Nomination PDF

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Nomination Form P. No.

____________________
D.O.J ____________________
D.O.B ____________________
I, __________________________ /O,_____________________________ hereby nominate the person/ persons mentioned
below to receive, in the event of my death, the percentage share shown below against each scheme:

Name of Scheme Name/Address & CNIC of the DOB of Relationship with %Share of scheme
Nominee (s) Nominee(s) the staff to be paid

1. a) Group Insurance (Life )

b) Group Insurance (Accident )

2. a) Provident Fund

b) Provident Fund (Insurance)

3. Benevolent Fund

4. Gratuity

Note: Please provide copy(ies) of each Nominee’s and/or Guardian’s B-Form and CNIC as applicable.
Please use a copy of this form if additional space is required
I hereby agree and confirm that payment to the above nominee(s) will completely discharge the Bank from
its liability in respect thereof.

Place ________________________________

Date ________________________________ ________________________________________________


Witness: Employee’s Signature

1. ____________________________________________ Designation____________________________________________
(Signature)
Branch/Dept./Div._______________________________________
____________________________________________ Verified
(Name and CNIC #)

2. ___________________________________________ _______________________________________________________
(Signature) (Signature)

_____________________________________________ Manager ________________________________________Branch


(Name and CNIC #) Head of the Dept./ Division HOK

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