GIAY BE NGH! MG HG SOTHONG TIN KHACH HANG CA NHAN, Al KHOAN TIEN GUI VA DANG KY SU DUNG DICH VU NGAN HANG APPLICATION FOR OPENING INDIVIDUAL CUSTOMER INFORMATION FILE DEPOSIT ACCOUNTAND. USING BANKING SERVICES S6 hé so théng tin khach hang (S6 CIF) CIF No. Véi moi tréch nhiém thudc vé minh, tdi dé nghi Ngan hang TMCP Ngoai Thuong Viet Nam (Vietcombank) mo tai khoan va dang ky su dung dich vu véi cdc théng tin sau/ Taking full legal responsibilty to myself, | kindly request Joint - Stock Commercial Bank for Foreign Trade of Vietnam (Vietcombank) to ‘open the account and banking services for me under the following information, = PHAN DANH CHO KHACH HANG BANG KY THONG TIN VA CHU KY FOR CUSTOMER REGISTERING INFORMATION AND SIGNATURE TIE NAAR NSE NM ete Ho va té (NIGIOI VENT IAIN TAL Full name Ngay sinh (TT PSATROTOTS) Gidi tinh ofan oN Date of birth Gender ale Female Quéc tich Viét Nam 9 Quéc tich khac Nationality Vietnam Other nationality — oO Cocu tra cg Khéng cu tra Thai han cu tré tai Viét Nam Resident Non resident Resident period in Vieinam Thé cn cube céng din 4 CMND (4 HO chiéu Noi cap Citizen 1D ‘0 Passport fssue by ~ - $6 (IMRT) 8S pscpnganan doce No Issue Date . Date /d 8042 Thi thye Gidy to ching minh duge mién thi thyc Visa Visa exemption documents 6 Nay cSp Ngay hét han No L Issue Date Exp. Date 1 Ma s thué ca nhan : Tax code Nghé nghigp hign tais Current Occupation Nhan vién Bac si, duoc si, y t8 _COng chic, _KY su, céng nhan xay dung, co khi Qvan phong =O) Doctor, pharmacist, Oivien choc =O Engineer, construction worker, mechanical Officer nurse Civil Servant engineer Luc lugng vd trang pLam viée ty do yer sinh, sinh vie 1c (ghi hil ST By Armed Forces Freelancer pi Student hers Chise vus Job Title Y Nhan _ Trudng Gidm d6c/Quan ty Cho doanh nse (gh co): Ovien Ciphéng/Giam sat 0 cap cao Onghiép el iecheuana Staff Manager/ Supervisor Director/ Senior manager Business owner Dia chi thusng tra Ss 2 < 7 Permanent Address = Dia chi nuéc ngoai Overseas Address Bia chi noi 6 hién tai Current Address ! 2 Thai gian 6 dia chi hién tai Time at Current Address ~ Dién thoai lién hé mona), dién ty Contact Phone No. (*) Email (**) — Quy khach ké khai ngay théng ndm theo dinh dang DD/MM/YYYY/ Date format D/MM/YYYY -(*) La s6 dién thoai mac dinh dé dang ky cdc dich vu Ngan hang dién tu va nhdn cdc théng bao vé dich vy tu Vietcombank/ This phone number is used in Ebanking services registration and receiving Vietcombank information/ alerts by default -(**) La dia chi thu dién tu mac dinh déng ky dich vy VCB Digibank va/hoac nhan théng tin dich vy Thé ghi ng, OTP (one time password) tu Vietcombank/ This email is iso! gene | registration and/or receiving Vietcombank Debit card related information/ alerts, OTP by defaultDA 1 Sig Dang ky chi ky mau dé giao dich cho tat ca cac tai khoan thanh toan, tai khodn tién gui c han, tai khoan tiét kiém,... va The Use specimen signature for all types of deposit account: current account, term account, saving account...and Cards Chir ky mu lan tho nhat (7 Specimen Signature) _Chit_ky méu ln this hai (2~ specimen Signature) Signature and Full name) (Signature and Ful name A HEN Ney Van A THONG TIN KH CHO MUC DICH TUAN THU feet Co Khong re Quy khach Ia ngudi khdng quéc tich/ You are a stateless person Quy khach 13 ngudi da quéc tich/ You are a multi-nationality person B Quy khach ld céng dan Hoa Ky hodc déi tuong cu tri tai Hoa KY/ You are a citizen or resident of the United States Quy khach c6 chu sé hd husng I9i/ You have beneficial owner(s) Quy khach c6 tham gia théa thuan phap I¥/ You participate in legal agreements) A - Quy khdch tham khdo théng tin cho muc dich tudn thi tai Huon 6 théna tin co ban dinh kém/ with regards to compliance purpose, kindly refer to the attached ain requirement -Truéng hop mét trong $6 cac céu tré [6% tai muc nay la "C6", Quy khach vui long bd sung mu THONG TIN KHACH HANG CA NHAN CHO MUC DICH TUAN THU theo quy dinh cia Vietcombank. Mau THONG TIN KHACH HANG CA NHAN CHO MUC DICH TUAN THU Id mét phan khéng tach rai Gidy dé nghi nay/ If your answer to any of the above-mentioned question is “Yes” kindly fil in Vietcombank’s regulated form INDIVIDUAL CUSTOMER INFORMATION FOR COMPLIANCE PURPOSE. All information within this form is an integral part of this Application ~ Quy khdch wui lng théng bdo cho Vietcombank trong vong 30 ngay ké tt ngdy c6 nhing thay déi lién quan dén cdc théng tin cho muc dich tuén thy néu trén v3 mau THONG TIN KHACH HANG CA NHAN CHO MUC BICH TUAN THU (néu c6)/ Please notify Vietcombank any content changes within 30 days of the occurrence related to the above-mentioned questions and form INDIVIDUAL CUSTOMER INFORMATION FOR COMPLIANCE PURPOSE (if any) Muc dich cia Quy khach khi thiét lap méi quan hé voi Vietcombank (cé thé chon nhiéu muc dichM/ Your purpose in banking relationship with Vietcombank (You may choose muttiple purposes) hanh toan/ Payment O Tiét kiém/ Saving O Vay vén/ Lending huyén tién trong nuoc/, Domestic remittance Chuyén tign nuéc ngoai/ Overseas remittance @ Khac (ahi 16)/ omer poe PHAN DANH CHO KHACH HANG DANG KY SU DUNG DICH VU FOR CUSTOMER REGISTERING SERVICES Téi dé nghi Vietcombank cung cdp cac dich vy sau day | request Vietcombank to provide the following services FaVANNTCM SAO) TRI OM EV Cn 10D MIN CLOT De Se eal eon eee er) Tén tai khosn I I \ccount name ~ Loai tai Khodn gejThanh toan Thanh toan chung 4 Khac (ahi 13}: \ccount type ‘urrent Account Voint-Account Others tthanh toan s6 chon Gurrent Account with favorite number Loai tién Khac (ghi 3): ee elo Gus O onesSYNE RANSTO Wen eer eee) & za a 3 a é Goi tai khoan VCB Eco/ vce Eco G6i tai khodn VCB Plus/ vce Plus G6i tai khodn VCB Pro/ vcB Pro Goi tai khoan VCB Advanced/ vcB Advanced GOi khac (ghi r3)/ Other package nooo ooooog VCB-SMS Benking (Dich vu Ngan hang qua tin nhin di d6ng)/ SMS banking service a0 VCB Digibank (Ngan hang sé VCB Digibank)/ VCB Digibank service a Qo VCB-Phone Benking (Dich vy Ngan hang qua téng dai 24/7)/ Phone banking service Dich vy VCB-Phone Benking 1a dich vy mac dinh, Vietcombank khéng thu phi dich vy VCB-Phone Benking is default service without fee charged by Vietcombank DANG KY PHUONG THUC XAC THUC GIAO DICH (Transaction autt C6 Khong Yes No Phuong thic xac thyc giao dich Vietcombank Smart OTP a a Transaction authentication method Vietcombank Smart OTP. DANG KY DICH VU THE GHI NO (C C6 Khéng — Phuong thuc Thanh toan phi phat Yes No phat hanh Issue fee payment Loai the Issue type Type of cards Thong Phat hanh Ty déng ghing Nép tién mat thudng nhanh tai khoan Cash deposit Regylar Quick Auto debit to account Vietcombank Connect 24 gt ] ace Q a o Vietcombank Connect 24 Visa OF O te] Q Q QO Vietcombank Visa Debit Platinum O Qo Q Qa Q Vietcombank Mastercard Ele) a Qo Q Q Vietcombank Unionpay ele) fl o o QO Vietcombank Cashback Plus American Express O 0 a a a The ghi ng khac (ghi r6)/ Other debit card a fo 6) ao a oO Phat hanh thé phy o © gf Khong Supplementary card issue Yes No Tinh nang thanh toan qua internet s dugc mac dinh cung cdp Khi thé dugc kich hoat. The online payment feature will be provided by default when the card is activated. Cac dich vu Ngan hang dién tu (VCB-SMS Benking, VCB DigiBank) sé duoc mac dinh dang ky cho chi thé. E-banking services (VCB-SMS Benking, VCB DigiBank) will be registered by default for cardholders Quy khdch tham khdo huéng dan str dung va théng tin cdc dich vy ngan hang dién tu, thé ghi no tai website https://portalvietcombank.com.vn/ Please refer to Ebanking and Debit Card services user guide {and information at website_httns://portalvietcombank.com.vn CAM KET CUA KHACH HANG CUSTOMER'S DECLARATION 4. Téi cam doan moi théng tin dua ra tai dé nghi nay déu day du va trung thuc. Toi hiéu va dong y rang Vietcombank cé thé yéu céu thém théng tin dé xdc thyc cc théng tin ma tdi xdc nhan 6 trén, thay mat t6i cung c3p théng tin cho cc ca quan nha nude cé thém quyén theo quy dinh cua phap luat. Dé nghi Vietcombank mé tai khoan va cung cp cac dich vy ma t6i da dang ky 6 trén, I hereby confirm that the information given above is true and correct. | acknowledge that | understand and agree that Vietcombank may request additional information to verify the self-certifications above and provide such on behalf of me to the applicable governmental authorities in accordance with laws. | kindly request Vietcombank to oe”‘and provide me with the services registered above. 2. Bang viéc déng ¥ st dung cac dich vy Ngn hang néu trén, Toi xac nh3n d3 dugc Vietcombank cung cap day dU théng tin vé théa thuan/hop déng/gidy dé nghi theo méu, diéu kién giao dich chung va cc dich vy tai gidy d@ nghi nay; da doc, hiéu r6, déng y va cam két thyc hién cdc Diéu khoan, diéu kién chung duGi day va déng ¥ ring khi dai dién hop phap ctia Vietcombank ky va0 "Phan danh cho Nan hang” tai van ban nay thi van ban nay va cdc Diéu khodn, diéu kién chung dui day duoc coi la Hop déng va cé gia tri rang budc cac bén: By agreeing to use the above mentioned Banking services, | declare that | have got all services information in this application; have read, understood, agreed and committed to the following Terms and Conditions and since Vietcombank’s legal representative sign in the ‘Bank use only’ part in this document, all parties are bound by this document and Terms and Conditions, which are considered as a Contract Déng ¥ Khéng déng ¥ ‘Agree Disagree Diu khodn va Didu kién vé me va su dung tdi khodn tién gui tai Vietcombank di vai khach hang ca nhan oe oO Terms and Conditions on opening and using deposit account at Vietcombank for individual customer Diéu khoan va Diéu kién str dung dich vu ngan hang dién tur danh cho khach hang ca nhan et Terms and Conditions on using Ebanking services for individval customer Diéu khodn va Diéu kién phat hanh va su dung Thé ghi ng Vietcombank (ap dung cho khach hang cé nhan) a Terms and Conditions for Vietcombank debit card issuance and usage (for individual customer) Diéu khodn va Diéu kién su dung Phuong thie xc thyc cla khdch hang cd nhan a a Terms and Conditions on Authentication methods for individual customers Téi chiu trach nhiém c&p nhét va chp thuan cdc Diéu khoan va Diéu kién ndi trén dugc sta doi theo tUng thi ky trén website https://portal.vietcombank.com.vn va/hoac cac kénh cung cép dich vy cla ngan hang. J agree that it is my responsibilty to update and accept the above Terms and Conditions as amended on the website +httos://portalvietcombank.com.yn and/ or other service distribution channels of the bank. 3. Téi cam két chiu trach nhiém quan ly, st dung tai khoan, dich vy Ngan hang dién tu va The ghi ng theo quy dinh cua phap luat va ca Vietcombank. | commit to operate and manage this account, ebanking and debit card services in accordance with law and Vietcombank’s regulations. KY va ghi 16 ho tén/ Signature and Full name Nay (Date) .. BO PHAN TIEP NHAN VA XU LY A ae Tiép nhan xa PHAN DANH CHO NGAN HANG Can bo ‘Bai din Vietcombank Can b6 Lop (Bank use ont) (kj tn, dng du) 56 HSTTKH $6 TK VND: SO TK NT Ten truy cBp VCB DigiBank va VCB-SMS Benking Higu luc tu ngay (effective from date) Ho ten Ho tén Ho tén Ho tén. 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