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Customer Name (वित्तीय ग्राहकको नाम)
Mobile No. (मोबाइल नम्बर)
Email (सम्पर्क इमेल)
Province (प्रदेश)
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Province No. 1
Province No. 2
Bagmati
Gandaki
Lumbini
Karnali
Sudurpashchim
District (जिल्ला)
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Municipality (नगरपालिका/गाउँपालिका)
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Ward No. (वडा नं.)
Street (टोल)
Bank Name (बैंकको नाम)
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Agricultural Development Bank Ltd.
Bank of Kathmandu Ltd.
Century Commercial Bank Ltd.
Citizens Bank International Ltd.
Civil Bank Ltd.
Everest Bank Ltd.
Global IME Bank Ltd.
Himalayan Bank Ltd.
Kumari Bank Ltd.
Laxmi Bank Ltd.
Machhapuchchhre Bank Ltd.
Mega Bank Nepal Ltd.
Nabil Bank Ltd.
NCC Bank Ltd.
Nepal Bangladesh Bank Ltd.
Nepal Bank Ltd.
Nepal Investment Bank Ltd.
Nepal SBI Bank Ltd.
NIC ASIA Bank Ltd.
NMB Bank Ltd.
Prabhu Bank Ltd.
Prime Commercial Bank Ltd.
Rastriya Banijya Bank Ltd.
Sanima Bank Ltd.
Siddhartha Bank Ltd.
Standard Chartered Bank Nepal Ltd.
Sunrise Bank Ltd.
Bank Branch (बैंक शाखा)
Complaint Subject (गुनासोको विषय)
Related Documents (सम्बन्धित कागजात) (If any)
Complaint Brief Description (गुनासोको तथ्य सहितको विवरण)
I hereby declare that the information provided is true and correct. (म / हामीले दरखास्त फारममा उपलब्ध गराएको सूचना तथा जानकारीहरु सत्य र ठिक छ भनि पुष्टी गर्दछु।)
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