NOMINEE
FORM (For
Sole Accounts Only) |
| I/We...................................................................................................................Son/Daughter/Wife
of |
| ...................................................................................................................................hereby
nominate |
| Mr./Mrs./Ms..........................................................................................................to
receive any sum of |
| monies which may be due to me from Everest
Bank Limited in the Event of my death:- |
| The full details of the nominee
are as Follows:- |
| Son/Daughter/Wife of......................................................................................................................... |
| Date of Birth (in case of minor)........................................................................................................... |
| Relationship to me:............................................................................................................................ |
| Address/Contact Details of Nominee.................................................................................................. |
| Signature/Contact Detail of Nominee................................................................................................. |
| Signature:................................................................................... |
| Account No.:................................................................................ |
|
| WITNESS |
| 1. Name:..................................................................................... |
| Signature:.............................................................................. |
|
| 2. Name:.................................................................................... |
| Signature:..............................................................................
|
| |