New Hope - Ex-gratia Application Form
| Sl.no | Name (or) Deceased's nominee | Applicant’s Address | membership No the person | Date of Death | Reason of Death | Bank Name | Nominee Account Number |
|---|---|---|---|---|---|---|---|
| 1 | Testing | 6-453, Monday Market | 4 | 2000-05-28 | choose | State Bank | 90876543212 |