non Residental Nepalese

Are you residing outside Nepal? ^*

Yes

You are current Resident in ^*

NRN Identification No.

Passport Details

Passport Scanned Image

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Passport No.

Passport Issued From

Passport Issued Date

Passport Expiry Date

Address Details

Permanent Address

Province ^*

District ^*

Municipality ^*

Tole

Ward No. ^*

House / Block No.

Phone No.

Location Map ^*

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Current Address

Is Your Permanent Address same as Current Address?

Yes

Province

District

Municipality

Tole

Ward No.

House / Block No.

Phone No.

Location Map

Upload

In case of living in rent

Are you living in rent?

Yes

Name of Landlord

Contact No. of Landlord

Address of Landlord

Family Details

Family Information

Marital Status ^*

Married

Unmarried

Other

Spouse's Name

Son's Name (separate by 'and' in case of multiple)

Daughter's Name (Unmarried) (separate by 'and' in case of multiple)

Daughter in Law's Name (separate by 'and' in case of multiple)

Father in Law's Name

Mother in Law's Name

Accounts Details

DEMAT Account

Scanned Image of DEMAT Confirmation Letter ^*

Upload

Beneficiary ID No. ^*

Enter your 16 digits Beneficiary Owner ID No.

Bank Account

Bank Account No. ^*

Name of Bank ^*

Branch ^*

Type of Bank Account ^*

Savings Account

Current Account

Nominee Details

Do you have a nominee? ^*

Yes

Name of Nominee

Relation

Terms and Conditions

Self Proclamation

I consent to open my online account and have provided all the genuine information to Premier Securities Co. Ltd. by filling this form. I will be responsible solely for all the documents and details provided by me. Also I will provide further verification if required and comply with the following Terms & Conditions.

The money used for investment isn't earned through opposing action of Money Laundering Act as per Law of Nepal
I am aware of risks possesed by the Securities Market
I will settle transactions related to the Buying and Selling of Securities within time
I will obey laws related to Securties trading
I am not black listed under Credit Information Bureau

Upload Image of your Signature ^*

Upload

Upload Image of your Thumb Prints (Right | Left) ^*

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Referreral

Were you referred by someone? ^*

Yes

Referred By (If Any)

Upload Image of Referrer's Signature

Upload

KYC - Individual

Premier Securities Co. Ltd.

अनुसूची-१२

नियम २९ को उपनियम (१) सँग सम्बन्धित

For Official use Only

Please complete all details and leave out the non-applicable fields.

Basic Details

Person's Details

Guardian's Details (in case of Minor only)

Official Documents

Citizenship Details

Non Residental Nepalese

Passport Details

Address Details

Permanent Address

Current Address

In case of living in rent

Family Details

Family Information

Professional Details

Occupation

Income

Involvement in Securities Trading Investment Company

Political

Conviction with Law

Accounts Details

DEMAT Account

Bank Account

Nominee Details

Terms and Conditions

Self Proclamation

Referreral

For Official use Only