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NRBC Bank Securities Limited

TREC NO - 082
Hadi Mansion (3rd Floor), 2, Dilkusha C/A, Dhaka-1000, Tel : +880257165253-54
Email : [email protected], Web : www.nrbcbanksecurities.com

Fund Withdrawal Application Form

Please fill in all necessary information carefully on your fund withdrawal request:

Request Date 17-Oct-2024

Account Number C038

Name of the Account Holder(s) KAZI AMIR KASHRO

Contact No. 01676635897

Email Address [email protected]

Bank Account Number 2101734615001


(According to BO Account)

Bank Name THE CITY BANK LTD.

Branch Name PRABARTAK

Routing Number 225156326

Amount(Taka)

Taka In Word

Name of the RM & Signature Asif Ahmed

Declaration: (1) I/We do hereby declare that no purchase will be made against the amount request for withdrawal as
well as the Proportionate loan amount.

(2) I/We agreed all transactions against my/our above mentioned trading ID before this withdrawal.

Signature of the Account Holder(s)

Generation Time: Oct 17, 2024/10:16 AM Page:1of1

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