Pin Code

Share Holder

Repayment of Deposit to be made payment to:

DateShare No.

First depositor

Either or Survivor Former of Survivor

Any one or Supervisor

Jointly

Tax to be deducted

Yes No Not Applicable

Tax not to be deducted Form 15G/15H Enclosed

A Company Registered 2013 & 2014 rules respectively, working on the lines of Nidhi Company.

MEMBERSHIP APPLICATION FORM

RD ID

Membership ID

Branch Centre Branch Code

I submit my application form to be an associate member of "Swatch Nidhi Limited" with the Membership fee of Rs. 10/100 after acceptance of my membership I will abide by all the existing rules, regulation, sub-rules any amendment modification or done by the company from time to time,. I solemnly declare that I am not a member of any other company similar in nature of "Swatch Nidhi Limited". However all information provided by me in the application form is true and correct to the best of my knowledge.

My Detail as Below :

Please fill in Appropriate Block

Permanent Address

DOB / AGE Gender Marital Status Educational Qualification (attach certificates) Religion Catagory

Age (Attach Birth Certificate)

Male

Female

Married

Unmarried

Below Matric

Matric / 10+2

Graduate / P.G.

Professional

Hindu

Muslim

Sikh

Christian

Jain

Other

BC

Occupation

Domicile (Attach Photo Copy)

Identity Card (Attach Photo Copy)

Service

Adhar Card

Identity Card

Business

Voter I.D.

Voter I.D.

Farming

Electricity Bill

PAN Card

Professional

Telephone BIll

Pass Port

Housewife

Education

Driving Licence

Student

Ration Card

Other

Other

Other

District

Mo. No. PAN No.:

Nominee : Mr. / Mrs. / Ms.

Relationship : Age :

If witness is a member of Swatch Nidhi Ltd., Then mention membership Number

Mr. / Mrs. / Miss

Correspondence Address

District State

Pin Code Mobile No.

Associate Code

Associate Name

Associate Sign.

ONLY FOR OFFICE USE

After review by the Divisional Manager / Membership Committee / Authorized Officer of theSWATCH NIDHI LTD., the above application is Accpeted / Rejected.

Attachments :1. Three New Colour Photograph2. Domicile3. Educational Certificate4. Birth Certificate5. Self Attested Photocopy of PAN Card

Date

Receipt No. of Membership Fee

Allocation Membership Number

Office Stamp & Signature of Authorised Officer

406, Silver Line Complex, Opp. BBC Tower, Sayajigunj, VADODARA - 390 005. (Gujarat) INDIA.Customer Care : 0265-2225875, Email : info.swatchnidhi@gmail.com Visit us at : www.swatchnidhi.com

Reg. No. : U65999GJ2016PLC094107

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Date

Status of the Depositor

Details of witness / Proof

Share Value: Share Purchase:

Sr. No.:

General

SC

ST

Taluka State

E-mail ID

Last Name

Mr. / Miss. / Mrs.

S/o. / D/o. / W/o.

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Office Stamp & Signature of Authorised Officer

Signature of Applicant / Thumb ImpressionDate :