a

<ilqaffi Limited
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{ I

F-2 (Revised)

Milrr{qqftR{R RIrqKriN
Mudaraba Savings Account Opening Form

<re-sR{lr
Individual Account

o-ffi q$ft R{K

(MSA-General)
Mudaraba Savings Account (MSA-General)
o 1n.KmrqreftfuR (MSA-Staff)
Mudaraba Savings Account (MSA- Stafl)
o vKKrqrcftRqK (MSA-RDS)
Mudaraba Savings Account (MSA-RDS )

O {rutXqffi{r{$ftffi{(sMsA)
Student Mtrdaraba Savings Account (SMSA)

O {qKKrfo{r c{F"rqrcftR{K (MSNA)

Mudaraba Special Notice Savings Account (MSNA)

o MrKrH{rfr qsft RTl< (MFSA)

Mudaraba Fatmer Savings Account (MFSA)

o wrsm?<qftsn5Tufl Rfl< (MFCDA)

Nludaraba Foreisn Cttmency Deposit Account (MFCDA)

O {qKFTffi$E qE I'ERqqrcftRfl< (MIESA)

Mudaraba Industrial Employees' Savings Account (MIESA)

R{rc<rqN
Name of the Account

R{Kq\
Account No

EEfrs $ls'flr qtt& mtu

Unique Customer ID Code

I
 6;ffi <fiqo il(Er6q.t frfrcts
w Islami B"gthpE5gl?dgrh Limited
gbah Mozidia Traders 1405/04)
(nranch)
,-''''' :''ilougii r*zuBrtur;euttqno'rlFtl
<IIE5?F IqTR flndividual Account)
*-*, >a/ &/n_l
<r-TqIq?F.
tEfi-rErqoqffi4qr3..
The Manager
<t(E[rq.i <lTqo cqB-* cols,
ffiaxq6+qqkmfrfrrtv (<fi(rs-{<I{{rs{ q-{l)

Sh^h Mozidia Tredcr

(Branch)
slr
qsRTT (Assalamu Ataikum.
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5*ft',1ll':;#ffi''r<r(srmcr)

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RqRqtolvsaffi I Accounts Information)

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r fulIT{firrl-{lT (<I(El{) : (Title ofAccount)
tcff,frfo (In English Block Letter) :.
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(0fi'{)' ffiRqr{(Mse4eoeral) WFr<Iqqrftfr{t< 1us{-sutrl
.1fuffi{eqe^ (F<'
- Account (MSA-General) Mudaraba Savings Acco tltS-{-Statr)
Nanre of Account lptease tick): Mudaraba savings

- - qamraqEgft ffi{EmGqr(MSA-RDS) ttgt {qEFI qqfi RqK (s}ts.'{)

Srudent Mudaraba Saving Accornt (SMSA)
Mudaraba Savings Account (MSA-RDS)

{q'rdrr fu{ 6{firr qqsft ffi{ UsNA) TnrEKI fi{ffi

qq6ft A{r< o\rFSA)
(MSI{A) \ludaraba Farmers Saving Account (MFSA)
Mudaraba Special Notice Savings Accoum

{qlrffi kffiFF E.t

qrr R{r< GvncPe) p-r<T ffi-qq qqefrE ffi fr{F UIESA)
lndustrial Employea' Savings Account
(MIESA)
(II'IFCDA) \bCaaiq
Mudaraba Foreign Cunency Deposit Account

e I EI (cunencyl tfio (r/) fii-+t ' \rqtT ?Firrr -'fiB€ w;rfrdT.......

8 I ffi{ qREW+ {hG tB<' ({) fial '

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(uod"rn Banking Facility)

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OITicer
Shalr l{ozirlir 't"'
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@ Islami Bank Limited
(nranch)

{Tffi+M Card)

A"/C No

Title of&cP, t
4{.qTt*-<

2
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3

Instruction
.rffl
(*o n ar
Authorized Officer / Manager
Date

crqcqF{q{fu{lqt (Transaction Profile)

ft-q (o^y) {l'l (Month) <Eit (Year)
ftrm{q.l:r (Title ofAccount) : '.. tul
rc-lfral,
Date \A o V|-.z<t
R{Tre{d(
Account No
WlOqTt (Probable DePosit)
q{lrr qflirq({rf qire q{lit irf{u. {ffiFr 6{tr{ttr{q{lTqffi{
----rv v @ v-o
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of
qsfq qE- q6dl{ !'E[) (Cash deposit by self/ others) le -<
:-?= ET{qI{ (Transfer by cheque/others Instrument)
a 0
cE-qti€Ilt
q<\ ,ff fFtI({ E,ll (Dsposit lhmugh Electronic & i'banking) \, 004 4
E'Eq'{I
(Deposit from F. Reminance Market

(Probable Withdrawal)
rfr{t€f
{|Fmtffilrffdq$It
\, aa@n
\, ----\o-o A <lto --il oo dr>
\, r\_0 @ u-0 c€
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from F. Remittance Market

iITE Total Probable Withdrawal Monthly)

n q tOA i-
6ffI-cq-{ | qlfr^qla<T
qlr{r fifi-sT qflr r-d& 6q,
ft rrr'*-otft t+rl ,{ nrd
qtfrlqFc-fl c-<Q m, wro e-;rcqr{-{q1fis {liil qlllr{trl{ftcr'flslR-f/erf"s profile is my/our normal/real transactions.
that the above transaction
qrmqqGlrtfqft/qrn-{T roI{i fifl c(r'tltnAl4iltfiq r3K I I/\\'e, the undersigned, confirm

IAVe, further assure that lr'we will time to time, if required.

.uld ,tffqtrffiltT (Customer's

IHtSunxing
hlam! Bank {!!Fi[ (Signature) ;

{rcr(?'wcfi{!r{&0ntlit
qF[pfirre fift{qalFd vlfi{ iPate; ,

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 a
tqffirtsEFlqEqfifr" nformation of trIominee
RcKrE('
(<rRF{<I{qf6<-dqdr)

)I qfrRqqGTg\r-efKft : (Nominee Information)

qlfrfqlT<T q R{r6<r qd qmr{Fml(qr q1fre7<iG{ctc-r qqr{r q-qj rffiAE s-<-drf{ r ffiFFKr
Tgj-< "K firH afu
BBRg qrqlir{ 6q col{ w'{ qtGEi a eft-q\iL-fi qfuomqR<F"f sR I qlfr/qT{t.{enc(qfficrGwI"r+s-{& m, qllK/
q:rro?r e ffiiTl ffilsl-6{s. {rtrc qd qnrq o-+c< e<q qd {kr.nq s-{I Em qqffi qntaio qqfu {KqT nr {fur
qr{rq<rE rf6rqr{
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I

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v) fuR{Ar lt[ct rr*6'........ , ,i
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t

E?s'{ -21 : --
<; ffifr-<xlxcrqq6. .. t97 r t'7^Y tff} *+Eo 1--*8
ICT[{rt[ s TIffi (Declaration and
qffr/qfn-<TTE'[rq c{lT6[<i{R cq, EBF]gsqrffrqsT r qrfrFl:q-flqT(rs-{urRfi crrelra 7- ->-7-7:7 F<-<<fEs-?Fr
I

qrrFr', af6-g s ffi4

\ t ................

aT:G <3=-K SF rF,,r Barik'i u!.r r.,ni',

{S?lT:..

Jatredrrl Islam
Offlcer
;."11,111'Jl.r::;.gl$ff iy-:RA?s{a6 a<c-sf-{
RqR c{q1Tq1sef
({Iry{sftfiExlqr e stR{) ({I+{gffffi<qrm e qR<t)

e. qffi ealFrs. {F E{ffi{ qt qc}| sffir Tr{ TT q(rfi qlret x{s Tirao qr{ I

8. ftqRqIft {l<Fro{raqrr<n+offi-<tm<<weRqr<qft<qfrsl{oTtF<TirtrFr
w
r

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)r' ftfl< ({lEl{ ToT Et Tf} "flcPltr crtq qfr, q1qmuiffi{^qfrE{Tqlsrni +rBfrq-{
ft'q<I QB6-tr{ 6'rmqr{ sqh s.s nl'ffr.sy ciq(qfr{E) <r fir-qrnmdr
$6'u' eqs 'r*Efuqa reftT') q*,ur <ilqi/dtr's-qoo.*
mt ii#ic*4 * *^o*"rR{q refr{rl E# * {.u (Accounr r horder is required to subp11
(with photograph) issued by employer
or certificate (with photograph) issued by person acceptable to the Bank/Financial
a
:\e' us Rqlu ccll-s {trflft fiBT q-{Trfr qB, sit <I Es qr( institution).
$T(Kr{ frTTErlft <lT'rfr'r Gfrrc- qfliT
and operating fees as well as other charges/fees
ofthe Bank will be realized on halfyearly basis as per
'r'frEq-dl fr qq( ercq*].ff o6q o-*r €,u (vAr/rax or tarif
Govt. rules and rules ofthe Bank).
)8' )bb)*m{qfi..mr,IftqE{'I$ft)o(fi)<E*ev5(oxm"rfuc+r+Rrt*ce-ff*+Eracsa?ffiq,fr_fo(unclaimed)Rr'F{qra*Evfu.ur
QG ot*rm <tro qlqgg o-*r qr oo transaction i' t"tn in an account for l0 years or more than that, then the account
company Act- I 99 I and the balance of that particular Account will be treared as an unclaimed Accounr as per
Bank
will be transfered to the Bangladesh Bank).

'" f,ffi"YnffiT,m,:ffimT,m"fl,N],;Tffi,Hmt*,.*sir'(vq54lsunL6oesnorpav..zakar"rromanycustomer,sdepositAccount.
)s' d*R,I,.{ rrm<fr tc<tqfi{:lErET q<qfuffifrrE6rr.-rarrEza.lqTrc
m, c{
fro crq-{qr-fffrs-u,fuRry.E rfrETE{I$irrs {3r.u, orc6'*,RE-<TIf
:*,tr*, *Htr m:m*,ff-* m*,#ffi, m .#,i"#'iiit E*# *.
";;+" ;"n J',. r a"u,r, r uny il *; o o

)c' q<'iF qlc{

"iffi'o fuft< firq{ ftft't ffi rffi qq6
q*TftGcrrs-'{'fc'1*im1'Wtr c+rq <r'furs lrmffv o-<t En, .,-ru a <Ifu ffi qffi vfur yu* "r* csa} Rqrrs i&E.qd
ryT RcR {slE {6{ (Ifany "ffi..*'fl"*
person is nominated as nominee as per
r omDrqilBr"I{.o{ ct,olc.,.q ffi <q **.., -t+ar. qa#or-rz. ri.*"k"
special instruction ofthe accounr, operated
Buttheaccountwilr
as individual account, the nominee can
be allowed to withdrarv the ^u,,,*
;ff:H:iffi::H:,.:"rT]|ff:Tfl"'J"#'peridentifcation beclosedarterwithdrawarortheremainingbalance.rrnomineeintendstoconrinue

lv' d{ R'I..{ ffia sfr d* 'll*,u qfrE,*flr fu, affrs qq{r f iT

fid'tTlT <EII all-r m., 6q 6qra qs-q-{ R{R eT
6{ crFr qoslc.K wr* ctccf cftq qsB?
ffiro ffinqrr <fi.q[T $r< r errro eflg stBfr.a_qeBfir_{ *#'ffim * (Any one operare the Account) E?Fl
fof'f Elvlt E-s fu,c< tffu, c( eh. "q
q'6.. qTs srlfr{r{ +ffr
-"flfi* xr{rcr qlqFnvq
,' ;e; **fi'"H fir,r ;;*"; il" 6-ap qne6* Brs6a **
"fu (rf there is any instruction to operate a Joint

ffiL:Tr'"r.T":::l,::::,rr,#::::;ffiffi'#;;"H.":ffi'i[:HT*r*ffi:*flTf;;;i;;#",hrough submi,,ing u loi,g uppii.u,ion arong wi,h

:l' RqtqqTft sEm EIr rE,{tr qrlTs ?ro qnffid siqr qfrft
Trd1fts^s-fls 'r{..{ i R{,-u{Krq{
qr*li{ "r@. {Eq r+oorqn rqrq qrffiffi{ F*ftFM s*,qq.ftfi-ft.# ryry 1* *.EB frqrr+-< qotTo qd ErsmT{ qry. qfrfr sEa ETfr
(o) fui<qTft? TW-QFE Tdr. qq I a-{ q"ffib q* *A"
il y *** ifrft .6-m}; sqs E.iilfr.sk c,rq.ql'rq <r{K Erflw fiQ
qqfr"o 'aEo qe'il
.rr Tg:. rra. laaaE *#; <,_.6s qfr,flTdv !-sFil{ * . lrry ar, afti_r zR66:< I,rcr
r

"fl'qztE qr+n<-r
<ilr<'{^rtq-{.*"ci *..r {,ft*
csrfiE Efr'r (s) ffift aqs G{frfD rg
iEffi ffi "ioo*frm
+d** ; ffi"#,t".w.,ua* rqo q's
<inr<rs Eto_q
r'rft{
Frq."rdr r (,r)
Eq'ro r (The Account holder can nominate
a nominee to withdraw the remaining
I
the death ofthe constituent(s)' The
following do"'-"ntt as well as application as per nomination
must be submitted by the nominee at the
barance of those Accounts after
time ofwithdrawar
ofthe remaining
death in the foreign land' Death certificate
signed by the Bangladesh Embassy ofthe
l
concemed counrry must be produced) (b)
certificate in favour ofnominee issued by
orUnion Parishad'/citv corporation or ward two valued
ili#il:"::"J[lil:jff;:*;[f*- Counc,or orMuniciparity) (c) Attested passporr
size photosraph ornominee) (d)

r'o' qtlrHqtt*lo:t({orc
rlfi-qglfr(
'{rtrGft+c-q), y*furyrq* toorD (to)t-\o:\, qrr(rfi{ftToe fifrq|qt \olrr s ffi-fr6ffiqQaift,aEertfueq
tBffi t'avqtRcl' otarn-r^<n<+ +6-o ** *"i'*at"-;m;ffiffi.*r <r*.dr DrRqT ;Mro" m 6{rFr sqr qrfiR air66 <r$. er{r*Fr
5q 6sl* 6{*raFft celfrF{ ER,T q{ift vqi
€FiF, Fgcq {lo,< (customer r ?fts
is obli}ed to submit any information as per demand of the

ffi#:#n*j;**;**tnx_; il;;;;;;,
Money Laundering prevention Act-
3'jill:t*lll;#;ilT;I;::';j:::n (Fru) and circu,ars/Ru,es i,,u.j,i.",o,ime
by
t)' fi({ R 6{',o cqr {fiRo frcr{ qq@'o cq 6{t,o foffi
"ifri6{, {fr'f{, {${R{ il u,&q q-*cs "frrr qqq R{rflff q 6{.* E T[s ici
add' amend or nullif any rules related to account and the account holder eFFtFr (Tbe Ban] can change,
is obliged to abide by the instruction made
by the Bank in this regard at any time).

m,Y,T"XrH*,1T;ffiXo,*ff"m,trffim"Xff=*torrwp'tu+mq-rq-{riprFr(we,theundersigned,areagreedtoaccomprish

I
eff{,ffr/Rqr<{lfi",Er{rrc, s stfr{
(Name ofthe account holder(s), "tTT
Signature & Date)

))

r.)

Jahedul fslan
rOfflcer

#'#$';Hffi-
Sheh Mozidia Trad9rsr+05/041
e)

(Signature oftheconcemed official

and date (Seal with name)