Singapore Dollar isavvy Savings Account Application Form (For Maybank Malaysia Customers only)

Transcription

1 IMPORTANT NOTES Singapore Dollar isavvy Savings Account Application Form (For Maybank Malaysia Customers only) Please allow up to 14 business days for processing. Applications with incomplete document or information will result in a delay in processing. This original application form must be submitted personally at any of the Maybank Malaysia Branch or Premier Wealth Centre listed at the end of this form. The newly opened account number and other facilities (i.e. Debit Card and Online Security Token) will be mailed to you as per the mailing address indicated on this form. Please place a deposit within 30 days from the date the account is successfully opened. You may also wish to note that a monthly fee of S$2 will be charged if average daily balance falls below S$500 in that month. ELIGIBILITY At least 18 years of age An existing Maybank Malaysia customer REQUIRED DOCUMENTS 1) This original isavvy Savings Account Application Form duly completed and signed; and 2) Original and a photocopy (front and back) of your Identification Card (IC); and 3) Proof of Address (i.e. latest utility bill with your name and Mailing Address indicated) For opening of a joint account, both you and your joint applicant are required to be present at the Branch at the same time. Your joint applicant will also need to present the above-mentioned Required Documents. I/We wish to open a Singapore Dollar (S$) isavvy Savings Account with Maybank Singapore. Purpose of Account Account Type Individual Joint (any-one to sign) Deposit Insurance Scheme Singapore dollar deposits of non-bank depositors are insured by the Singapore Deposit Insurance Corporation, for up to S$50,000 in aggregate per depositor per Scheme member by law. Monies and deposits denominated in Singapore dollars under the CPF Investment Scheme and CPF Retirement Sum Scheme are aggregated and separately insured up to S$50,000 for each depositor per Scheme member. Foreign currency deposits, dual currency investments, structured deposits and other investment products are not insured. Page 1 of 22

2 INDIVIDUAL TAX RESIDENCY SELF-CERTIFICATION FORM INSTRUCTIONS Please read these instructions before completing page 4 and page 7 of the form. Income Tax (International Tax Compliance Agreements) (Common Reporting Standard) Regulations 2016 require Malayan Banking Berhad to collect and report certain information about an account holder s tax residence. Each jurisdiction has its own rules for defining tax residence, and jurisdictions have provided information on how to determine if you are resident in the jurisdiction on the following website: In general, you will find that tax residence is the country/jurisdiction in which you live. Special circumstances may cause you to be resident elsewhere or resident in more than one country/jurisdiction at the same time (dual residency). If you are a U.S. citizen or tax resident under U.S. law, you should indicate that you are a U.S. tax resident on this form and you may also need to fill in an IRS W-9 form. For more information on tax residence, please consult your tax adviser or the information at the OECD automatic exchange of information portal. If your tax residence (or the account holder, if you are completing the form on their behalf) is located outside Singapore, we may be legally obliged to pass on the information in this form and other financial information with respect to your financial accounts to Inland Revenue Authority of Singapore ( IRAS ) and they may exchange this information with tax authorities of another jurisdiction or jurisdictions pursuant to intergovernmental agreements to exchange financial account information. You can find summaries of defined terms such as an account holder, and other terms, in the Appendix. This form will remain valid unless there is a change in circumstances relating to information, such as the account holder s tax status or other mandatory field information, that makes this form incorrect or incomplete. In that case you must notify us and provide an updated self-certification. This form is intended to request information consistent with local law requirements. Please fill in this form if you are an individual account holder, sole trader or sole proprietor. For joint account holders, please complete page 7. Where you need to self-certify on behalf of an entity account holder, do not use this form. Instead, you will need an FATCA/CRS Entity Self-Certification Form. Similarly, if you are a controlling person of an entity, please fill in the CRS Controlling Person Self-Certification Form Annex of a FATCA/CRS Entity Self-Certification Form instead of this form. If you are filling in this form on behalf of someone else. Please tell us in what capacity you are signing in Part 3. For example, you may be the custodian or nominee of an account on behalf of the account holder, or you may be completing the form under a power of attorney. A legal guardian should complete the form on behalf of an account holder who is a minor. As a financial institution, we are not allowed to give tax advice. Your tax adviser may be able to assist you in answering specific questions on this form. Your domestic tax authority can provide guidance regarding how to determine your tax status. You can also find out more, including a list of jurisdictions that have signed agreements to automatically exchange information, along with details about the information being requested, on the OECD automatic exchange of information portal. Page 2 of 22

3 MAIN APPLICANT PART 1: PERSONAL PARTICULARS (MAIN APPLICANT) Name as in IC or Passport (Mr / Dr / Mrs / Mdm / Ms ) (please underline surname) Identification Card (IC) No. Date of Birth (dd/mm/yyyy) Country of Birth Nationality (Country of Citizenship) Singapore Permanent Resident Race Gender Yes No Chinese Malay Indian Marital Status Others Male Female Single Married Divorced Others Highest Education Primary SPM/ O Levels STPM/ A Levels Diploma Degree Postgraduate Residential Address Country: Mailing Address (if different from Residential Address) Postal Code: Contact Details Country: Postal Code: Home Office Mobile Number* * Name to appear on Maybank Platinum Debit Card (Maximum of 19 characters) Employment Details Working in Singapore Yes No Self-employed Yes No Company Name Nature of Business Designation Annual Income (SGD S$ equivalent) Below S$30,000 S$50,000 S$99,999 S$30,000 S$49,999 Above S$100,000 *The mobile no. and provided will be used for all your banking services, and updating of all your existing records. Only SG-registered mobile no. will receive SMS, alerts and notifications on all banking services. Page 3 of 22

4 MAIN APPLICANT PART 2: FATCA SELF-CERTIFICATION (MAIN APPLICANT) Please tick ( ) Yes or No for each of the following questions: The term U.S. person or United States person means a person described in Section 7701(a)(30) of the Internal Revenue Code: The term United States person means a citizen or resident of United States. 1. Are you a United States (U.S.) Citizen? 2. Do you hold a U.S. Permanent Resident Card (Green Card)? 3. Are you a U.S. Resident? Yes No 4. If you have responded No to all three questions above, then please tick ( ) the box below. Non U.S. person PART 3: TAX RESIDENCE INFORMATION (MAIN APPLICANT) I am a Tax Resident of Singapore only and my Tax Identification Number ( TIN ) is. Please proceed to Part 5 if you ticked this. Otherwise, proceed to Part 4. PART 4: TAX RESIDENCE INFORMATION (MAIN APPLICANT) Please complete the following table indicating (i) The country where the Account Holder is resident for tax purposes (including Singapore, where applicable); (ii) The Account Holder s Taxpayer Identification Number ( TIN ) or functional equivalent for each country indicated. If you are a US person under US Regulations, please fill in and provide an IRS Form W-9 in addition to this form. If the Account Holder is a resident for tax purpose in more than three countries, please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C. Reason A: The country where the Account Holder is liable to pay tax does not issue TINs to its residents Reason B: The Account Holder is otherwise unable to obtain a TIN (Please explain why Account Holder is unable to obtain a TIN in the below table if you have selected this reason) Reason C: No TIN is required (note: Only select this reason if the authorities of the country of residence for tax purposes entered below do not require the TIN to be disclosed) 1 Country of tax residence TIN If no TIN available, enter Reason A,B or C 2 3 Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above Page 4 of 22

5 MAIN APPLICANT PART 5: DECLARATIONS FOR FATCA SELF-CERTIFICATION AND TAX RESIDENCE INFORMATION (MAIN APPLICANT) By signing below, I hereby: 1. certify that I am the Account Holder (or am authorized to sign for the Account Holder) of all the account(s) to which this Self-Certification Form relates; 2. represent and declare that all statements made in this Self-Certification Form and the information provided above are, true, accurate and complete in all aspects. I understand the term "U.S. person" means any citizen or resident of the United States; 3. consent to Malayan Banking Berhad, Singapore Branch or any of its related entities and affiliates (collectively the Bank ) disclosing any information contained in this form and information relating to me including details of any Reportable Account(s), investments or transactions to any government, tax and regulatory agency or authority or any party (located in or outside Singapore) for the purpose of enabling the Bank to comply with any legal, tax or regulatory obligation under any applicable laws (including the Foreign Account Tax Compliance Act ( FATCA ) or any similar law in any jurisdiction) or pursuant to any intergovernmental agreement to exchange financial account information; 4. authorise the Bank to deduct or withhold from my account(s) maintained with the Bank such amounts or otherwise make any payment on account of any tax or levy in any jurisdiction where the Bank is required to do so by any government agency, revenue authority or any party in any jurisdiction and/or under any applicable law (including FATCA); 5. consent that the Bank may classify me as a recalcitrant account holder and/or suspend, recall or terminate my account(s) and/or facilities granted to me, in the event I fail to provide accurate and complete information and/or documentation as the Bank may require; 6. undertake to notify the Bank in writing within 30 calendar days if there is a change in circumstances which affect the tax residency status of the individual identified in Part 1 of this form or causes any information I have provided to the Bank or contained herein to become incorrect or incomplete, and to provide the Bank with a duly updated self-certification and declaration; 7. agree to indemnify the Bank, to the extent permitted by law, for any loss or liability that may be incurred by the Bank in connection with any breach by me of any obligations herein and/or the Bank s compliance with FATCA or any tax or regulatory obligations under any applicable law; 8. acknowledge and agree that I may incur liabilities arising from or in connection with the Bank s compliance with FATCA or any tax or regulatory obligations under any applicable laws and I agree that the Bank shall not be liable for that loss; and 9. agree to provide the Bank with any information that the Bank may require from time to time to comply with FATCA or any tax or regulatory obligations under any applicable law. Signature of Main Applicant Print Name Date (DD/MM/YYYY) Note: If you are not the Account Holder please indicate the capacity in which you are signing the form. If signing under a power of attorney please also attached a certified copy of the power of attorney. Capacity Page 5 of 22

6 JOINT APPLICANT PART 1: PERSONAL PARTICULARS (JOINT APPLICANT) Name as in IC or Passport (Mr / Dr / Mrs / Mdm / Ms ) (please underline surname) Identification Card (IC) No. Date of Birth (dd/mm/yyyy) Country of Birth Nationality (Country of Citizenship) Singapore Permanent Resident Race Gender Yes No Chinese Malay Indian Marital Status Others Male Female Single Married Divorced Others Highest Education Primary SPM/ O Levels STPM/ A Levels Diploma Degree Postgraduate Residential Address Country: Mailing Address (if different from Residential Address) Postal Code: Contact Details Country: Postal Code: Home Office Mobile Number* * Name to appear on Maybank Platinum Debit Card (Maximum of 19 characters) Employment Details Working in Singapore Yes No Self-employed Yes No Company Name Nature of Business Designation Annual Income (SGD S$ equivalent) Below S$30,000 S$50,000 S$99,999 S$30,000 S$49,999 Above S$100,000 *The mobile no. and provided will be used for all your banking services, and updating of all your existing records. Only SG-registered mobile no. will receive SMS, alerts and notifications on all banking services. Page 6 of 22

7 JOINT APPLICANT PART 2: FATCA SELF-CERTIFICATION (JOINT APPLICANT) Please tick ( ) Yes or No for each of the following questions: The term U.S. person or United States person means a person described in Section 7701(a)(30) of the Internal Revenue Code: The term United States person means a citizen or resident of United States. 1. Are you a United States (U.S.) Citizen? 2. Do you hold a U.S. Permanent Resident Card (Green Card)? 3. Are you a U.S. Resident? Yes No 4. If you have responded No to all three questions above, then please tick ( ) the box below. Non U.S. person PART 3: TAX RESIDENCE INFORMATION (JOINT APPLICANT) I am a Tax Resident of Singapore only and my Tax Identification Number ( TIN ) is. Please proceed to Part 5 if you ticked this. Otherwise, proceed to Part 4. PART 4: TAX RESIDENCE INFORMATION (JOINT APPLICANT) Please complete the following table indicating (iii) The country where the Account Holder is resident for tax purposes (including Singapore, where applicable); (iv) The Account Holder s Taxpayer Identification Number ( TIN ) or functional equivalent for each country indicated. If you are a US person under US Regulations, please fill in and provide an IRS Form W-9 in addition to this form. If the Account Holder is a resident for tax purpose in more than three countries, please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C. Reason A: The country where the Account Holder is liable to pay tax does not issue TINs to its residents Reason B: The Account Holder is otherwise unable to obtain a TIN (Please explain why Account Holder is unable to obtain a TIN in the below table if you have selected this reason) Reason C: No TIN is required (note: Only select this reason if the authorities of the country of residence for tax purposes entered below do not require the TIN to be disclosed) 1 Country of tax residence TIN If no TIN available, enter Reason A,B or C 2 3 Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above Page 7 of 22

8 JOINT APPLICANT PART 5: DECLARATIONS FOR FATCA SELF-CERTIFICATION AND TAX RESIDENCE INFORMATION (JOINT APPLICANT) By signing below, I hereby: 1. certify that I am the Account Holder (or am authorized to sign for the Account Holder) of all the account(s) to which this Self-Certification Form relates; 2. represent and declare that all statements made in this Self-Certification Form and the information provided above are, true, accurate and complete in all aspects. I understand the term "U.S. person" means any citizen or resident of the United States; 3. consent to Malayan Banking Berhad, Singapore Branch or any of its related entities and affiliates (collectively the Bank ) disclosing any information contained in this form and information relating to me including details of any Reportable Account(s), investments or transactions to any government, tax and regulatory agency or authority or any party (located in or outside Singapore) for the purpose of enabling the Bank to comply with any legal, tax or regulatory obligation under any applicable laws (including the Foreign Account Tax Compliance Act ( FATCA ) or any similar law in any jurisdiction) or pursuant to any intergovernmental agreement to exchange financial account information; 4. authorise the Bank to deduct or withhold from my account(s) maintained with the Bank such amounts or otherwise make any payment on account of any tax or levy in any jurisdiction where the Bank is required to do so by any government agency, revenue authority or any party in any jurisdiction and/or under any applicable law (including FATCA); 5. consent that the Bank may classify me as a recalcitrant account holder and/or suspend, recall or terminate my account(s) and/or facilities granted to me, in the event I fail to provide accurate and complete information and/or documentation as the Bank may require; 6. undertake to notify the Bank in writing within 30 calendar days if there is a change in circumstances which affect the tax residency status of the individual identified in Part 1 of this form or causes any information I have provided to the Bank or contained herein to become incorrect or incomplete, and to provide the Bank with a duly updated self-certification and declaration; 7. agree to indemnify the Bank, to the extent permitted by law, for any loss or liability that may be incurred by the Bank in connection with any breach by me of any obligations herein and/or the Bank s compliance with FATCA or any tax or regulatory obligations under any applicable law; 8. acknowledge and agree that I may incur liabilities arising from or in connection with the Bank s compliance with FATCA or any tax or regulatory obligations under any applicable laws and I agree that the Bank shall not be liable for that loss; and 9. agree to provide the Bank with any information that the Bank may require from time to time to comply with FATCA or any tax or regulatory obligations under any applicable law. Signature of Joint Applicant Print Name Date (DD/MM/YYYY) Note: If you are not the Account Holder please indicate the capacity in which you are signing the form. If signing under a power of attorney please also attached a certified copy of the power of attorney. Capacity Page 8 of 22

9 ALL APPLICANTS PART 6: MAYBANK PLATINUM DEBIT CARD AND ELECTRONIC SERVICES Together with my/our Singapore Dollar isavvy Savings Account, I/we will be issued with Maybank Platinum Debit Card Maybank2u.com.sg (Online Banking) ^ Note: If you are already an existing Maybank Online Banking ( user with 2FA, please do not complete this section. Please tick ( ) one: Main Applicant SMS + New Security Token New Security Token Joint Applicant SMS + New Security Token New Security Token I/We understand that the application for the above services is applicable to all accounts with Single or Joint any-one to sign mandate, now or hereafter maintained by me/us. ^ If you are an existing Maybank2u.com.sg user, you can use your current Access ID/Username and PIN/Password to access your S$ isavvy Savings Account. You will not be issued with a new Access ID/Username and PIN/Password. PART 7: MARKETING COMMUNICATION CONSENT FORM In addition to s and direct mailers, please send me such marketing and promotional material(s) via the following mode(s), regardless of my registration with the Do Not Call Registry: (please tick) Main Applicant SMS/ MMS/ Other phone number based messaging Phone Call Joint Applicant SMS/ MMS/ Other phone number based messaging Phone Call Declarations: A. I/We further request for and consent to Malayan Banking Berhad and its related corporations (collectively, the Bank ), their agents, and their authorised service providers collecting, using, disclosing and/or processing my/our personal data (including my Singapore telephone numbers which I/we may provide to Maybank from time to time), and sharing such personal data with Bank s business partners, marketing partners, the co-brand partner (as may be applicable, depending on the product or service which I/we have applied for) and their authorised service providers in order to send me/us marketing and promotional material about products and services as well as advertisements, promotions and events, conduct consumer or market research and identify products and services which may be relevant to me/us ( Promotional Purposes ). B. I/We acknowledge that: (a) leaving any of the boxes above blank is not a withdrawal of any consents which I/we may have previously provided to the Bank in relation to my/our personal data, (b) my/our consent for Promotional Purposes (i) does not supersede or replace any other consent previously provided to the Bank and is in addition to any other rights which Bank may have at law to collect, use or disclose my/our personal data and (ii) shall survive the termination or expiry of any agreement or other relationship between us. Important Notes: 1. The information provided above is solely for the purpose of providing the consent for marketing and does not serve as a notification for update of personal particulars. 2. I/We understand that if I/we do not wish for the Bank to collect, use or disclose my/our personal data for such Promotional Purposes, I/we may withdraw my/our consent at any time via forms available through the Internet Banking (IB) portal or from the Bank s branches. I/We further understand that if I/we do not wish for third parties (such as the Bank s business partners or marketing partners) to collect, use or disclose my/our personal data for such Promotional Purposes, I/we should contact these third parties directly with my/our request. Page 9 of 22

10 ALL APPLICANTS PART 8: DECLARATIONS (1) I/We confirm that I am/we are applying for the above-mentioned savings account ( Account ), the Maybank Platinum Debit Card ( Card ) and Internet Banking services ( Services ) and are the sole beneficial owner(s) of the Account; (2) I/We agree that Maybank may send the Card and New Security Token to me/us by ordinary mail or such other means at my/our sole risk to my/our mailing address specified herein; (3) I/We agree to abide by the applicable charges relating to and the terms and conditions governing the Account, the Card and the Services and all other terms and conditions governing the respective services linked to the Account, the Card and the Services, including any amendments and revisions that Maybank may impose in relation to any applicable charges and to any of the above terms and conditions from time to time, a copy of which is available at all Maybank Branches in Singapore and Maybank s internet website; (4) I/We agree that my/our application herein is subject to Maybank s approval and Maybank has the absolute right and discretion to decline my/our application without giving any reason and to retain documents submitted as property of Maybank; (5) If this application is not accepted by Maybank, I/we confirm and agree that Maybank may send the cheque(s) (free of interest) and correspondence by ordinary mail or such other means at my/our sole risk to my mailing address (in the case of single applicant) or to the mailing address of the main applicant (in the case of joint applicants) indicated in this application form; (6) I/We represent and warrant that all information provided by me/us in this application is true and complete and undertake to notify Maybank immediately of any change in such information and acknowledge that Maybank reserves the right, at any time (whether before or after the Account is opened) and for any reason whatsoever, to require me/us to attend personally at any Maybank Branch in connection with the opening of the Account and/or verification of my/our signature(s); (7) I/We confirm that at the time of this application, I am not/none of us is an undischarged bankrupt and no statutory demand has been served on me/any one of us nor any legal proceedings commenced against me/any one of us; (8) I/We agree to the purposes set out in the Bank s Data Protection Policy (the link to which is provided below) for the collection, use and disclosure of my/our personal data, including authorising the Bank to disclose or release, any information whatsoever relating to me/any one of us to: (a) any credit bureau or any other organisation or corporation set up for the purpose of collecting and providing information relating to the credit standing of persons; (b) any other person(s) for the purpose of processing this application; or (c) for such other purposes as Maybank may from time to time deem necessary or expedient (9) I/We acknowledge and agree that the Card comes with a NETS FlashPay stored value facility of which Network for Electronic Transfers (Singapore) Pte Ltd ("NETS") is the holder and operator and in this regard, I/we authorise Maybank to disclose any information relating to me/us to NETS as may be necessary for usage of the NETS FlashPay stored value facility on the Card. I/We acknowledge and agree that the terms for the use of the NETS FlashPay stored value facility (if any) shall be governed by NETS' Terms and Conditions Governing the Use of NETS FlashPay which is available for viewing at or such website as NETS may designate from time to time; (10) By providing the information in this application form (and any other information that I/we may provide to the Bank from time to time in connection with the Bank s products and services): (i) I/We agree and consent to Malayan Banking Berhad and its related corporations (collectively, "Maybank") collecting, using, disclosing and sharing amongst themselves my/our personal data, and disclosing such personal data to Maybank's authorised service providers and relevant third parties for purposes reasonably required by Maybank to process my/our application(s), provide me/us with the products or services which I am /we are applying for, as well as the purposes set out in Maybank, Singapore branch s Data Protection Policy, which is accessible at or which may be provided to me/us upon request. I/We confirm I/we have read and understood the Data Protection Policy; and (ii) If I/we should withdraw my/our consent to the processing or handling of my/our personal data in respect of any purpose which Maybank may reasonably consider to be essential in order for Maybank to provide me/us with the products and/or services applied for, Maybank shall be entitled to treat my/our account and/or card as having been terminated by me/us without prejudice to any rights and remedies which it may have at law against me/us. (11) I/We agree that Maybank Singapore may, at any time and in connection with my/our application herein, request from or verify with Maybank Malaysia any or all information provided by me/us in this application form, and I/we consent to and authorise Maybank Malaysia to disclose such information on record with Maybank Malaysia at the time of such request. By signing below, I/we acknowledge and agree to all the declarations as stated in this application form: Signature of Main Applicant Date: Signature of Joint Applicant Date: Page 10 of 22

11 Appendix Glossary Note: Further details can be found within the Income Tax (International Tax Compliance Agreement) (Common Reporting Standard) Regulations This can be found at the IRAS website ( If you have any questions, please contact your tax adviser. Account Holder The term Account Holder means the person listed or identified as the holder of a Financial Account. A person, other than a Financial Institution, holding a Financial Account for the benefit of another person as an agent, a custodian, a nominee, a signatory, an investment advisor, an intermediary, or as a legal guardian, is not treated as the Account Holder. In these circumstances that other person is the Account Holder. For example in the case of a parent/child relationship where the parent is acting as a legal guardian, the child is regarded as the Account Holder. With respect to a jointly held account, each joint holder is treated as an Account Holder. Financial Account A Financial Account is an account maintained by a Financial Institution and includes: Depository Accounts; Custodial Accounts; Equity and debt interest in certain Investment Entities; Cash Value Insurance Contracts; and Annuity Contracts. Reportable Account The term Reportable Account means an account held by one or more Reportable Persons or by a Passive NFE with one or more Controlling Persons that is a Reportable Person. Reportable Person A Reportable Person is defined as an individual who is tax resident in a Reportable Jurisdiction under the tax laws of that jurisdiction. Dual resident individuals may rely on the tiebreaker rules contained in tax conventions (if applicable) to solve cases of double residence for purposes of determining their residence for tax purposes. TIN (including functional equivalent ) The term TIN means Taxpayer Identification Number or a functional equivalent in the absence of a TIN. A TIN is a unique combination of letters or numbers assigned by a jurisdiction to an individual or an Entity and used to identify the individual or Entity for the purposes of administering the tax laws of such jurisdiction. Further details of acceptable TINs can be found at the OECD automatic exchange of information portal. End of Singapore Dollar isavvy Savings Account Application Form Page 11 of 22

12 FOR BANK S USE (on Main Applicant) PART 9: FOR BANK S USE ONLY (MAYBANK MALAYSIA) Questions below to be considered in conjunction with all documents & forms collected from customers (including this form). S/N U.S. Indicia Status Yes/No If Yes, please take note of the FATCA documentation required 1 Have the account holder(s) provided any indication that the account holder(s) are U.S. citizen or resident? (ii) Appropriate documentation* and Form W-8BEN 2 Have the account holder(s) provided a U.S. place of birth? 3 Have the account holder(s) provided a U.S. address (including P.O. Box)? 4 Have the account holder(s) provided only a U.S. telephone number? 5 Have the account holder(s)provided any standing instructions to transfer funds to an account maintained in the U.S.? 6 Have the account holder(s) provided a U.S. telephone number and a non U.S. telephone number? 7 Have the account holder(s) granted Power of Attorney or signatory authority to a person with a U.S. address? 8 Have the account holder(s) provided only a hold mail or in care of address, that is the sole address for this account? (ii) Certificate of Loss of Nationality, and (iii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation*or form W-8BEN (ii) Appropriate documentation* or form W-8BEN (ii) Appropriate documentation* or form W-8BEN (a) Where all questions above are answered as no, appropriate documentation as below should still be obtained. (b) * Appropriate documentation refers to documentation to establish the person(s) non-u.s. status. The documentation must contain a permanent residence address outside of the U.S., and must be one of the following documents: (i) Certificate of residence (issued by tax officials) (ii) Government identification document (such as Identification Card) evidencing non-u.s. citizenship or nationality. (c) If the permanent address listed on the appropriate documentation obtained differs from the address provided in the application form, ensure that the appropriate documentation indicates the country in which the account holder(s) is a citizen or resident. (d) In the absence of such documentation, relationship manager should obtain form W-8 BEN from account holder(s). (e) W-8BEN form should not contain a permanent residence address in the U.S. to conclude a customer s status as Non U.S. Customer s FATCA Classification: Customer is: U.S. Non U.S. Page 12 of 22

13 FOR BANK S USE (on Main Applicant) Questions below to be considered in conjunction with all documents & forms collected from customers (including this form). S/N CRS Indicia Status Yes/No Country(ies) / Jurisdiction(s) of Indicia 1 Have the account holder(s) provided any indication that the account holder(s) are foreign* resident? 2 Have the account holder(s) provided a foreign residence / mailing address? 3 Have the account holder(s) provided only a foreign telephone number? 4 Have the account holder(s) provided any standing instructions to transfer funds to an account maintained in a foreign jurisdiction? 5 Have the account holder(s) granted Power of Attorney or signatory authority to a person in a foreign jurisdiction? If Yes, please take note of the CRS documentation required Documentary evidence # Documentary evidence # Documentary evidence # Documentary evidence # Documentary evidence # Declaration and Acknowledgement I declare that the required account opening checks have been performed for the customer(s) listed above; and that the information provided is true, correct and updated. *Foreign refers to any jurisdiction / country other than Singapore. #Any valid identification issued by an authorized government body that includes the individual s name. Maybank Malaysia Staff Name / PF No. Date Page 13 of 22

14 FOR BANK S USE (on Joint Applicant) PART 9: FOR BANK S USE ONLY (MAYBANK MALAYSIA) Questions below to be considered in conjunction with all documents & forms collected from customers (including this form). S/N U.S. Indicia Status Yes/No If Yes, please take note of the FATCA documentation required 1 Have the account holder(s) provided any indication that the account holder(s) are U.S. citizen or resident? (ii) Appropriate documentation* and Form W-8BEN 2 Have the account holder(s) provided a U.S. place of birth? 3 Have the account holder(s) provided a U.S. address (including P.O. Box)? 4 Have the account holder(s) provided only a U.S. telephone number? 5 Have the account holder(s)provided any standing instructions to transfer funds to an account maintained in the U.S.? 6 Have the account holder(s) provided a U.S. telephone number and a non U.S. telephone number? 7 Have the account holder(s) granted Power of Attorney or signatory authority to a person with a U.S. address? 8 Have the account holder(s) provided only a hold mail or in care of address, that is the sole address for this account? (ii) Certificate of Loss of Nationality, and (iii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation* and Form W-8BEN (ii) Appropriate documentation*or form W-8BEN (ii) Appropriate documentation* or form W-8BEN (ii) Appropriate documentation* or form W-8BEN (a) Where all questions above are answered as no, appropriate documentation as below should still be obtained. (b) * Appropriate documentation refers to documentation to establish the person(s) non-u.s. status. The documentation must contain a permanent residence address outside of the U.S., and must be one of the following documents: (i) Certificate of residence (issued by tax officials) (ii) Government identification document (such as Identification Card) evidencing non-u.s. citizenship or nationality. (c) If the permanent address listed on the appropriate documentation obtained differs from the address provided in the application form, ensure that the appropriate documentation indicates the country in which the account holder(s) is a citizen or resident. (d) In the absence of such documentation, relationship manager should obtain form W-8 BEN from account holder(s). (e) W-8BEN form should not contain a permanent residence address in the U.S. to conclude a customer s status as Non U.S. Customer s FATCA Classification: Customer is: U.S. Non U.S. Page 14 of 22

15 FOR BANK S USE (on Joint Applicant) Questions below to be considered in conjunction with all documents & forms collected from customers (including this form). S/N CRS Indicia Status Yes/No Country(ies) / Jurisdiction(s) of Indicia 1 Have the account holder(s) provided any indication that the account holder(s) are foreign* resident? 2 Have the account holder(s) provided a foreign residence / mailing address? 3 Have the account holder(s) provided only a foreign telephone number? 4 Have the account holder(s) provided any standing instructions to transfer funds to an account maintained in a foreign jurisdiction? 5 Have the account holder(s) granted Power of Attorney or signatory authority to a person in a foreign jurisdiction? If Yes, please take note of the CRS documentation required Documentary evidence # Documentary evidence # Documentary evidence # Documentary evidence # Documentary evidence # Declaration and Acknowledgement I declare that the required account opening checks have been performed for the customer(s) listed above; and that the information provided is true, correct and updated. *Foreign refers to any jurisdiction / country other than Singapore. #Any valid identification issued by an authorized government body that includes the individual s name. Maybank Malaysia Staff Name / PF No. Date Page 15 of 22

16 FOR BANK S USE PART 10: FOR BANK S USE ONLY (MAYBANK MALAYSIA) Checklist Main Applicant (Tick ) Joint Applicant (Tick ) 1. All fields on this application form are duly completed 2. Customer s signatures on this application form Page 5 and Photocopy of original sighted Identification Card (front and back) (Staff to indicate your Name, PF No., Initial and affix branch stamp) 4. Proof of Address (Utility bill or other bank s statement must be dated within 3 months from today) 5. Customer s CIF No. based on Maybank Malaysia account Main Applicant Joint Applicant 6. Tick if customer is a Maybank Malaysia Premier Wealth customer. Main Applicant Joint Applicant 7. Staff attending to sign off PART 9 of this application form Page 12 and 13 Attended By: Approved By: Page 8 and 10 Page 14 and 15 Initial Date Initial Date Name: PF No.: Branch Stamp: Name: PF No.: Branch Stamp: Please mail the complete Application Form to the following address: Maybank Singapore New Client Services (PSC-MT) 2 Battery Road Maybank Tower #14-01 Singapore PART 11: FOR BANK S USE (MAYBANK SINGAPORE) Attended By: Approved By: Initial Date Initial Date Name: PF No.: Name: PF No.: Page 16 of 22

17 PART 12: LOCATIONS FOR SUBMISSION OF APPLICATION FORM Maybank Malaysia Branches KL MAIN SSC 1st Floor, Menara Maybank, 100, Jalan Tun Perak, Kuala Lumpur Tel: / AMPANG PARK SSC Lot 1.01, Ampang Park Shopping, Jalan Ampang, Kuala Lumpur Tel: SHAH ALAM SSC 10, Persiaran Perbandaran, Section 14, Shah Alam, P.O. Box 7109, Shah Alam Tel: JOHOR BAHRU MAIN Lot 1-22, Level 3, Johor Bahru City Centre, , Jalan Wong Ah Fook, Johor Bahru Tel: / MELAKA MAIN SSC 114 & 114A, Graha Peladang, Jalan Hang Tuah, Melaka, P.O. Box 173, Melaka Tel: ALOR STAR SSC 1535, Jalan Sultan Badlishah, Alor Star, P.O. Box 82, Alor Star Tel: BUTTERWORTH SSC 4277, Bagan Luar Road, Butterworth Tel: / KOTA BHARU SSC 3880-E, Jalan Mahmood, Kota Bharu, P.O. Box 108, Kota Bharu Tel: KUANTAN MAIN SSC UMNO Building, 1, Jalan Hj Abdul Aziz, Kuantan Tel: / LABUAN SSC Lot E005, Ground Floor Podium, Financial Park, Labuan Complex, Jalan Merdeka, Wilayah Persekutuan Labuan Tel: BANGSAR BARU SSC 66, 68 & 70, Jalan Maarof, Bangsar Baru, Kuala Lumpur Tel: PETALING JAYA MAIN SSC 50-52, Jalan Sultan (52/4), Petaling Jaya, P.O. Box 270, Jalan Sultan, Petaling Jaya Tel: / / SUBANG JAYA SSC C8, C9 & C10, Jalan SS15/4D, Subang Jaya, Petaling Jaya Tel: / BATU PAHAT SSC 32-4, Jalan Rahmat, Batu Pahat Tel: / SEREMBAN SSC , Jalan Dato' Bandar Tunggal, Seremban, P.O. Box 163, Seremban Tel: PENANG MAIN OFFICE SSC 9, Lebuh Union, Penang, P.O. Box 297, Penang Tel: IPOH MAIN Bangunan Mayban Trust, 28, Jalan Tun Sambanthan, Ipoh, Tel: KUALA TERENGGANU SSC No 92, Jalan Sultan Ismail, Kuala Terengganu Tel: / KARAMUNSING SSC Bangunan Maybank, No. 1, Lorong Kemajuan, Karamunsing, Kota Kinabalu, P.O. Box 12599, Kota Kinabalu Tel: / KUCHING SELATAN SSC No 15 & 16, Ground Floor Batu 2 1/2, Jln Rock, Kuching Tel: Page 17 of 22

18 BUKIT BINTANG BRANCH G-Floor Bangunan Yayasan Selangor, Jalan Bukit Bintang, Kuala Lumpur Tel: BANDAR SUNWAY BRANCH No. 30 & 32, Jalan PJS, 11/28A Bandar Sunway, Petaling Jaya Tel: KEPONG BRANCH 8-10, Jalan 53, Desa Jaya, Kepong, Kuala Lumpur Tel: PUCHONG JAYA BRANCH No.7, Jalan Kenari 1, Bandar Puchong Jaya, Puchong Jaya Tel: JALAN SULTAN IDRIS SHAH BRANCH Ground Floor, Jalan Sultan Idris, Ipoh Tel: PENANG ROAD BRANCH 1, Arked Ria Satu, Komtar, Penang Tel: JALAN SEGGET BRANCH 49-A, Jalan Segget, Johor Bahru Tel: PASIR GUDANG BRANCH 14 Pusat Perdagangan, Jalan Bandar, Pasir Gudang Tel: SANDAKAN BRANCH 48 Jalan Tiga, Jalan Hj Abdul Aziz, P.O. Box 374, T90704 Sandakan Tel: MIRI BRANCH Lot 112, Jalan Bendahara, Miri Tel: DESA SRI HARTAMAS BRANCH 21 & 23, Jalan 23/70A, Desa Sri Hartamas, Kuala Lumpur Tel: BANDAR UTAMA BRANCH Lot C.01, Concourse, Level 8 First Avenue, Bandar Utama, Petaling Jaya Tel: MUTIARA DAMANSARA BRANCH Lot G96 Ground Level, The Curve Mutiara Damansara, Petaling Jaya Tel: JALAN YONG SHOOK LIN BRANCH Grd. Floor, Wisma IJM, Jalan Yong Shook Lin, Petaling Jaya Tel: TAIPING BRANCH Jalan Chung, Thye Phin, Taiping Tel: JALAN LARKIN BRANCH Jalan Glasiar, Taman Tasek, Johor Bahru Tel: JALAN TEBRAU BRANCH Jalan Meranti Merah, Kebun Teh, Johor Bahru Tel: KULIM BRANCH 254, Jalan Putra, 09000, Kulim Tel: KOTA KINABALU BRANCH 9 Beach Street, Kota Kinabalu, P.O. Box 10862, Kota Kinabalu Tel: BAYAN LEPAS BRANCH , , & iavenue Medan Kampung Relau 1, Bayan Lepas, Penang Tel: Page 18 of 22

19 Maybank Malaysia Premier Wealth Centres PWC Dataran Maybank Dataran Maybank, Ground Floor, Mayban Assurance Tower, No. 1, Jalan Maarof Bangsar, Kuala Lumpur Tel: PWC K.L Main 27th Floor, Menara Maybank, 100 Jalan Tun Perak, Kuala Lumpur Tel: PWC Marc Residence A-01-01, Tower A, Marc Service Residence, No 3, Jln Pinang, Kuala Lumpur Tel: PWC Plaza Damansara Plaza Level, Block B, 45 Medan Setia 1, Bukit Damansara, Kuala Lumpur Tel: PWC Wisma Genting Level 2, Wisma Genting, Jalan Sultan Ismail, Kuala Lumpur Tel: PWC Mont Kiara 11, 13 & 15, Ground & First Floor, Jalan Solaris 1, Mont Kiara, 50480, Kuala Lumpur Tel: PWC Kepong Prima 1st Floor, No 10 & 12, Pusat Niaga Metro Prima, Jalan Prima 5, Metro Prima, Kepong, Kuala Lumpur Tel: PWC Seremban First Floor, , Jalan Dato' Bandar Tunggal, Seremban Tel: PWC Jalan Sultan Idris Shah, Ipoh Level 2, No , Jalan Sultan Idris Shah, Ipoh, Perak Tel: PWC Johore Bahru Level 3, Lot M1-22, JB City Square, , Jalan Wong Ah Fook, Johor Bahru Tel: PWC Setia Tropika, JB No. 8, Jalan Setia Tropika 1/21, Taman Setia Tropika, Kempas, Johor Bahru Tel: PWC Intan Millennium Suite 1.01 & 2.01, Intan Millennium Square, 68, Jalan Batai Laut 4, Taman Intan, Klang, Selangor Darul Ehsan Tel: PWC PJ New Town No. 6 & 8, Jalan Yong Shook Lin, Petaling Jaya, Selangor Tel: PWC SS2 1st Floor, 8 & 10 Jalan SS2/63, Petaling Jaya, Selangor Darul Ehsan Tel: PWC Shah Alam Level 4, Bangunan Maybank, No. 10, Persiaran Perbandaran, Section 14, Shah Alam Tel: PWC UEP Subang Jaya 66, Jalan USJ 10/1B, UEP Subang Jaya, Petaling Jaya Tel: PWC Bandar Utama Lot C.01, Concourse Level, 8 First Avenue, Bandar Utama, Petaling Jaya Tel: PWC Bandar Puteri Puchong 1st, Floor, No 29 & 31, Jalan Puteri 1/4, Bandar Puteri, Puchong, Selangor Tel: PWC Giza Kota Damansara Level 2, B01 & B02 Sunway Giza Mall, 2 Jalan PJU 5/14, Kota Damansara, Petaling Jaya Tel: PWC Cheras Selatan No 1 (G-3) & 2 (G-3), 2nd Floor, Jalan C180/1, Dataran C180, Batu 11 Cheras, Selangor Tel : PWC Kajang 1st Floor, 28-30, Jalan Tukang, Kajang, Selangor Tel: PWC Kuantan 1st. Floor, Kuantan Chinese Commercial, Chamber Industry (KCCCI), Lot 46 & 47, Section 18, Jalan Bukit Ubi, Kuantan Tel: Page 19 of 22

20 PWC Batu Pahat 1st Floor, Maybank Jalan Zabedah Branch, 84, Jalan Rahmat, Batu Pahat, Johor Tel: PWC Karamunsing Level 1, Bangunan Maybank, No. 1, Lorong Kemajuan, Kota Kinabalu Tel: PWC Sandakan Lot No. 218, 219, First Floor, Block 24, Prima Square, Mile 4, Jalan Utara, Sandakan, Sabah Tel: PWC Tawau 1st Floor, , Fajar Complex, Jalan Mahkamah, Tawau, Sabah Tel: PWC Burmah House 405-G-1, Burmah House, Burmah Road, Penang Tel: PWC Taman Desa Damai First Floor, No 4177 & 4178, Jalan Padang Lalang, Taman Desa Damai, Bukit Mertajam, Pulau Pinang Tel: PWC Melaka 114 & 114A Graha Peladang, Jalan Hang Tuah, Melaka Tel: PWC Crown Towers Ground Floor Crown Towers, 88 Jalan Pending, Kuching, Sarawak Tel: PWC Miri 1st Floor,Wisma Yong Lung, Lot 698, Block 7, MCLD, Jalan Pujut, C.D.T No 28, Miri, Sarawak Tel: PWC Sibu 35, 37 & 39 1st Floor, Jalan Kampung Nyabor, Sibu, Sarawak Tel: PWC Penang Main Level 1, Penang Main Office, 9, Lebuh Union, Penang Tel: Maybank Malaysia Premier Wealth Lounges PWL Desa Parkcity Lot GF-32 Ground Floor, The Parkcity KL, 5 Persiaran Residen, Desa Parkcity, Kuala Lumpur Tel: PWL Pavilion Lot , Level 6, Pavilion Kuala Lumpur, 168, Jalan Bukit Bintang, Kuala Lumpur Tel : PWL Taman Setiawangsa Wisma Prima Peninsular, No 12 Jalan Setiawangsa 11, Taman Setiawangsa, Kuala Lumpur Tel: PWL Sentul Raya 12 & 14 Jalan 14/48A, The Boulevard Shop Office, Off Jalan Sentul, Kuala Lumpur Tel : PWL Putrajaya Dewan Persiaran, Kompleks Perbadanan Putrajaya,Percint 3, Putrajaya Tel: PWL Damansara Utama 62-66, Jalan SS21/35, Damansara Utama, Petaling Jaya, Selangor Tel: PWL Port Klang 60-64, Persiaran Raja Muda Musa, Port Klang, Selangor Tel : PWL Sea Park 1 Jalan 21/11A, SEA Park, Petaling Jaya, Selangor Tel : Page 20 of 22

21 PWL Jalan Kuchai Lama No 1 & 3, Jalan Kuchai Maju 1, Off Jalan Kuchai Lama, Kuala Lumpur Tel : PWL Taman Tun Dr Ismail 2 Lorong Rahim Kajai 14, Taman Tun Dr Ismail, Kuala Lumpur Tel : PWL Rivercity Jalan Ipoh & 7A Block D, Rivercity, 3rd. Mile Jalan Ipoh, Kuala Lumpur Tel : PWL Jalan Gombak Wisma K S, No 5, Jalan Meranti, Taman Setapak, Setapak, Kuala Lumpur Tel : PWL Kompleks Bandar , Jalan Mega Mendung, Bandar Park, Jalan Kelang Lama, Kuala Lumpur Tel : PWL Jalan Kelang Lama No. 1 & 3, Jalan Desa, Taman Desa, Kuala Lumpur Tel : PWL Taman Midah Jalan Midah Satu, Taman Midah, Cheras, Kuala Lumpur Tel : PWL Jalan Pudu , Jalan Pudu, Kuala Lumpur Tel : PWL Setapak Wisma Lee Kay Huan, Lot Jalan Genting Kelang, Setapak, Kuala Lumpur Tel : PWL KL Sentral Lot No. 7,8 & 9, Departure Hall Level 1 KL City Air Terminal (KLCAT) Kuala Lumpur Sentral Kuala Lumpur Tel: PWL Sri Petaling No.15 & 17, Jalan Radin Anum Bandar Baru Seri Petaling Kuala Lumpur Tel: PWL Wisma Consplant G01 West Tower, Ground Floor Wisma Consplant, 1, 2 Jalan SS16/4, Subang Jaya Tel : PWL Subang Perdana No 1 Jalan Dinar G U3/6, Taman Subang Perdana, Seksyen U3, Shah Alam, Selangor Tel : PWL The Reef Rawang Lot A1,A2 & A3, Jalan Reef 1/1, Pusat Perniagaan Reef, Rawang, Selangor Tel : PWL Bandar Baru Bangi No 2, Jalan 6C/16, Section 16, Bandar Baru Bangi, Selangor Tel : PWL Shaftsbury, Cyberjaya Lot P1-36, Shaftsbury Square, 2350 Persiaran Multimedia, Cyber 6, Cyberjaya, Selangor Tel : PWL Kepong 8-10, Jalan 53, Desa Jaya, Kepong, Kuala Lumpur Tel : PWL Kota Kemuning No 9 & 11, Jalan Anggerik Vanilla N3 1/N, Kota Kemuning, Shah Alam, Selangor Tel : PWL TTDI Jaya No 3 & 5, Jalan Opera F U2/F, Taman TTDI Jaya, Seksyen U2, Shah Alam, Selangor Tel : PWL Menara Klang Jalan Raja Hassan 26, 28 & 30 Jalan Raja Hassan Menara Klang Klang Selangor Tel: PWL Port Dickson 2-G-09 & , Persiaran Waterfront, PD Waterfront, Port Dickson, N.Sembilan Tel: PWL Alor Setar 1535, Jalan Sultan Badlishah, Alor Star, Kedah Tel: Page 21 of 22