MDSE Charitable Trust

Name

Fathers Name

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Full Address

House Number

Street

Post

District

Foregin Address

Phone No

Pos. Box. No

Stree No

Country

No

Dt.of.Birth

Identification Marks 1

Identification Marks 2

Nomineee Particulars

Nominee Name

Relationship

Sinature Of Nomine

Attested with Share Holder

SHARE HOLDER DECLARATION

I Agree to Deposit of share, Membership Fee Rs. 5,00,000/-(Ruppes Five Lakhs) And further I State that I will not Interfere in any, what so ever manner like Administration, organization and policy matters of thr management. Only attend of General body meetings.It is best of my interest lies only in profit of my investment.Above furnished information is true and correct.

Sinature Of Share Holder

For Office Use

S. No.

A.No.

A/c No.

V.No.

Signature of the Executive Offer

V.L. No.

GPF No.

GPM. No.

G.M No.

Signature of the Cashier

G.D No.

RC No.