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NOMINEE DETAILS
Dear Sir,

      Having completely read or caused to be read and fully understood the rules governing the conduct to the chit which is proposed to be started from day of and assented to the same, I, hereby remit a sum of Rs. ( Rupees only ) by cash/DD/Cheque No. dated Drawn on being the first instalment of Numbers ticket of chit No. Pooval/ Quarterly/ Bi-Mly/ Monthly. I request you to allot me the ticket and I, also hereby agree to any change in the commencement of the chit.

Yours faithfully,
Witness :  
Signature :  
Name :  
Signature of Subscriber :  

Ticket No. stt No. Cust code Entd. By Cashier Acc/Manager
           
Place :  
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Pooram Kuries
Private Limited.

Corporate Office :
Pathayappura,
Near Ragam Theatre,
Round South, Thrissur - 680 001
Kerala - India
Regd office :
Pudukkadan Aipu Buildings
Rice Bazar, Thrissur-1
Kerala - India
0487-2441752
0487-2444849
Branch :
12621, Near Sanic Colony,
Sector-28,Faridabad.
pooramkuries@gmail.com
info@pooramkuries.com