NET WORTH STATEMENT Mega Bank Nepal Ltd Bishnupur Branch Dear Sir/Madam, I am pleased to furnish my net worth statement to your bank substitute my personal guarantee for banking facilities. (Amount in Rs. ‘000) Type of Assets 1 Land (Vacant) 2 Land with Building 3 Vehicles 4 Cash / Bank 5 Other Movable Assets 6 NSBs / DBs 7 Shares/Stocks of any Companies 8 Others, if any Description Pledged / Mortaged? (Y/N) Loan Availed Rs. Estimated Value Rs. Total Values Rs. I declare that all the particulars and information given above are true, correct and complete and that they shall form the basis for any decision making in regard to any loan / facility. Signature : ……………………………….. Name : ……………………………….. Address : ……………………………….. Date :…………………………………