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lmperiaL$ee Uriti_es Company Pvt. Ltd. qrr* - 1i Annes - 13 (frFrqc io rirr ilryFqil) {Pursant to Byelaw 20) qT.ii.: I Form No.: 2 Emair:45'imperiar@gmair'com rE.tftffi arfm artfi erc dtrTrdt ffi qkn ffi Ffu Format gf Account Openino Form for Gorporate Beneficial Owner fiqtdq rfrffifir infir qra ForOfficatUse Only fit(:{ ilrfi : Application No.: kfr: Date : $S'o q-q{ : Symbol No.: a.rrffi ffi qrfl {rdr : Company's Beneficial Owner Account No.: 1 o t I 1 o t. t. A. D. E.(. B. S. arq-fr iqnq-{r frfr Date of lncorPoration sEte fr. Pvt. Ltd. qtdilo k. Public Ltd. ((Frt sltrfi qqdr Govt. Owned ilffi Nepal {q Gsl( qt6 3rq i{r cwr sdc rtl Others (Please mention it fl"t thu" N"p'l) *.rrfr Eat 'Ig61t{r Cuntry of Registratlon qrffdt F+firq : Types ofAccount : .n- / r*I ChAting I m"*

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  • lmperiaL$ee Uriti_esCompany Pvt. Ltd.

    qrr* - 1iAnnes - 13

    (frFrqc io rirr ilryFqil){Pursant to Byelaw 20)

    qT.ii.: IForm No.: 2

    Emair:45'imperiar@gmair'com rE.tftffi arfm artfi erc dtrTrdt ffi qkn ffi Ffu

    Format gf Account Openino Form for Gorporate Beneficial Owner

    fiqtdq rfrffifir infir qraForOfficatUse Only

    fit(:{ ilrfi :Application No.:

    kfr:Date :

    $S'o q-q{ :Symbol No.:

    a.rrffi ffi qrfl {rdr :Company's Beneficial Owner Account No.: 1

    o t I 1 o

    t. t.A. D.

    E.(.B. S.

    arq-fr iqnq-{r frfrDate of lncorPoration

    sEte fr.Pvt. Ltd.

    qtdilo k.Public Ltd.

    ((Frt sltrfi qqdrGovt. Owned

    ilffiNepal

    {q Gsl( qt6 3rq i{r cwr sdc rtlOthers (Please mention it fl"t thu" N"p'l)*.rrfr Eat 'Ig61t{rCuntry of Registratlon

    qrffdt F+firq :Types ofAccount :

    .n-/ r*I ChAting

    I m"*

  • 6qffi qq ft-fiul

    (FFIIFF ffit{d fr-{$rDetails of Clearing Member

    rTtqT/Flqlqq (HT ( {s{ TH {nqr/6rcr{q'8re 1ilSlBranch/Number of offiee and Main !-try:1-:l9t1i:.t,"!t !

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    (di'i,Registration No

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    SEEOFt.$gr,tai kfr 'Registrarion, Oate

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    osrffi ffar+i BqrmCurrent Address of ComPanY

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    Nearest Landrnark

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    Name of Securities Market

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    ratedetailscanbesubmitteclincaseofrnorethanthree.

    '**rMffi

    l'"s;;ii,E;;-]j

    sa'{-d qf6Contact Person

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    NiarnelSumamr

    T(Designatbn

    e'ft/qFffi qrs"Spouse's Name

    qrgdt aqFathe/s Name

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    ETqd }{fiTCunentAddress

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    {rfu sdilk-r kfiur q-tq

    {qrffT,, Trdmrft sBe' { qTem' {qlEf$gqfr eE{pT (Details *f Directors, CEO and Authorised Account Operators}

    t^^le shail accept to the terms and conditiis rglqtjry to tre asEeeqeq* getwgel.Pqpositorv participglF.gld Beneficial owner, prevailent act'

    reourations, bveraws and any amendments on ii tA/t'e ["?l1i'i&-,i6i-Ltip-;{!fii'@;ffivl'oisctoddo details are true. I further herebv consent

    r^i-^..^ anrr rinar anrinns in'mse anv false disctosuraoi inJ6iiidtioii rerat6o tb'rteius aniilti=Depository Participants reserve right to close my[31',ji,l31irilE5[""fl'.".1i';!#;i E!: iilqj,lffii eifirl;f,;ffitr EiiEtr 1ffi;1ufu.sr+,ttrii'Defositorv Participants reserve risht to crose mv

    account. Ail disputes ure suUp.ito tlre jurisdiction ot CUU*s+n t

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