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Transcription:

General Requirements: Account Document Checklist Additional Requitments: For Salaried Person: (PvKzixRxex `i Rb ) For Business Individual (e emvqx e w³) For Odd jobs / Housewife / Household / Un-employed / Landord / Student / Rtd. Person: M wnbx / QvÎ / ekvi / Ae:cÖvß / j vûjw NOTES: Page 1 of 14

RELATIONSHIP CONTRACT m úk Pzw³ (Account Opening Form) wnmve Lvjvi dig The Manager e e vck Bank Alfalah Ltd. e vsk Avjdvjvn& wjwg UW Bangladesh (evsjv `k) Branch (kvlv) PERSONAL ACCOUNT (e w³k wnmve) Account. wnmve bs Customer ID : Kv gvi AvBwW bs Day Month Year w`b gvm eqi Sir, I / We hereby request you to open an account in the books of your bank in the name mentioned hereunder and providing my/our personal details and account related information as follow: wcöq g nv`q, Avwg / Avgiv Avcbvi kvlvq GKwU wnmve Lvjvi Rb Av e`b KiwQ Avgvi/Avgv `i wnmve msµvší I e w³mz Z_ wb gœ cö`vb KiwQ 1. Title of Account: (Bangla) wnmv ei bvg (evsjvq) In English (Block Letter) 2. Type of Account (Please Tick): wnmv ei cök wz (wuk w`b) Savings Current NFCD mâqx PjwZ GbGdwmwW Alfalah Premium Plus Savings Account Avjdvjvn& wcöwgqvg cøvm mâq wnmve 3. CURRENCY OF ACCOUNT (Please Tick) gy`ªv (wuk w`b) BDT UvKv USD Wjvi EURO BD iv RFCD AviGdwmwW GBP cvdû SND GmGbwW Alfalah Salary Account Avjdvjvn& ezb wnmve FCY ˆe `wkk gy`ªv Others (please specify) : Ab vb Alfalah Rising Star Avjdvjvn& ivbwms vi Alfalah Udyog Current Account Avjdvjvn& D ` vm PjwZ wnmve Others Ab vb 4. OPERATION OF ACCOUNTS (Please Tick): wnmve cwipvjbvi aib (wuk w`b) Singly Jointly GKKfv e hš_fv e 5. Purpose of Account Opening : wnmve Lvjvi D Ïk Any one of us h Kvb GKRb Either or Survivor h Kvb GKRb A_ev RxweZRb Others (please specify) : Ab vb 6. Details of other Bank Account (Please Tick): (nu v) (bv) MÖvn Ki Ab Kvb e vs K wnmve Av Q wk (wuk w`b)? If the answer is please provide below information. (DËi nu v n j wbgœiƒ c wee Z Kib) Bank & Branch Name (e vsk I kvlvi bvg) Nature of the Account (Please Tick) cwipvwjz wnmv ei cök wz (wuk w`b) Deposit Account Loan Account Rgv wnmve FY wnmve Deposit Account Loan Account Rgv wnmve FY wnmve Deposit Account Loan Account Rgv wnmve FY wnmve Deposit Account Loan Account Rgv wnmve FY wnmve Deposit Account Loan Account Rgv wnmve FY wnmve Page 2 of 14

7. Minor Account: If one or more accountholders are Minor: GK ev GKvwaK wnmveavix bvevjk n j t I, as the legal guardian of the following accountholder declare that the accountholder is a minor. His/Her related information is herewith attached with this form. The account will be operated by my signature as the legal guardian until the minor becomes major or any further instruction is given by me. Avwg wbgœœewy Z wnmveavixi AwffveK wn m e GB g g NvlYv KiwQ h, wnmveavix bvevjk Zvi cö qvrbxq Z_ mshy³ di g cö`vb Kiv n jv wnmveavix mvevjk bv niqv ch ší wksev Avgvi ciezx NvlYv bv `qv ch ší AwffveK wn m e wnmvewu Avgvi ^vÿ i cwipvwjz n e te: Guardian means father or mother or any other legal guardian. (AwffveK ej Z evev A_ev gv A_ev Ab Kvb AvBbMZ AwffveK K eysv e) a. Name of Accountholder (Minor): wnmveavix (bvevjk) Gi bvg b. Name of Guardian: Awffve Ki bvg Signature of Guardian: Date of Birth: Rb ZvwiL Relationship with the Minor: bvevj Ki mv _ m úk Awffve Ki ^v i te: The guardian and the minor both need to fill up the personal information form and for the minor applicant both the personal information forms will be signed by the guardian. (bvevjk Ges AwffveK-Df qi Rb B Òe w³ msµvší Z_ vejxó dig c~iy Ki Z n e Ges bvevjk Av e`bkvixi Î Dfq di gb Av e`bkvixi ^v ii j AwffveK KZ K ^vÿi Ki Z n e ) 8. Introducer s Information: cwipq`vbkvixi Z_ t Name: bvg Title of the Account: wnmv ei bvg Reference/Relationship with the Customer: MÖvn Ki mv _ cwiwpwzi m~î/ m úk Contact : Telephone: hvmv hvm gva g dvb bs Signature & Date: ^vÿi I ZvwiL Verifying Officer s Name & Signature (Seal & Date): cwipq`vbkvixi Z_ cöz vqbkvix mswkøó ø e vsk kvlvi Kg KZ vi bvg, ^vÿi (wmj I ZvwiLmn) t Account Number: wnmve bs Branch Name: kvlvi bvg Mobile : gvevbj bs 9. Initial Deposit: cöv_wgk Rgvi cwigvy Cash : Amount bm` cwigvy Date: ZvwiL Bank & Branch e vsk I kvlv 10. Sources of Fund (Please mention specifically & details) A _ i Drm/Drmmg~n (mywbw` ó I we ÍvwiZ D jøl Ki Z n e) Cheque. PK bs Amount cwigvy Account. GKvD U bs RULES & REGULATIONS (wbqgvejx) I / We hereby request BANK ALFALAH LTD. (the BANK ) to open the account(s) mentioned above on the basis of the information supplied by me/us herein, which I / we confirm is true and correct in all aspect. I / we hereby declare and confirm that I / we have read, understood and received the copy of account Opening From and Terms and Conditions governing the account and hereby covenant and agree to observe and be bound by the said Terms and Conditions and any changes, supplements or modifications thereto that may be made by the Bank from time to time. Avwg / Avgiv e vsk Avjdvjvn& wjwg UW K wbwðz KiwQ Avgvi / Avgv `i mieivnk Z Z_ vw` mwvk Ges cö`ë Z _ i wfwë Z Dc i DwjøwLZ GKvD U Lvjvi Rb Aby iva KiwQ Avwg / Avgiv wbwðz KiwQ h, wnmve Lvjvi di gi hvezxq kz vejx c o m Z n qwq Ges Zv gvb Kie e vsk KZ K h Kvb mg q wnmve msµvší h Kvb kz cwiez b n j Avwg / Avgiv Zv gvb Kie Page 3 of 14

It is understood that this account will be used for bonafide transactions relating to me /our business. I / we agree to inform you of any changes in the information provided in this form or in related documents. Avwg / Avgiv GB wnmv e A_ev Avgvi / Avgv `i bv g cwipvwjz Ab Kvb wnmv e (GKvD U) cö`ë h Kvb cökv ii Avw_ K myweav A_ev `vq cwi kv ai `vqe Zv ^xkvi KiwQ G msµvší h Kvb cökv ii cö hvr PvR (ïé, Ki BZ vw`mn) GB wnmve _ K WweU K i Av`v qi m wz cö`vb KiwQ I / we agree to be liable for any finance or debts due to you which you may permit on this account or any other account in my/our name. You may debit my/our account for your charges (along with excise duty, Govt. Taxes, if applicable) in this regard. Avwg / Avgiv Avcbv K m wz w`w Q Avgvi / Avgv `i bv g GB GKvD Ui ev Ab Kvb GKvD U WweU K i FY msµvší A_ Av`vq Kivi Rb GB msµvší h Kvb PvR Avgvi GKvD U WweU K i Av`vq Kiv hv e I / we understand that if my / our cheque book is not collected personally by me / us within 90 days from the date of this request, the Bank at its own discretion, reserves the right to destory the cheque book, in such event, the cheque book charges debited to the accountwill not be refunded. Avwg / Avgiv evamg h Avgvi / Avgv `i PK eb hw` Bmy Kivi Aby iv ai ZvwiL _ K 90 w` bi g a msmön bv Kiv nq Zvn j e vsk Zvi wbr ^ we epbvq PK eb evwzj Kivi AwaKvi iv L Ges PK eb qi Rb Av`vqK Z PvR diz `qv n e bv I / we agree and undertake to indemnify the Bank for any loss, damage, claim, action, costs and expenses (including legal expenses) suffered or incurred by the Bank howsoever arising out the or in the online Facilities. Avwg / Avgiv GB g g m wz cö`vb KiwQ h, Ab-jvBb e vswks myweav MÖnYv _ h Kvb cökv ii Avw_ K ÿ wz, e q (AvBbx e qmn) en b Avwg / Avgiv eva _vke 1st Applicant s Name 1g Av e`bkvixi bvg 2nd Applicant s Name 2q Av e`bkvixi bvg 3rd Applicant s Name 3q Av e`bkvixi bvg Signature & Date ^vÿ i I ZvwiL Signature & Date ^vÿ i I ZvwiL Signature & Date ^vÿ i I ZvwiL FOR BANK USE ONLY ( Kej e vs Ki e env ii Rb ) Comment: gšíe Account Opening Officer s Certificate wnmve Lvjvi mswkøó Kg KZ vi cöz qb I have checked this Account Opening From and the required documents and certify that these are as per requirement & photocopies are verified from original identification documents. I also certify having verified the identity and credentials of the Applicant(s) and, where applicable, identity of guardian after having seen the original identification document(s). Avwg GB wnmve Lvjvi dig I cö qvrbxq WKz g Um PK K iwq Ges cöz qb KiwQ h G wj kz gvzv ek Ges g~j WKz g U _ K hvpvb Kiv n q Q Avwg Av iv cöz qb KiwQ h Av e`bkvixi cwipq hvpvb Kiv n q Q Ges cö hvr ÿ Î g~j WKz g U `Lvi ci Awffve Ki cwipq I hvpvb Kiv n q Q Account Opened by (Account opening officer) (Signature with Name, Seal & Date) wnmve Lvjvi mswkøó Kg KZ vi (bvghy³ mxjmn ^vÿ i I ZvwiL ) Approved by (Branch Manager) (Signature with Name, Seal & Date) Aby gv`bkvix Kg KZ vi (kvlv e e vck) (bvghy³ mxjmn ^vÿ i I ZvwiL ) Page 4 of 14

Date ZvwiL D D M M Y Y Y Y PERSONAL INFORMATION (e w³ msµvší Z_ vejx) Branch Name : kvlvi bvg Account Number : wnmve bs Customer ID Number : MÖvn Ki AvBwW bs Applicant's Photo (to be attested by introducer) 1. Title of the Account: (wnmv ei bvg) 2. MÖvnK/ ewbwdwmqvj Ibvi/ wnmve cwipvjbvkvixi bvg 3. Relationship with the Account (Please tick where applicable) wnmv ei mv _ m úk (bx P cö hvr ÿ Î wuk w`b) 1st Applicant 1g Av e`bkvix Partner cvu bvi 2nd Applicant 2q Av e`bkvix Sole Proprietor GKK ^Ë vwakvix 3rd Applicant 3q Av e`bkvix Attorney Holder GU bx nvìvi Director cwipvjk Trusty Uªvw Minor Accountholder wnmveavix bvevjk cök Z myweav fvmx Guardian AwffveK Account Signatory wnmve cwipvjbvkvix Others Ab vb 4. Father s Name: wczvi bvg 5. Mother s Name: gvzvi bvg 6. Date of Birth: Rb ZvwiL 8. Nationality: Religion: Country of Residence: RvZxqZv ag emevmiz `k te: For foreign national copy of passport with VISA must be collected. (we `kx bvmwik n j wfmvmn cvm cv U i Kwc Avewk Kfv e MÖnY Ki Z n e) 9. Gender (please tick): wj½ (wuk w`b) Spouse Name: ^vgx/ xõi bvg 11. Applicant s Occupation: Av e`bkvixi ckv 12. Name of Employer: wb qvm`vzvi bvg Male cyiæl Business / Employment Address: ckvmz wvkvbv 13. Present Address (Residence): ez gvb Avevm wvkvbv D D M M Y Y Y Y 7. Place of Birth (Including Country): Rb vb ( `kmn) Female gwnjv 3rd Gender Z Zxq wj½ 10. Marital status: ˆeevwnK Ae v Job Title/ Designation: Kv Ri wk ivbvg/ c`ex 14. Permanent Address: vqx wvkvbv te: Customer/ Accountholder must provide at least one proof of address document. MÖvnK/ wnmve cwipvjbvkvixi Gi wvkvbv cögvy mc ÿ WKz g Um cö`vb Ki Z n e (Kgc ÿ 1wU wvkvbvi mc ÿ) Single AweevwnZ Married weevwnz Page 5 of 14

15. Introduction: cwiwpwz NID : RvZxq cwipqcî b ^i Rb wbeüb mb`cî b ^i Passport Number: Expiry Date: D D M M Y Y Y Y E-TIN : cvm cvu bs gqv` DË x Yi ZvwiL B jkuªwbk-u v AvBwW b ^i Driving Licnce : Expiry Date: D D M M Y Y Y Y W«vBwfs jvb mý bs Others ( Please Specify): gqv` DË x Yi ZvwiL Ab vb (wbw` ófv e D jøl Ki Z n e) 16. Resident Status (please Tick): Resident n Resident emev mi Ae v (wuk w`b) iwm W U bb- iwm W U te: Guidelines for Foreign Exchange Transactions needed to be followed if necessary. (cö qvrbxq ÿ Î e vsk KZ K MvBWjvBÝ di d ib GK PÄ Uªvb RKkbm& Gi wb ` kbv AbymiY Ki Z n e) 17. Monthly income (For Personal Account): gvwmk Avq (e w³k wnmv ei ÿ Î) te: Detail sources of Income and the valid documents required by the Bank need to be provided. we ÍvwiZ D jølc~e K cö hvr ÿ Î e vs Ki Pvwn`v gvzv ek `wjjvw` cö`vb Ki Z n e 18. Communication : hvmv hvmt Address: wvkvbvt Present ez gvb Permanent vqx 3) Mobile (1): Uwj dvb b ^i evmv Awdm gvevbj b ^i 4) Mobile (2): gvevbj b ^i 6) Email: B- gbj 19. Emergency Contact (Riæix cö qvr b hvmv hvm) minated Person for emergency contact: Riæix cö qvr b hvmv hv Mi Rb g bvbxz e w³ Name: bvg Address: wvkvbv Business Kg j 5) Fax.: d v b ^i Relationship with Accountholder: Mobile : wnmveavix/ wnmve cwipvjbvkvixi mv _ m úk gvevbj b ^i E- Mail Address: B- gbj wvkvbv 20. Credit Card Related Information ( if any): µwwu KvW msµvší Z_ (hw` _v K): Issuing Institution / Bank (if more than one mention all the Bank Name): Bmy Kvix cöwzôvb/e vsk (GKvwaK n j mkj e vs Ki bvg) a. Local Card ( vbxq): b. International Card (AvšÍR vwzk): Name & Signature of the Applicant Av e`bkvixi ^vÿi I bvg Date (ZvwiL): (Signature with Name & Seal) wnmve Lvjvi mswkøó Kg KZ vi (bvghy³ mxjmn ^vÿi I ZvwiL ) Approved by (Branch Manager) (Signature with Name & Seal) Aby gv`bkvix Kg KZ vi (kvlv e e vck) (bvghy³ mxjmn ^vÿi I ZvwiL ) Page 6 of 14

Date ZvwiL D D M M Y Y Y Y PERSONAL INFORMATION (e w³ msµvší Z_ vejx) Branch Name : kvlvi bvg Account Number : wnmve bs Customer ID Number : MÖvn Ki AvBwW bs Applicant's Photo (to be attested by introducer) 1. Title of the Account: (wnmv ei bvg) 2. MÖvnK/ ewbwdwmqvj Ibvi/ wnmve cwipvjbvkvixi bvg 3. Relationship with the Account (Please tick where applicable) wnmv ei mv _ m úk (bx P cö hvr ÿ Î wuk w`b) 1st Applicant 1g Av e`bkvix Partner cvu bvi 2nd Applicant 2q Av e`bkvix Sole Proprietor GKK ^Ë vwakvix 3rd Applicant 3q Av e`bkvix Attorney Holder GU bx nvìvi Director cwipvjk Trusty Uªvw Minor Accountholder wnmveavix bvevjk cök Z myweav fvmx Guardian AwffveK Account Signatory wnmve cwipvjbvkvix Others Ab vb 4. Father s Name: wczvi bvg 5. Mother s Name: gvzvi bvg 6. Date of Birth: Rb ZvwiL 8. Nationality: Religion: Country of Residence: RvZxqZv ag emevmiz `k te: For foreign national copy of passport with VISA must be collected. (we `kx bvmwik n j wfmvmn cvm cv U i Kwc Avewk Kfv e MÖnY Ki Z n e) 9. Gender (please tick): wj½ (wuk w`b) Spouse Name: ^vgx/ xõi bvg 11. Applicant s Occupation: Av e`bkvixi ckv Name of Employer: wb qvm`vzvi bvg Male cyiæl 12. Business / Employment Address: ckvmz wvkvbv 13. Present Address (Residence): ez gvb Avevm wvkvbv D D M M Y Y Y Y 7. Place of Birth (Including Country): Rb vb ( `kmn) Female gwnjv 3rd Gender Z Zxq wj½ 10. Marital status: ˆeevwnK Ae v Job Title/ Designation: Kv Ri wk ivbvg/ c`ex 14. Permanent Address: vqx wvkvbv te: Customer/ Accountholder must provide at least one proof of address document. MÖvnK/ wnmve cwipvjbvkvixi wvkvbv cögvy mc ÿ WKz g Um cö`vb Ki Z n e (Kgc ÿ 1wU wvkvbvi mc ÿ) Single AweevwnZ Married weevwnz Page 7 of 14

15. Introduction: cwiwpwz NID : RvZxq cwipqcî b ^i Rb wbeüb mb`cî b ^i Passport Number: Expiry Date: D D M M Y Y Y Y E-TIN : cvm cvu bs gqv` DË x Yi ZvwiL B jkuªwbk-u v AvBwW b ^i Driving Licnce : Expiry Date: D D M M Y Y Y Y W«vBwfs jvb mý bs Others ( Please Specify): gqv` DË x Yi ZvwiL Ab vb (wbw` ófv e D jøl Ki Z n e) 16. Resident Status (please Tick): Resident n Resident emev mi Ae v (wuk w`b) iwm W U bb- iwm W U te: Guidelines for Foreign Exchange Transactions needed to be followed if necessary. (cö qvrbxq ÿ Î e vsk KZ K MvBWjvBÝ di d ib GK PÄ Uªvb RKkbm& Gi wb ` kbv AbymiY Ki Z n e) 17. Monthly income (For Personal Account): gvwmk Avq (e w³k wnmv ei ÿ Î) te: Detail sources of Income and the valid documents required by the Bank need to be provided. we ÍvwiZ D jølc~e K cö hvr ÿ Î e vs Ki Pvwn`v gvzv ek `wjjvw` cö`vb Ki Z n e 18. Communication : hvmv hvmt Address: wvkvbvt Present ez gvb Permanent vqx 3) Mobile (1): Uwj dvb b ^i evmv Awdm gvevbj b ^i 4) Mobile (2): gvevbj b ^i 6) Email: B- gbj 19. Emergency Contact (Riæix cö qvr b hvmv hvm) minated Person for emergency contact: Riæix cö qvr b hvmv hv Mi Rb g bvbxz e w³ Name: bvg Address: wvkvbv Business Kg j 5) Fax.: d v b ^i Relationship with Accountholder: Mobile : wnmveavix/ wnmve cwipvjbvkvixi mv _ m úk gvevbj b ^i E- Mail Address: B- gbj wvkvbv 20. Credit Card Related Information ( if any): µwwu KvW msµvší Z_ (hw` _v K): Issuing Institution / Bank (if more than one mention all the Bank Name): Bmy Kvix cöwzôvb/e vsk (GKvwaK n j mkj e vs Ki bvg) a. Local Card ( vbxq): b. International Card (AvšÍR vwzk): Name & Signature of the Applicant Av e`bkvixi ^vÿi I bvg Date (ZvwiL): (Signature with Name & Seal) wnmve Lvjvi mswkøó Kg KZ vi (bvghy³ mxjmn ^vÿi I ZvwiL ) Approved by (Branch Manager) (Signature with Name & Seal) Aby gv`bkvix Kg KZ vi (kvlv e e vck) (bvghy³ mxjmn ^vÿi I ZvwiL ) Page 8 of 14

Branch Name : Customer ID Number : kvlvi bvg MÖvn Ki AvBwW bs Account Number : wnmve bs minee Related Information: (bwgwb msµvší Z_ vejx) I/We hereby nominate the following person, who in the event of my death will be eligible to withdraw the money from my/our account. I/ We have the right to change or cancel the nomination anytime. I/We hereby also consent that, Bank will provide money according to my/our direction and bank will not be liable for that. Avwg/Avgiv G wnmv ei A_ Avgvi/Avgv `i g Zy i ci wb gœœ ewy Z e w³/e w³my K cö`v bi Rb g bvbxz Kijvg Avwg/Avgiv DwjøwLZ g bvbqb h Kvb mgq evwzj ev cwiez bi AwaKvi msiÿy Kwi Avwg/Avgiv GB g g Av iv m wz Ávcb KiwQ h, Avgvi/Avgv `i wb ` kbv gvzv ek e vsk A_ cö`vb Ki e Ges GRb e vsk Kv bvfv e `vqe n ebv Number of minee: (bwgwbi msl v) 1. Account Title: wnmv ei bvg 2. Name of minee: bwgbxi bvg 3. Father s Name: wczvi bvg 4. Mother s Name: gvzvi bvg 5. Date of Birth: D D M M Y Y Y Y 6. Spouse Name: Rb ZvwiL 7. Present Address: ez gvb wvkvbv 8. Permanent Address: vqx wvkvbv 9. Occupation: Relationship with Accountholder: Percentage Alloted: ckv wnmveavixi mv _ m úk eivïk Z nvi 10. Introduction of minee:(bwgwbi cwiwpwzcî) NID : Passport Number: Expiry Date: RvZxq cwipqcî b ^i cvm cvu bs gqv` DË x Yi ZvwiL Driving License : Expiry Date: Rb wbeüb mb`cî b ^i W«vBwfs jvb mý bs gqv` DË x Yi ZvwiL E- TIN : Others (please Specify): B jkuªwbk-u v AvBwW b ^i Ab vb (wbw` ófv e D jøl Ki Z n e) 11. If minee is a Minor, According to the Section 103(2) of the Bank Company Act 1991 at the event of the death of Accountholder(s) the deposited money will be received by: bwgwb bvevjk n j Zvi/ Zv `i bvevjk _vkv Ae vq wnmveavix/ wnmveavixm Yi g Zz i Î e vsk Kv úvwb AvBb, 1991 Gi 103 (2) aviv Abyhvqx Avgvb Zi UvKv MÖnYKvixi Z_ t a. Name: bvg b. Father/ Husband s Name: wczv/ ^vgxi bvg c. Current Address: ez gvb wvkvbv d. Permanent Address: vqx wvkvbv e. Date of Birth: Rb ZvwiL g. Awffve Ki cwiwpwzcî msµvší Z_ If any non-resident is made a nominee & that nonresident person receives the accounts balance, then the received money to be sent abroad will be governed by the existing foreign exchange act) ( Kvb Awbevmx K bwgwb Kiv n j Ges H Awbevmx mswkøó wnmv ei A_ cövß n j cövß A_ we ` k cöi Yi ÿ Î we` gvb ˆe `wkk gy`ªv wbqš Y AvB bi wewa weavb cö hvr n e ) minee Signature with Date (Optional) : bwgwbi ^v i I ZvwiL (Hw QK) Signature, Name & Date of 1 st Applicant 1g Av e`bkvixi ^v i, bvg I ZvwiL Date ZvwiL D D M M Y Y Y Y NOMINEE(S) RELATED INFORMATION (bwgwb msµvší Z_ vejx) D D M M Y Y Y Y ^vgx/ xi bvg f. Relationship with minee: (bwgwbi mv _ m ck ) Signature, Name & Date of 2 nd Applicant 2q Av e`bkvixi ^v i, bvg I ZvwiL minee's Photo (to be attested by accountholder) MÖvn Ki ^v i hvpvbkvix e vsk Kg KZ vi bvghy³ wmjmn ^v i I ZvwiL (bvevjk Ges AwffveK Df qi e w³mz Z_ dig c~iy Ki Z n e ) * Please use separate nominee form if you nominate more than one person. (G Ki AwaK bwgbxi ÿ Î AbyMÖn K i Avjv`v bwgbx dig e envi Kib ) Page 9 of 14

TRANSACTION PROFILE (m ve jb ` bi AbywgZ gvîv) Branch Name : Account Number : Customer ID Number : kvlvi bvg wnmve bs MÖvn Ki AvBwW bs 1. Title of Account: wnmv ei bvg 2. Type of Account: 3. Monthly Income (Estimated): wnmv ei aib gvwmk m ve Avqt 4. Monthly Estimated Turnover ( For Institution): gvwmk m ve Uvb Ifvi (cöwzôv bi Î)t Details we ÍvwiZ Deposit : Rgv Cash deposit (Including online & ATM) bm` Rgv (AbjvBb/GwUGgmn) Deposit through transfer / instrument UªvÝdvi/B Uªy g U Gi gva g Rgv Foreign inward remittance d ib BbIqvW iwgu vý Export proceeds ißvbx eve` Avq Deposit/Transfer from BO Account cuywr evrvi wnmve n Z Rgv/ vbvšíi Others (Specify) Ab vb Total: (me gvu) Expected. of Deposit (Monthly) m ve gvwmk Rgvi msl v Expected Total Deposit Amount (Monthly) m ve gvwmk gvu Rgvi cwigvy Expected Maximum Size (Per Deposit) m ve m e v P GKK Rgvi cwigvy Withdrawal D Ëvjb Cash withdrawals (including online / ATM) bm` D Ëvjb (AbjvBb / GwUGgmn) Payment through transfer / instrument UªvÝdvi/B Uªy g U Gi gva g cwi kva Foreign Outward Remittance d ib AvDUIqvW iwgu vý Import Expense Payment Avg`vwb eve` cwi kva Deposit/Transfer in BO Account cuywr evrvi wnmv e Rgv/ vbvšíi Others (Specify) Ab vb (wbw` ófv e) Total: (me gvu) Expected. of withdrawals (Monthly) m ve gvwmk D Ëvj bi msl v Expected Total Withdrawals Amount (Monthly) m ve gvwmk gvu D Ëvj bi cwigvy Expected Maximum Size (Per withdrawal) m ve m e v P GKK D Ëvj bi cwigvy I / We the undersigned, hereby that this Transaction truly represents the transactions arising out of the normal course of business of my / Avwg/Avgiv wbgœ ^vÿ ikvix(my)g g g wbðqzv cö`vb KiwQ h, m ve jb ` bi AbywgZ gvîv Avgvi/cÖwZôv bi ^vfvwek cök Z jb `b Avwg/Avgiv Av iv wbðqzv cö`vb KiwQ h, cö qvrb ev a Avwg/Avgiv m ve jb ` bi AbywgZ gvîv ms kvab/nvjbvmv` Kie Customer/Account Holder Signature: MÖvnK/wnmve cwipvjbvkvixi ^vÿi Name: bvg Date: ZvwiL Customer/Account Holder Signature: MÖvnK/wnmve cwipvjbvkvixi ^vÿi Name: bvg Date: ZvwiL For Bank use only (e vs Ki e env ii Rb ) evsjv `k dvbb vwýqvj B Uwj RÝ BDwb Ui wb ` kbv gvzv ek MÖvn Ki m ve jb ` bi AbywgZ gvîv ch v jvpbv Kiv n jv MÖvn Ki m ve jb ` bi AbywgZ gvîv (cwiez b Kiv/ bv Kivi KviY)t Signature, Name & Seal mxjmn ^vÿi Page 10 of 14

SMS Alert, E-Statement & Internet Banking Facility (GmGgGm GjvU, B- U g U Ges B Uvi bu e vswks myweav) Statement of Account: wnmve weeiyx Frequency for E-Statement B- U g Ui Rb wd«kv qwý E-mail : B- gbj SMS Alert Facility Gm Gg Gm mzk Zv myweav Intimate me about new products / services info on telephone as and when introduced Uwj dv b bzzb cy / mev Pvjy m ú K Avgv K Rvbvb Internet Banking Facility B Uvi bu e vswks myweav nu v If, Please provide below information: (DËi nu v n j wbgœiƒ c wee Z Kib) Login Name: (3 Choices min 5, max 15 Characters) Account Number : (wnmve bs) Account Title: (wnmv ei bvg) Mother s Name: (gvzvi bvg) Date of Birth: (Rb ZvwiL) E- Mail: B- gbj nu v E-Statement B- U g U Daily ˆ`wbK Mobile. gvevbj bv ^vi Weekly mvßvwnk Statement of A/C Mail by Post/Courier cv / Kzwiqvi K i GKvD U U g U gbj Monthly gvwmk (Terms & Conditions for internet banking will be applicable) (B Uvi bu e vswks Gi Rb wbqg Ges kz vejx cö hvr n e) 1) 2) 3) D D M M Y Y Y Y NID : (RvZxq cwipqcî b ^i) Mobile : gvevbj b ^i Date ZvwiL D D M M Y Y Y Y Quarterly ˆÎgvwmK bv nu v bv Semi-Annually Aa evwl K bv Security Question/Secret Answer (Tick any one): What is your Middle Name? What is your favorite sport? What is your favorite hobby? What is your favorite book? What is your favorite song? What is your favorite personality? What is your favorite color/ flower? What is your favorite place / building What is your favorite dish / sweet Any Key word... Mention your answer (in one word) for question you have ticked: Signature of 1st Applicant cö_g Av e`bkvixi ^vÿi Online View ID: For Bank use only (ïaygvî e vs Ki e env ii Rb ) Signature of 2nd Applicant wøzxq Av e`bkvixi ^vÿi I confirm that the applicant is the authorizd signatory to operate account(s) mentioned above. Signature Verified by MÖvn Ki ^v i hvpvbkvix Authorized Signatory Aby gvw`z ^vÿikvix Page 11 of 14

Customer ID. (1) MÖvn Ki AvBwW bs Account. wnmve bs A/C Marketed by BDO wnmve wecybkvix we ww I Name of Bank Staff/ BDO e vs Ki vd / we wwi Gi bvg CBC Done : m úvw`z wm we wm Y nu v N bv Contact : hvmv hvm bs A. Depositor's Information (For SBS-2 Reporting) Account : For Individual: 1. Account Title : 2. Profession : 3. Type of Account : Sector Code: For Institution: 1. Account Title : 2. Type of Institution : (2) Date ZvwiL D D M M Y Y Y Y FOR BANK USE ONLY ( Kej e vs Ki e env ii Rb ) BAFL Staff we G Gd Gj vd Walk-In IqvK-Bb FORM FOR REPORTING SBS-2 & SBS-3 RETURN (See page 87-106 of Guidelines for SBS-1, 2 & 3 Return) Type of Deposit Code: (See page 107 of Guidelines for SBS-1, 2 & 3 Return) 3. Type of Account: Sector Code: (See page 87-106 of Guidelines for SBS-1, 2 & 3 Return) Type of Deposit Code: Account : For Individual: 1. Account Title : 2. Profession : 3. Purpose of Loan : 4. Security : For Individual: 1. Account Title : 2. Profession : 3. Purpose of Loan : 4. Security : (See page 107 of Guidelines for SBS-1, 2 & 3 Return) A. Borrower's Information (For SBS-3 Reporting) Sector Code: (See page 87-106 of Guidelines for SBS-1, 2 & 3 Return) Economic Purpose Code (See page 111-123 of Guidelines for SBS-1, 2 & 3 Return) Security Code (See page 124 of Guidelines for SBS-1, 2 & 3 Return) Sector Code: (See page 87-106 of Guidelines for SBS-1, 2 & 3 Return) Economic Purpose Code (See page 111-123 of Guidelines for SBS-1, 2 & 3 Return) Security Code (See page 124 of Guidelines for SBS-1, 2 & 3 Return) RM / BDO Code Avi Gg/ we ww I KvW Contact Date & Time : hvmv hv Mi ZvwiL Ges mgq Prepared By: Signature Customer Servic cer V Signature Operation Manager Approved By: Signature Head of branch te: 1. Experienc form. 2. This Form will be preserved with AOF 3. In case of Joint A/C, 1st Applicant will be considered. 4. SBS-1, 2 & 3 (4th Edition 2005) will be followed. 5. In case of Loan against multiple securities, effective security will be considered. 6. Assimilate this with original SBS report. Page 12 of 14

Foreign Account Tax Compliance Act (FATCA) Checklist (For Individuals & Sole Proprietors) Date: Account Title New Account Account Number Change in Circumstances of existing account Section A. Customer Type (please indicate as applicable) Individual / Sole Proprietor Minor Joint Please use Applicant 1 column to provide your responses In case of Account of Minor, please use Applicant 1 Column for Minor and Applicant 2 Column for Guardian Please use separate column for each joint account applicant, use additional checklist if more than 2 applicant(s) Section B. U.S Status Information Applicant 1 Applicant 2 Name of Applicant As per instructions given in Customer Type Section 1. Are you a U.S Citizen, a U.S Green Card Holder or a U.S Resident 1? If : Provide Form W-9 and proceed to Section C below; If : Proceed to Next Question. 2. Were you born in the U.S? If : Provide Form W-9 and proceed to Section C below; If : passport (iii) Signed Form W-8BEN If : Proceed to Next Question. ) A non-u.s 3. Do you have a U.S address or telephone Number? 4. Are you assigning a signatory authority/mandate to a person with a U.S address? 5. Are you aware of any other information that may indicate U.S links? Including U.S source of funds / income, U.S nationality, residence status of authorized signatory / mandate holder, expected remittances to / from U.S etc. For Questions 3, 4, 5 and above: If and you accept being U.S person: Provide Form W-9 and proceed to Section C below; If and you claim being a non-u.s person: Provide an ID Document (NID) showing your permanent address (Which should not be a U.S address), OR Provide Form W-8BEN & proceed to section C; If : FATCA documentation required, proceed to Section C below. I / we hereby con rm that the information provided above is true, accurate and complete. Subject to applicable local laws, I / we hereby consent for Bank Alfalah Limited or any of its liates, subsidiaries (including branches) (collectively the Bank ) to share my /our information with domestic or overseas regulators or tax authorities where necessary/applicable to establish my /our tax liability in any jurisdiction. Where required by domestic or overseas regulators or tax authorities, I / we consent and agree that the Bank may withhold from my /our account(s) such amounts as may be required according to applicable laws, regulations and directives. I/we also agree and undertake to notify the Bank within 30 calendar days if there is a change in any information which I / we have provided to the Bank. Signature of Applicant(s) Applicant 1 Applicant 2 Date 1 A person may be a U.S resident if the person was present for the period of 183 days or more during the current and last two preceding years. For further details, please refer to Tactful Questioning guidelines under the FATCA policy & procedu remanual Document Version; 1.2 (v 2014) Page 13 of 14

Person with U.S citizenship / U.S Green Card / U.S residence Form W-9 Person born in U.S Form W-9 For Bank s Use Only FATCA Documentation Checklist Applicant 1 Applicant 2 Person born in U.S But claims being a n-u.s person Form W-8BEN; Certi ate/ Written Explanation of Revocation of U.S Nationality; and A non-u.s passport Person with U.S address / Telephone number / U.S signatory / Other U.S links (accepts being a U.S person) Form W-9 Person with U.S address / Telephone number / U.S signatory / Other U.S links (claims being a n-u.s person) Form W-8BEN; OR ID Document showing permanent address (which should not be a U.S address) Form W-8ECI (claim that income is effectively connected with trade or business within the U.S) Form 8233/ W-4 (Claim that applicant is receiving compensation for personal services performed in U.S) Form W-8IMY (Claim that the person is acting as an Intermediary) ) FATCA Documentation Required Applicant 1 Applicant 2 1. U.S Person; Applicant responds to S.. 1 (Section B)or Applicant responds to any question from S.. 2 to S.. 5 (Section B) and accepts being a U.S person. U.S Tax Identi cation. (TIN); U.S Social Security. (SSN), Individual Taxpayer Identi ation.. (ITIN) or U.S Employer Identi ation.(ein) as mentioned in Form W 9 provided by the customer 2. n U.S Person; Applicant responds to all questions from S.. 1 to S.. 5 (no documentation required) ; or Applicant responds to any question from S.. 2 to 5, claims being a non U.S person & provides required documentation (as per section B ) 3. Recalcitrant Applicant refuses to provide required documentation (as per section B ) or refuses to provide con rmation (as per section C). Accounts of such applicant will not be opened. U.S Account n U.S Account Recalcitrant Account Any of the applicants has been classi ed as U.S person. All of the applicants have been classi ed as non U.S person Any applicant has been marked as Recalcitrant (Only Applicable to Existing Account Holders) Branch Authorization We con rm that the responses of the applicant(s) to checks in Section B have been cross against information provided by them in the account Opening Form and during the KYC process and that no discrepancy has been found therein. We also con rm that duly signed and completed FATCA Documentation has been obtained from ALL applicants as established through Section C and marked above. Moreover, each applic and accordingly the account status has been marked above. Signature Date: Branch Of cer Operations / Branch Manager Document Version; 1.2 (v 2014) Page 14 of 14