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Name of the Nominee Mr. /Ms. Relationship with the Applicant if any Address of Nominee Contact Details of City/town/ village PIN Code State Country Tel. Off. Tel. Res. Fax No. Mobile No. Email ID Nominee Identification details please tick any one from a to f and provide details of the same Photograph Signature Photograph of nominee a i Signature of nominee ii across photograph b PAN of nominee c Aadhaar number of nominee d e f Savings bank account number of nominee if maintained with the same...
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