Account Opening Form for Individual BW

(100% Subsidiary of Mega Bank Nepal Ltd.)Saket Complex, Tripureshwor, Kathmandu, Nepal

Ph: 01-4262772, 4262775 I Email : [email protected]

Mero Share

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I……………………………... hereby authorize Mega Bank Nepal Limited to debit my Bank Account with the following details for payment of DMAT account related charges of my DMAT account as mentioned below maintained with Mega Capital Markets Limited. This is an irrevocable mandate and will be valid until I operate DMAT account with Mega Capital Markets Limited. Further this Debit Authority / Standing Instructions will be valid, even if my signature is amended.Even if my account is in dormant status, I authorize the Bank to activate my account only for the purpose of payment of DMAT related charges as speci�ed above. I agree to maintain su�cient amount in my bank account.Furthermore, I hereby agree to hold myself responsible and liable for any loss, claim, liability and indemnify the bank for any loss incurred under the above authorization.

Customer Detail:

(100% Subsidiary of Mega Bank Nepal Ltd.)Saket Complex, Tripureshwor, Kathmandu, Nepal

Ph: 01-4262772, 4262775 I Email : [email protected]

Debit Instruction SlipTo Mega Bank Nepal Limited.

For DMAT related Charges Payable to Mega Capital Markets Ltd. (A/C No. : 0010010563002)

Charge Detail:Particular Amount Schedule of Debit Charges

1. Annual Maintenance Charge Rs.100 Start Date of Each Fiscal Year i.e. 1St Shrawan2. Mero Share Renewal Charge Rs.50 One week prior to the expiry.

Date: ...............................

Branch: ...............................

Customer Name:

Bank Name:

Branch:

Bank Account Number:

DMAT Account Number:

Mega Bank Nepal Limited

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……………………Authorized Signature:

Standing Instruction Ref No.

Bank Use OnlyAuthorized ByName : ..............................................

ID No.: ..............................................

Sign: .................................................

Date: ................................................……………………

Signature Veri�ed by

Inputted ByName: ................................................

ID No: ................................................

Sign: ..................................................

Date: .................................................

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