You are on page 1of 20
S ASIA 2 SECURITIES INTGRITY | INSIGHT | INNOVATION CLIENT REGISTRATION FORM ( FOR INDIVIDUALS/JOINT A/C) Bee eho ker oe on ‘Assign Client 1D | ] * Delete Accordingly! o@ e=nb0 88) BED SoD looted | accdded Bead (808 qae8aceod /racconted Bloc) | (is Gls 9088 ae8Og eee BABS GAS! Should be fled in English Capt Letters) | LITTLE ackioa: [Mrlém | Mrs/@a | Wiss e@ea8= | Reviacs | Drieabes | Otherisoad: 2. SURNAMBIgDe@ oe 3. INTIALS Bea: 4. NAMES DENOTED BY INITIALS exc: 083 atid Om 28/8 5. CORRESPONDENCE ADDRESSiacecg G3 + 6.DISTRICT/ B4@coe: 7. POSTAL CODE /axsxe sveciaa: 8, PERMENANT ADDRESS/ 2886 @800: 9, BANK ACCOUNT DETAILS TO REMIT DIVIDENDS & COUPONS (Non Resident Applicants shall state their HA AVC details) BANK CODE [BRANCH CODE, x NO 10. DATE OF BIRTH (Year Month Date) cos Eat (03/8) | IL NATIONAL IDENTITY CARD No. PASSPORT No. i ec00 Bete 68d B59 WS 12," RESIDENTINON-RESIDENT I3.NATIONALITY/ poco «. 14, OCCUPATION. 15, CONTACT DETAILS, [RESIDENCE OFFICE FAX, Continued. (@onite | L_JPless tek the orto receive SMS alerts regarding the transaction taking place through your CDS account. Please refer the CDS 27A From for applicable Terms &Condition.| ‘Monthly subscription of Rs.60/= willbe charged. (©) EMAIL [J “Piessalck the box to receive CDS account statements via email Ifyou require fo receive CDS unt statements pertalning to you CDS account In printed form. please submit a request ‘writing tothe CDS after subscribing forthe Statement. 16. NAME OF PERSON(S) AUTHORIZED TO OIVE INSTRUCTIONS (Pise Atcha lycris copy ceri copy of Power ‘of Axtomey - if applicable) Coad 89 eum Sesed EXoen/aoeBal (eDe Sos a8 comBa Bes x8608 OGax0/ «KOES Bgoge eBada) Ist Joint Holderioeg 86 aocBace (08 es @.98 exSog nbs B26 gS. / Should be fled in English Capt tors) Drlesbes | OthersOos LITTLE axis: [Melon [Mala Minleteaba Reve 2. SURNAME/90200 98 SLINTIALSBeace: 4. NAMES DENOTED BY INITIALSiQea%e 88 ogod 09 68/08 5. CORRESPONDENCE ADDRESSiaxoxd! G8513 6, DISTRICT Bee 7.POSTAL CODE / axed exedios: 8. PERMENANT ADDRESS / 886 8800: 9. DATE OF BIRTH (Year/Mont/Dute)/ Coe Boo (Gbea/ 60/80) 10, NATIONAL IDENTITY CARD No. / PASSPORT No, Bo ecpgod quac/Dage See Bgog MOS 11.* RESIDENTINON-RESIDENT 12. NATIONALITYigeex6e00 13, OCCUPATION. 14, CONTACT DETAILS. RESIDENCE [MOBILE [EMAML OFFICE FAX ‘Continued. Sign 2% Joint Holder/ecb= ©¢ eae 8ace (8 eo» 9.98 exBOg abe! BCE ge. / Should be filed in English Capital eters) LITLE eddea [Mileo [Melts | Wissiebe5s | Revigs | Orlesbes | Otherebad 2. SURNAMEQ@e30 38 3.INTIALS/Be .. 2) «[bearing National Identity Card [bearing National Identity Card No. 3) {bearing National identity Card NO... of (hereinafter ‘sometimes jointly and severaly referred to as the “Clientés") of the One Part. And ASIA SECURITIES (PRIVATE) LIMITED a company duly incorporated under the laws of Sri Lanka bearing Company registration No. PV 1924 and having gits registered office at 4" Floor , Lee Hedges Tower, 349, Galle Road, Colombo 3 (hereinafter referred to as “the Stockbroker Firm” which term or expression has herein used shall where the context requires or admits mean and include the said ASIA SECURITIES (PRIVATE) LIMITED, its successors and permitted assigns) of the Other Part; ‘The Clients and the Stockbroker Firm shall hereinafter be collectively referred to as “Parties” and each individually as “Party”. WHEREAS the Stockbroker Firm is a Member/Trading Member of the Colombo Stock Exchange (hereinafter referred to {as the ‘CSE") and is licensed by the Securities and Exchange Commission of Sri Lanka (hereinafter referred to as the *SEC’) to operate as a Stockbroker; AND WHEREAS the Clients is/are desirous of trading on the securities listed on the CSE through the said Stockbroker Firm and the Stockbroker Firm agrees to provide such services to the Clients in accordance with the applicable Rules of the CSE, CDS, SEC and other applicable laws of Sri Lanka. NOW THEREFORE THIS AGREEMENT WITNESSETH and it is hereby agreed by and between the Parties hereto as. follows: 1.0 RIGHTS AND RESPONSIBILITIES OF THE CLIENTIS 1.1 Subject to clause 1.5 below; a) In the event of a Joint Account, the Client/s shall provide to the Stockbroker Firm, the name/s of the Persons; - authorized to give trading orders and settlement instructions; and, to whom payments by the Stockbroker Firm are to be made. ») In the event of a Corporate Client Account, the Client shall provide to the Stockbroker Firm, the rnamels of specific directors and officers authorized to; - trade in securities; and, - execute all documentation for trading and settlement in the account, together with a copy of the Board resolution certified by the Company Secretary evidencing same. ‘The aforesaid person/s shall hereinafter be referred to as ‘authorized person/s. 4.2 The Client/s shall notify the Stockbroker Firm in writing, if there is any change in the contact and/or other information provided by the Clients to the Stockbroker Firm, within seven (7) calendar days of such change. 1.3. Subject to clause 1.5 below, in the event the Client/authorized person(s) (as applicable) intends to purchase andlor sell securities, the Clientéauthorized person(s) (as applicable) shall give specific order instructions to the Investment Advisor (an employee of the Stockbroker Firm, who is certified by the CSE/SEC to deal with Clients) assigned to deal with the Client’s regarding same. 4.4 The Clientauthorized person(s) (as applicable) authorize/s the Stockbroker Firm to accept order instructions siven by the Client/authorized person(s) (as applicable) to the Stockbroker Firm pertaining to the CDS Account of the Client/s through electronic means and other means including telephone, Short Message Service (SMS), E-mail and Fax. The order instructions provided by the Client/authorized person(s) (as applicable) through aforesaid means shall not be revoked or withdrawn by the Clientfauthorized person(s) (as applicable) after the ‘execution of the order and shall therefore be confirmed. ‘Sign Here a 18 16 17 18 19 20 - Sign Here If the Clients intends the Stockbroker Firm to use the Stockbroker Firm's own judgment, expertise and discretion to buy andior sell securities on behalf of the Clients, the Client/s shall provide the prior written ‘authorization to the Stockbroker Firm for same. The said written authorization provided by the Client/s to the Stockbroker Firm shall clearly include the following; "Name of the Client/s and the CDS Account Number; - Effective Date of the authorization; = Applicable period of the authorization; = Investment objective (short time, long term, trading in any specific industry, any other specifications); and, ~ Purpose of giving discretion to the Registered Investment Advisor. The Client’s shall ensure that cleared funds are made available to the Stockbroker Firm in respect of the ‘securities purchased by the Stockbroker Firm on behalf ofthe Client/s, by 09.00 hours on the settlement date of ‘such purchase transaction and if the Clients fail’s to make payment as aforesaid, the Stockbroker Firm may, at its absolute discretion, charge an interest commencing from the day after the settlement date at a rate decided by the Stockbroker Firm, but not exceeding 0.1% per day as specified in the StockbrokeriStock Dealer Rules of the CSE, ‘The Client/s shall accept the liabilities arising from all authorized transactions executed in the CDS Account of the ClienVauthorized person(s) (as applicable) by the Investment Advisor. If the Cliont/s hasmhave a complaint against the Stockbroker Firm relating to a particular transaction’s, the Client's shall first refer such complaint to the Compliance Officer of the Stockbroker Firm, in writing, within a Period of three (3) months from the date ofthe transaction’. Where the Clients is/are not satisfied with the decision given by the Stockbroker Firm or the manner in which the complaint was dealt with by the Stockbroker Firm, the Client's may refer the complaint to the CSE, in writing, in accordance with the Procedure set out by the CSE (which is available on the CSE website, wwww.cse.IK). ‘The Client's agreels that the Stockbroker Firm may, at its absolute discretion, sell not only the securities in respect of which payment has been defaulted by the Clients, but also any other securities lying in the CDS ‘Account of the Client/s in respect of which payment has been made by the Clientés, in full or part, in order to enable the Stockbroker Firm to recover the monies due to the Stockbroker Firm from the Clients including interest and other applicable charges. ‘The Client/s shall not; . use any funds derived through illegal activity for the purpose of setting purchases of securities to the Client's COS Account. . enter into any verbal or written agreement/s with the employee! of the Stockbroker Firm to share profits arising from the transactions carried out on behalf of the Client/s by the Stockbroker Firm. (TS AND RI ISIBILITIES OF THE ST ER FIRI 2.1 Subject to clause 2.3 below; 2) In the event of a Joint Account, the Stockbroker Firm shall obtain from the Client/s, the namels of the persons; ~ authorized to give trading orders and settlement instructions; and, - to whom payments by the Stockbroker Firm are to be made. b)_ Inthe event of a Corporate Client Account, the Stockbroker Firm shall obtain from the Clients, the: namels of specific directors and officers authorized to: - trade in securities: and, ~ execute all documentation for trading and settlement in the account, together with a copy of the Board resolution certified by the Company Secretary evidencing same, ©) the Stockbroker Firm shall carry out all transactions based on the specific order instructions provided by the Clientiauthorized person(s) (as applicable) through the communications channels specified in clause 1.4 of this Agreement. 2.2 Prior to accepting any orders from a third party on behalf of the Clients, the Stockbroker Firm shall 2 23 24 25 26 27 28 29 2.10 an 242 2.43 244 2.18 2.16 first obtain the written authorization of the Client/s empowering the third party to trade on behalf of the Clients through the Client's CDS Account. ‘The Stockbroker Firm shall not exercise the discretion to buy or sell securities on behalf of the Clients, Unless the Client’s hasfhave given prior written authorization to the Stockbroker Firm to effect transactions for the Client's without his/their specific order instructions as set out in clause 1.5 of this ‘Agreement. ‘The Stockbroker Firm shall send to the Client's a note confirming the purchase andlor sale of securities (bought/sold note) by the end of the trade day (T), Upon obtaining the prior consent of the Clients, the Stockbroker Firm may send the bought/sold notes to the Client/s in electronic form to the e-mail address provided by the Client/s for such purpose. ‘The Stockbroker Firm shall send a Statement of Accounts to the Client/s who is/are debtor/s over ‘Trade Day + 3 (T+3), on a monthly basis by the 7th day of the following month. This should apply hen the client/s has/have had transactions during the month and the “interest charged on delayed payment” should also be considered as a transaction for this purpose. Such Statement of Accounts, shall specify the transactions in the account including receipts and payments during the month under reference In the event the Statements of Accounts are issued electronically, the Stockbroker Firm shall obtain the consent of the Client/s and retain evidence of such consent. ‘The Stockbroker Firm shall provide a copy of its latest Audited Financial Statements filed with the CSE to a Clients, upon request by such Clients. ‘The Stockbroker Firm shall communicate in writing, directly with its Clients in respect of statements, bought/sold notes or any other information unless the Client/s has/have authorized the Stockbroker Firm otherwise in writing. ‘The Stockbroker Firm shall ensure that ‘cleared funds’ are made available to the Client(s) /authorized person(s) (as applicable) on the settlement date, unless the Client/s has/have expressly permitted the ‘Stockbroker Firm, in writing, to hold the sales proceeds for future purchases. Upon the request of the Clients, the Stockbroker Firm may: 1a) extend credit facilitates to the Clients solely for the purpose of purchasing securities on the CSE ‘and in accordance with the applicable Rules set out in the CSE Stockbroker Rules and terms and condition mutually agreed to between the Client/s and the Stockbroker Firm by way of a written ‘agreement for extension of such facilities. b) provide internet trading facilities to such Cliont/s based on a written agreement mutually agreed between the Client/s and the Stockbroker Firm, in accordance with the requirements applicable to Internet Trading published by the CSE from time to time, “The Stockbroker Firm shall assign a Registered Investment Advisor to deal with the Client/s and shall inform such Clientis regarding the name and contact details of the Registered investment Advisor assigned to such Client/s. Further, the Stockbroker Firm shall inform the Client in writing regarding any change to the Registered Investment Advisor within seven (7) Calendar Days of such change. ‘The Stockbroker Firm shall forthwith notify the Clients in writing, if there is any material change in ‘contact or other information provided to the Clients by the Stockbroker Firm, ‘The Stockbroker Firm undertakes to maintain all information of the Clients in complete confidence and the Stockbroker Firm shall not disclose such information to any person except in accordance with the Stockbroker Rules of the CSE. “The Stockbroker Firm shall disclose to the Clients, the existence of any incentive scheme applicable {for employees of the Stockbroker Firm, which is based on tumover generated from the transactions carried out by the employees for the Clients. “The Stockbroker Firm may recover any outstanding balance arising from the purchase of securities of the Clientis from the sales proceeds due to the buyer only in the circumstances set out in the ‘Stockbroker Rules of the CSE. ‘The Stockbroker Firm shall provide services to sin compliance with the applicable Rules of ae Sign Here / @) the CSE, CDS, SEC and other applicable laws of Sri Lanka, 30 RI LOSURE STAI 3.1. The Stockbroker Firm agrees that a member of its staff who is authorized by the Board of Directors of the Stockbroker Firm to make declarations on behalf of the Stockbroker Firm has explained the applicable Risk Disclosures to the Client's and has executed the declaration set out in Schedule 1 hereto in proof of same and such Schedule 1 shall form part and parcel of this Agreement. 3.2 The Clients agree/s and acknowledges that he/shelit has understood the Risk Disclosures explained by the Stockbroker Firm and executed the Acknowledgement set out in Schedule 2 hereto and such ‘Schedule 2 shall form part and parcel ofthis Agreement. 4.0 INDI ID LIMITATION OF LIABILI 4.1, Each Party hereto, agrees to indemnify, defend and hold harmless the other Party against any loss, liability, damages, claims and costs, which each such Party may sustain by reason of negligence ‘and/or breach of the terms and conditions hereof committed by the other Party hereto or its representatives. The aggrieved Party shall be entitled to enforce its/hisiher indemnity rights by injunction or other equitable reli in any competent court of law in Sri Lanka. 42 The Cliont/s agrees/s that the Stockbroker Firm will not be liable for any losses arising out of or relating to any cause which is beyond the control of the Stockbroker Firm. 50 TERMINATION 5.41 This Agreement shall forthwith terminate, if the Stockbroker Firm for any reason ceases to be a Member/Trading Member of the CSE or ifthe license issued to the Stockbroker Firm by the SEC is cancelled. 5.2 The Parties shall be entitied to terminate this Agreement upon giving notice in writing of not less than fourteen (14) calendar days to the other Party. 5.3 Notwithstanding any such termination, all rights, liabilities and obligations of the Parties arising out of © in respect of the transactions entered into prior to the termination of this Agreement shall continue to be in force, 60 GENERAL 6.1 Words and expressions which are used in this Agreement, but which are not defined herein shall, Unless the context otherwise requires, have the same moaning as assigned thereto in the Rules of the CSE, SEC and other applicable laws of Sri Lanka. 6.2 The terms and conditions contained in this Agreement shall be subject to the applicable Rules, Regulations, Guidelines and Directions issued by SEC, Rules and Circulars of the CSE and other applicable laws of Sri Lanka, {In the event of any contradiction between the terms and conditions hereof and the applicable Rules, Regulations, Guidelines and Directions issued by SEC, Rules and Circulars of the CSE or other ‘applicable laws of Sri Lanka, the applicable Rules, Regulations, Guidelines and Directions issued by ‘SEC, Rules and Circulars of the CSE or other applicable laws of Sri Lanka (as applicable) shall prevail, IN WITNESS WHEREOF the Parties to the Agreement have set their respective hands hereto and to one (01) other of the same tenor and date as herein above mentioned, Signature of the Client(s/Authorized Authorized Signatory of the natory of the Client(s) Stockbroker Firm Witness: “ | ‘SCHEDULE 1 DECLARATION foo. son shame of the Advisor in block letors>,an employee of ASIA SECURITIES (PVT) LTD, whois duly authorized bythe Board of Directors ofthe Stockbroker Firm o make declarations on its behalf hereby confi thatthe following risks involved in investingtading in secuis listed on the Colombo Stock Exchange (Risk Disclosure Statements’) were clearly explained by me to . (the Client/s') and the Clients to read the below mentioned Risk Disclosure Statements, ask question and take independent advice if he Clients wishes to: a) The prices of securities fluctuate, sometimes drastically and the price of a security may depreciate in value ‘and may even become valueless. )_ Itis possible that losses may be incurred rather than profits made as a result of transacting in securities. ©) Itis advisable to invest funds that are not required in the short term to reduce the risk of investing. ‘Signed on behalf of the Stockbroker Firm by Signature 4 if sca - (RIA) Designation _: Registered Investment Advisor (RIA) Date ‘SCHEDULE 2 ACKNOWLEDGEMENT We, (1) . . [bearing National Identity Card No. Company registration NO. seenene] Of one
@ . nea [bearing National Identity Card No... of ‘and(3) . {bearing National ‘agree and acknowedge that the Identty Card No. es -] of folowing risks involved in Investng/vading in securtes listed on the Colombo Stock Exchange (‘Risk Disclosure Statements’) were explained to melus BY a... sovsseny aA employee (RIA) of ASIA SECURITIES (PVT) LTD (Stockbroker Fim, and le was/vere invite to read the below mentioned Risk Disclosure ‘Statements, ask questions and take independent advice if Vwwe wish to. ‘Additionally, wwe acknowledge that Wwe understood the following Risk Disclosure Statements; a) The prices of securities fluctuate, sometimes drastically and the price of a security may depreciate in value ‘and may even become valueless. )_ Itis possible that losses may be incurred rather than profits made as a result of transacting in securities. ©) Itis advisable to invest funds that are not required in the short term to reduce the risk of investing. as (2) sso . (8) fgnaturels of the Clients. Date ©) e-Services Form secOnities sects J Registration/Modification Form for E-Statement, E-Contract Notes, and Bank Details for Electronic Settlements We wish to avail the following services for mylour below mentioned securities account maintained with ‘Asia Securities (Pvt) Ltd: Account Number [ ] Nameis of Account Holderis Please tick (y) the relevant boxes. rea Email addressies to which e-Statements and e-Contract Notes are to be sent to: See a1 02 03, ees Bank account to which trade settlements will be remitted Bank Name/Bank Code Bank Branch/Branch Code Account Number l MANDATORY: Please attach a copy of your bank book or statement. \Me give Asia Securities (Pvt) Ltd the authority to send account statements and contract notes via email andior to remit my/our trade settlements to the bank account given above. We declare that the information furnished above by me/us is true and correct. Signature of Account Holderis ‘Authorized Signatory/Signatories Date ‘Asia Secures (Privat) Limtes 4h Foor, Lee Hedges Tower, 48, Ge Road, Colombo 3 |: 04 11 772 2000 |F:-+94 11 237 2280/ +94 11 237 2263 E inquiles@asiasecurties |W: waw asiaecurtes net Form 1 (A-1) KNOW YOUR CUSTOMER (KYC) PROFIL Fo be retained by the Participant) [Lv@8od ade edan Vea seae: acsin) eapaiCLeL apaiammtisah sor ion wtemti ay) Documents Provided (Please mark placing a \) tain | 2" Joint | 24oine For k¥e hotter | ‘ter | “Hoier [Bie seats [ont omina ata / tae Poo) [Bod Bcoas Ja aidi / Passport ~lTolrolo TEE OCSRS THES SERIOTIGET OCSTS COS COT OOD BOER BIT TAT seraes goss 20) | of mcsinscind OpealiophG Bdenpmn spe Gries obpid mo soondsin Oak) ‘ving License An Afidavit is equred confming the fac that both NIC Passpor ae nt avalabe) Reba word B8e acer /apad bp BeyRivadane / For Proof of Residency DBS SEBEOD | Op en wala. 7 National Meity Card oO Oo Oo Bee | 6989 Bed Sares Jerid cue snibg / Bank) Credit card Statement “Bone Beso /GprentuRl Giga / Telephone Bil Bek /Se BCOm / Batangas yaa / Clecvily/Water Bil Oo jolojojojolo CoGD 95 GOR [Bay Grint. Gio wishupinn / Roitered eave Agreement Bus wees TSS epeses aoe Ge Ge We) EnBes | Hage Gamat aia BiasGpace Gyr Breasts) wudyPpap /Gramasevata Certificate certifed by the Dsona oO ddolololo 9 |olololoolo 23 edboasa Gbucleaad be 8S San Ble BES PES WES TES BE GCE HSSRT be atin? GBa Bact osm ce 8s /PeAiydars omens gasmiach Bedarp Opn Gemmeun ash Opis. Gasnjenusrnyre® angsiacucl aypib/ eter isued by superintendent ofa Oo oO Oo ataton estat n respect of erate workers who haven ther documentary poo WET wa (ee woaS Gee BIER Te peaD Samal Gam (jim Gilg BALSLaay 7 Any Other Document (Please SPeCif) wre n-mrrnmernnensnsnnn Qo | a o echa Blidd Sie Bive Bled aciies gad B20 ta Go ex aaa 3) GIG REET BS BFA Siz gemma (DS aemigs alien ines eopisidin Seateiots 0) raieeded These dca should Bewthin (3) months sof the date of ubmision ofthe CDS Account pening form. 2.eRB CBned (S8ged) domba : Vena acaai adain) exe qpmasfue oho: (euera) (V cist sync ustenoyb) ‘Status of Residency Address: (Premises) (Please mark placing a ‘Beste q35i/e.fincsra / Owner 1 Join | 24t0ne Walder | “Holder SSa Gee /Gubtrsia/ With parents Sgloe Soe So / ebpmalea me / ease] Rent BaSQIAS | HAS GSS [watcha pabanjacter/ Fend’s Relates WSoESS [otra 66a |e wpahLWlpigihib / Board Lodging Be Dewe Stow 8 Je fedusrayjonregs Offical wid diese (ea aies Bead SSeS) [oawu Guam Guay Caw OBA | | Ormer aces Pate spec) aes gjojolojolo|o) & Olo|ojojoo|o ololold}oloja Cconinues Form 4 (A-1) 3.€Bdo goo Bmos Bac Edas, (Ven aca acca) . Brcerc-ewusfono eAugrinst (cra aan serondh oy) dont | reel _Duncizeship Detals (lease mnt plsing 29) f " ST [County — Fj ed! eco eas /siaihis Be / Passport, — o|o 2/5 County 2 = Sed acog nos / aaphig Ge [Pamper iad an o(o 2 136 Coury = = ed ocog eos Jaa G Be / Passport Ned su o/o {ioe qacied Bade Sie ag qaqem Con odes qadied oymsieod 8 300000 esi / 100.009 ~ 50.00 eed / RS 700.0000 Rs 500,000, [2S son000 Be 28 ¥000000 ceics 750,00 — 100.00 qpimih/ RS 00,000 Rs 3,000,000 BE Towa w0) ES SE ooAvwW GET 7.000 — Foon ean] RS 1,000,500 RS 800.000 olojojo| fF 48 2000000 Be 68 2000000 gies / 20m000 — 3,000,900 erat / RS 2,000,000 0 Rs 3,000,000 218. 8000000 Ge &8. 4000000 ¢sie> /3.0m,000 ~ «007.000 esad/ Rs 3,000,000 oR 000,000, ‘SE Looe Ee GE So0no00 Gar eomAO — SKnpOO waa] Re OOO}DOOTS 5,000,000 28 S000000 82 GE 10000000 ese /.00n800 — 10.00 eum / RE5,000,000 0 Re 430,000,000 8 10000000 © GB 101M UNL Cd / Over Re 10,000,000 Oo }o!O jo} Do joo lojojo;0)0 jo jojo |Oo}o}o0/0 Taeeee Boe Veae Sead aceia BAsaepanra coo (0 am amano) Saure of funds (lease mark lacing) iF 1 Joint | 2oint : 2eS/O2 OSB /abumblaeu exyenb / Salary /Proftincome enw C5 RECIPES 528/ pAK.G Gugemnae/ GeBinpact/ Investment Proceeds / Savings Reis on emote 820,G9 /pumauset cSununis ysla/ Sales and Business Tumover aisigs CIES [oiniipll Gopmmane / Correct Proceeds stcelocio® Basie / aysaminst/ Gompgyhadt Baas / als of Property/assets 200 / ardent / Gis Boma) yor nc (eGBJOaCE) /petGare me opbaLL emanates Onan) / Donations / Charts Leal / Foreign) works mqa8 / 57 sxgunend/ Commision Income BE ede / bu Uam xg / Fariy Remittance Ojo} O jojojo,o jojo OREO C5 CC / DOP yeu Guyeonse / Exper proceeds OjoO;O,O;O/O/oO/O/0 jojo redid cumtce / sringnt! wiafinjiact / Membership contribution Ofolojofojojojo}o joo) € Ojo) send (ocpeinens eqacd asela) /ommaime (pin Goss ksh apiy / Others (Spec) Seond Ge onadjedBes eog9 olsen yma Gpnjymcu alumumrina Opnpawry Grupunbat 7 ‘Any other connected Businesses! Professional tivities Form 4 (A-1) Defaaessd aBadd we~ed (eno ccag adele) | oyiua fauna Gg jysoas pujasi CPEPs) (“cat sync unow spb) / Politically Exposed Persr Main Holder T 1 Joint older Point ‘older (PEPs) (Pease mark placing a \) | Secs adh coca go stad wos aogaes 5an Siow sal SO a er cacael Clad aol paged aman cies enoreged Sn aoa vel oe py a eg ey ey SE Selcahe dao “ate 00d Scttine Sede aoe Sina gacinom tip Siro pafengioarg cri, inti Tena oe Sa mitts ay teen” fetta ent apatite Rees: ‘Are you indvivals who ae or have been entrusted domesally by 2 with prominent public functions? For ‘cramp, Heads of State or of government, senior oltcans, senor government js or miltary ofl, fenier executives of state owned corporations, Important polieal party ofa. Yes" pease expan Se ee ee eiteSasce Oa seks Chao at tastes Sa aaah airgee eces acetate yee anes tie Besse Sere tae Soe Sr aS ores oe Se Eee Sater Sms Some Pees Sona Sea Lee i ae al as eel nih Rakcedtee iat regi ect cetera Some ree te at eae pe aga FB, BES SSS SST SH Sat Ta aas STS So ET Seca sacaae aT jamin ae seunia co ocydos Sees Eeae 20 ob acer amet aoe en Sayyina on pl se, fers pap, saatnan contin) Sage io amantacte gohan PBs Opus anna st Ox) epost Gaiam Golercssyacrr? cuchar a-pal teanpanas xpi ‘re you ints who re rat te PEP eter det (cnsanginiy] or tvowgh mainge or er (chal forms of partnership? Ves please explain he relatonship, a SeecSmcen gate an mnyean eal Bese 40 ne miiwine ina wose ea soe flare stew SG seus Yous emits Pree Soe alla acta wee at Sete ge a ie Ae you nda wo arco ened a PP. thr sd ot fasion 1116 pecan oh Al gctgfed Ge cBadoeod +emafnad comd C8 ogy Geo ed giswaleteedd [Ge® SBxe ceacO wom akoewoniaieetd Se oBadoecd cored e@ seca a eemdo des GOB oO | EB aeoge aged) / haiDDoke aBaDiaacr ephoninbe mikaSéain pufeinuadih Cou Grsad Cemuais BieeiuppralipotingsnW Booswssoyoy Name of the person(s) authorized to give instructions tothe Participant (Please Attach ‘2 duly certified copy of Power of attorney if applicable): coher a Od Heomding op so sme mdi oe! moms Beat /asaingNH cant A mp mb nin SES a) PrScpant means. {our Sochbvoke of Custadan Bank A2eped acc [ocee! (eben) /saus winyses (9p Boviend) / Other remarks / notes (ifany) comin Form 1 gduder! Sgex! quite S808 qogdon (24 sdocdel vem) Saremunioat semis arb Niupparon sGsshemiuid (BAfuirt as) pein Application for Opening of Securities Account (For Individuals) Siemon sete yoatina sem 288 Sormeat Stpdinautenfat main oc. One tne On sweet = (_T TTT TTT TTT 1) sec emoneo nore | ba Seah Plt ad tomee ug Hoe omce matey o/c gO ee GSO MMR img Ul sang aA ea Poripant means, your ‘Sckiater or Casa Bank qugemaed mated Oxins (qagton a0gbe 8080 CDS 1B cog efind Satein,) Bocmon 459 eam HEE 80d enbe! at abe me ane. a Simtaniuanyfai(aniet) sauyias ammahoUNGAALUGABIS, Bp sdetemuiuyend Gufs syst mygpesastd WonuGiniubed Cash. (Goamuiesh sande ashiogd vada ysoniubie CDS 1B ‘aBewpbeiscincosr anBbsay) Particulars of Applicant's - This application should be filed in English capita letters for the purposes of computerizing records. 1. TITLE: Mis Miss Rev. De] Other 2, SURNAME: SINTIALS: 4, NAMES DENOTED BY INITIALS: 5. CORRESPONDENCE ADDRESS: 6, DISTRICT: 17. POSTAL CODE: reall 8 PERMANENT ADDRESS: 9. BANI T DETAILS TO REMIT DIVIDENDS & COUPONS (on Resident Applicants shall state their SA AIC deals) BANK CODE [BRANCH CODE ‘ACCOUNT NO. 10. DATE OF BIRTH (Dste™Mooth’ Yeu) [ sale zt J II NATIONAL IDENTITY CARD NO, / PASSPORT NO.: 12, RESIDENT NON-RESIDENT 13, NATIONALITY: oF er Continued. 14, OCCUPATION 15. CONTACT DETAILS RESIDENCE | 3 = vam oracle sae catttee aceasta account Pease refer the CDS 27A Form for applicable Terms & Conditions, Monthly subscription of Re will be charged. (EMAIL | Please place your sigaature to receive CDS account statements via ema. If you require to receive CDS. account statements pertaining to your CDS account in printed form, please submit a request in writing 0 | So esiure the CDS after subscribing forthe e-Statement. ic 16, NAME OF PERSON(S) AUTHORIZED TO GIVE INSTRUCTIONS TO THE CDS (Please Attach a duly certified copy of Power of Attorney ~ if applicable) SES wRC 4a8Hd/ Leyd Gemamis aambgs wexpBeine | 1 Joint Holder (114 gatos 988 mBOd amet B55 g98/ Gufs apsien aapbasentd YromiUisyeA Cavuto! Should be filled in English capital veers) imme = (CMe Mix [i De [ote 2. SURNAME: : 3.INTIALS: = 4, NAMES DENOTED BY INITIALS: 5, CORRESPONDENCE ADDRESS: 6, DISTRICT: 17. POSTAL CODE: 8, PERMANENT ADDRESS: 9. DATE OF BIRTH (Date Mont Yeu) L 10, NATIONAL IDENTITY CARD NO. / PASSPORTNO. : Continue. 11, RESIDENT (NON-RESIDENT 12, NATIONALITY: 13, OCCUPATION 14. CONTACT DETAL RESIDENCE MOBILE OFFICE, E-MAIL FAX (1-14 gto: 98 m80d autor 86a ged. Om BAC gagtm! Laub Bmambp amine, sayiievines | Joint Holder ‘TITLE: Mer Mis Miss. Dr 2, SURNAME: 4, NAMES DENOTED BY INITIALS: $. CORRESPONDENCE ADDRESS: 6, DISTRICT: 7, POSTAL CODE: 8 PERMANENT ADDRESS: 9 DATE OF BIRTH (DateMond Vea L L 10, NATIONAL IDENTITY CARD No. / PASSPORT No. 1H. RESIDENT /NON -RESIDENT 13, OCCUPATION 4 CONTACT DETAILS. 2. NATIONALITY: RESIDENCE MOBILE OFFICE FAX. E-MAIL Continued. () toed / good" mtatintGet pigtod Sgox! Coxe mdm ace 1 ebetraem ao ace ¢ OUat Od Sredlqved” BaAnod SGtO Stetee aon ae ome® Omer bee BOErGe08 crBdgam md gS BamBET DCD goed Ged / goed" BrelotING ecw BORA BI ‘2cu B0/9S? eons! ace B2RIBDE?. caplooy Guus/Gujacts Semmiompiniiac seiGanhon onthe unnofinningi whasb ana red, coma Se eats “cide Maaikemaem cage Sug Wosppmnedla naan kon SouciGupiigad Osmie ompacs maiicrmre CuuiiGuniad —praipnd Bigrd —Comotant sigedaCpalcSSadeiConi. UWer hereby request you to open and maintain a Sesrities Account in my/our nals and to act as my/our depository in ratio othe secre listed onthe Colombo Stock Exchange ta may be depsied in my /our* Secures Account frm ime to time, (01 0801 0s aereteme onsden 88, Srbocioeda, o8e9 m emetegB OCD ERED BAREEH BGP eanadN 900 FAI4S" mE batemsige SemianpinAsch senisimp upp, mnie sepme waded, guess safarided ode pass Bie wei Gtopaniens arheston era mage Gepoanaee no comtugsi Bospee smwbets Setiuchatnge cckase pealans a aubiOpdle snGiagel. [Wet agree thatthe Securities Account wil be operate in accordance withthe Rules of the CDS, the applicable guidelines and procedures and ‘any amendments mde thereto Fom time to time bythe CDS. i gasgboe! 800 ayeton £60 ues ODet 05 880 Bs a4 RE Bdeu Ard exe gages $220 28/98" BOs! 480 Be2 0D oeelentloestenet O2 paneer Oo ¥oiqed" Amagme Gada! ad Abe O8 asloRD adm + wombindd ced mated #080 Somnse aBdae dean 30 wm By0 00 AB O88 Ses cbs dean Abe G8/G" o8Ge! eurimn exmd puma mo EDR) BPS, Unenifingnbec embed mokisGapiar seigtes crud a deerie ga to eas. Gacad abate Soe ences; Bbadcense oo eaciSecen Boa 308 ‘Bra (ton aes S| Soa cone Se FanSsacdn en Sn tones tone gsm ‘aru nudeeuret | nuhtan) | garmesnas” eay amise. 30 28 ttm da Opninnn Spal, oie opt ammad “aap "saw “pemiaree peaa aStderg "eh matt tease et ‘wots Gomydcomnte ote osahibise sua Chectod ton hut ‘ademas nase’ wpa emia pets opt cimuiomaroe aimrinn myaseasee Gtiioe canedacpa angst Garndncene Ue. or cpecty a Tse Gascon | Nanaer shel manta omaten each a ane, sree od natenaltespoaing {he untae of he ezunt and unde to ompty eae We GDS & te Pakcput such ometon petra se Donets, an tne, required ye CDS 8s Parkopa 2 eset eas co 2a mae WB elses em os Box yocmas, gong 09 Mas. or sami; Sod AIRC Hel sees GDOD O athe demisan baw sens wigs uated Sha Catena spa cates oe Sige emia er : Secpoet Lnemunmants shnmmansngs 3, [Souter pean Sepuabara see! samen Bos Batamphare paasnow Sosoon, tlpon mcs Beuyie foscee The application andthe documents attached thereto bear tue and comect Information and no alteration, modification or falsification was cared out to them to hide o detect tue fac. hb nium enn nen | Be, Ganiiyamb be vighd whfu waive ypegmeh ammicaicnn arin BEB catenins esi (mines) maiahdacnrs Gems ajaomrinchd capnlnt gaatak® yCpgd wim RDLLp aightEbn mpgmeu exper Contes SiG ini named mph Erm ohu eatuapsde wins HuBHDBNOLS pre fond oxfalinnde CnpiMyigeh Cxrskbsionst JGimptujip Greibareons. In tho event of variation of any information given in the CDS Form 1, this Declaration and other information submited by matus along with the ‘applicaton fo open a CDS Account, Uwe undertake fo inform the CDS & the # Parcant in writng within fourtaen (14) days of such variation. 42823 argue Soro 6290 Bale edaded See ecm gi_sod eR oSe Seis pacing 96 ga WaCU omNS oB ace ace Dagiodeiadel dams 2 (Jake sal gaaoR oni 8 send BS Basi arcead Ber wecics acm CHICAS BLOM CM MECC eS eeu oaiue qpapmowld Ppdatrcuter JeemiGupinjead sons Genstasmoyiare yppe8 ine seen Btacnsia Schou eeinu ue Grupuseigbs Gabe Garton ‘Sings tangas antag! Sonus oe etches, (ramen wolggss Upbeat. Gfeare BERET. ‘Cou ‘The funds to be invested forthe purchase of secures through the Secures Account to be opened wih the COS wil not be Funds derived fom any ‘money laundering act or funds generated through the fnancing of traitor any other llega! Acti Saigo 28 co seas acco’ ctedinad G cme a6 2 enh ead coo 2 38 moe © 4 qocw/Gte SEkrcecnonas "oni “Soereaes” acscae Bad” once C88%e Solel gececs Gee cxf! satibe “Be eae, ik sm, daha seapash Qpn fds Gerknsidd sing osx Gap sind pew winds /epidud Guru sauLNe sO DpawE aparyronse pom Grin wig oog, PrrafeeinnG wbpsionng Be Dpesngeeadsmm itwe have not been banned andlor rejected and for suspended by any criminal tibunal or administatve authorly in Si Lanka or in any other ‘county in connection with the folowing offences: + 2006 9 00 <0 83 Oeiaca obo) B8e8 ono edt gbo ByC053 06 HB OBZ o9 aEd © p85 Desi Gawd wn a aos 8 2 88 Desid Gunvdd co eecola aayoe ani ous Unos cori em! CoCOe adavin cB 200 © g eised aducLesd om oe Bose g ogecgom aioe ent ogo Bua De, 206 aid aieinat Ocaub Baas due Vordodad oPimehs ripferd cdufiacieny oSeqs —— aiseshe youn Grurinigigs ong! Bagh KiSBke Yee GrushTLys GpMssciAGsy eB UaNaTS Lipp Lelebs BENyLNe eR empyacts Grbph CatciminGLay sUpgss aysmb Gon jena Whunigeds Opyyune img! wsrpipsiret MGB. Engaging direct or indvedy in any transaction In relaon to any propery which is derived or realized directly or indirectly, fom any unlawful ‘activity of rom the proceeds of any uniawul activity as defined by the Financial Transactions Reporing Act No.6 of 2006; + poo send 26 582 28 a0ce g 8S Bead Snodal ent a@ ooce 9 BSL Sarda cal ecdokd ave wai vave dams 2cadioy eal o2c85 acador a8 edced carne, asioaed maraSe, 088, es Sle, § c-m0 geo enm de on sone! OOD 00 a1e eat 8 came 9¢ ni sean! coe peaiios Ble onl Oct efit Gren GOsgr wisBe qjroma Grunge aes spend si tsds yumm Grunt nd Gipeasciiaiey Oru aang mepyEETs Guns CurKimAGoaD SEO aaabmp CUDA, CrumpomnGEss, warps, stip Siéne cing! onme Beimasgr oving srg piLGent Gates wesw oudwy Aanensibs owen) sex Com Bags (eaAibembare Gara aaa Receiving, possessing, concealing, disposing, of or bringing into Sil Lanka or into any other country, or fr investing in Sri Lanka or in any other ‘county, any property which is derived or realized, drectly or indirect}, from any unlawful activity or from the proceeds of any unlawful actly ‘referred to above; or + 2006 quo 05 (005 aed Dggaceis De(dBe® com aded B9 08 cam Bt Oe 29 e-ealomad ani ecioed ani 08 2050 2 Gon trode Jo owe Sdad coed bare Dasael 20 Sayweis QUA Cea GS 00 som Ooee Be BZD. osa4d aysios Saud Gade aint Ueons BGhse 2b wig Bsr HL sgAaTe oBxgH Kabab ouioy acded sp—yi geen UBpiie acer oper emote eLonéad adhunsiiah Lp perGmranpre chpaniunguta 90pgx> Jam) 5p ‘Any other offence which has been defined as an offence under the Prevention of Money Laundering Act No.5 of 2006 and any amendment thereto (ran similar legislation in any oer part of the word Garlge m8 quo aces ae ose eBarioaad 8 cme aE ani GB sons coe % qUEID OscMS OxKad OS HE BLD OXS@OET eNOS ened aasoe U9 auc weld wed massed Gana ao S28/BoR, Defend, Cute @ALLILOND gamed Gpnpdd Beniondd ones oCpgw Con pried — tpahud Shintdniars Son BLsmaujoLw Gade BeddadnedRedddCond am Bdgrs meen’ Oya anuiGaderGne yes. r Me hereby further declare that We arvare person(s) of good standing with no record of erminal conviction in relation tothe offences stated above, In Sei Lanka orn anyother country. 7.208 o00 acest oy 2099 ac (Emre sdBel cOSD a8 ance B op DOE Skee Exiac cad actin) G cum gE aa! scined sooo! Be mode B com f wife Bacax Oe CBOd Sods eas B0|gos OadED Taleo! BoIgad Goa co SOs 8 2 SiwoafaasoeS Bahia! ecfeco desta 08 ave p qddvane (oxdacined, emedB¥adag, qosdeanceaRe) CEB Ea Om GOI ME OOED some. Balan’, sing, askComGloutunG Opn jyaru puilaulsct upgeoninr) addenGindBors Geenserin ( 9G unianagre, Hugi oourcyns, uniutepe) segs Somme andgiacke owing Gute GrisicLany Saumbp whp ena Opn fy inieeeo, G8 Seto churiast gels, Gerimasdd sins, a ter Cag nsinepilgsd Oude eichinvanp smadug ips Hines Bang Hay apsacints Sapo pLaykonironp acm. We or any persons(s) associated with melus andlor any ent connected to melus (as a partner, sharehoker, director) do nat have against malus or persons connected andlor associated as aforesaid any convicons/pending criminal proceeding In Sf Lanka orin any oer part of he word excopt the folowing (give detailed description of any pending ligation} 8, Abed omoee Sejesi Dov Bao si2ed aco c ereaeced qaceoe aa soad que RBsCon gSciedo © eae B00 ami BBed Smo 28 sone f saoWioding Bad a8 abd © oneID Seatismood 8 eed Gackees as ened ood weled vodd Dagcod pons os a ion, WRB eae qmpmoikd oatygsd geou UiguigRTT wihu wails Yapme smbdsrang spidkinepere aee/otE Satan Syraféainn dome ies Open cbuuty Opi hysel wpdaiia sim em Spat maiGigvdOpe Nira uGpguOarGonh le declare that myiour application and other relevant documentation to open a CDS account has not been refused or any business relationship has not been dedined previously by any othe « Paricipant ofthe CDS. contd Fowm 114-2 a. ml Bl 408 yiden me 9 0 203 © p gore GSied carmen Seam eons adap 28 ences aa! ara saad Ua) Ooms SoS Se ae! cSlece Seie" Relate es oo Sage Sbads aoe aooded oaiecm Sawccsod cane Sbecgnccoregs agece Sor ace Memood tenon ob tod cmoec, sil sen suc od eange Yarn’ cy fom bad Sone 6s ened SA Sages meats ‘Race nycog co somed So(S canvedl Goobie good eons aoe Se obec hbo Boos oo Sonal Bare qamd odes Ubiod sens evo sold ats pons toa com aco sele® adgeod Gana amo Cam we¥luum be ons ies anit cpio sonny mbBgitmind sing apsmnss amie mubhosunenat Open st Brpabadt Ii, ace tin tng. = Gents naan 9a ans ay sms, ns art gra Feoclaniser Gomecte ederbes sennie Baers Gog (declare and xcs) ym minGHh 2LsuGeOne a. snsGldGnnd. {We further dectare and agree that, should the CSEICDS determine any statements made by malus herein to the convay, (or any such matter through ‘publidy available information or otherwise) which would inthe opinion of the CSEICDS be detimental othe CDS as an instittion having to comply with {he lawsiregulaions of Sri Lanka pertaining to transaction of is account holders or pares connected to such account holders, the CDS is hereby ‘authorized to unilaterally terminate all depository and such other services connecied to malus and recover related costs or oer expenses pertalning to this aocount. 10.008 poo cael emcees: 2s 5a Boxc% om oacl AOR Mackin COx8 eamoCo FaRC O9 Soc SeI48 GARD O58) BENE nis 0g eid inGddy panded eodmauteeeasd sfiremeiTed omOgTS atamen panieeshe ait) ams/aue yuBat BokO’ ‘om Gra mBpartnOne (bya. ub parbaome YWe decare thet the information sei out below Is tue and accurate and our investments wl be in ‘ecordance with svc information leo Ca coe panded eoed 2enison age Gee w-cléde some (I 09 pads (4 1))) a0 ganas agen arsed {1 60 Meds (0 2) qonw acxejoco qdod B20 625 Eo) 2) E28 ao) #O Om Od avoRL + Dies bbc! | oo mnded ened Oweoibon acer ada excita Boned (1 om peide (¢ 1))) G0 ganas ae Pavdad (1 Om ‘panda (ar 2) coum ce emnac, Back om aod oo/tS eee ange oc BOR/SCR Loo pasted ooed cidenide agar @8e8 anode avoed (1 om Masse (¥ 1))] em Sanae O¢e garded (I Ym ero. (2) tong Sood oo earciedSota lee ax S00 00 © [68 aegced Sao eosjomo see . Gute wacimiuAbapiig sm) sad 1, amyswnustend aahire sim’ (open ICart)) wind SyamlGpen pond (yen War2) chars fens gah, soe, cbriehd Garbo) aig, Sraict. tpead 1, empdmeumen) apse, choo Capa Mar) wigab Ayaemubéee upead (omesd Mar?) umd echomifaiund sis. pacuiact furmees sig ton» pBinsGeaGpe a yBbasGesSaropm ZiT, saphensartny ghee akg Cope Teri) Wand Grek ibis uyeud (apead I(ae2) asuesiah Bubect winsd Dubsmauesie, " ie Laude {esigning. ‘the inormation provided by melus nthe eld Form 1, long with the KYC Profle (Form 1 (A-1) andthe Declaration Form 1 (A) ie accurate. \ie further ages thats We shal be bound by terme and condone contained in Frm, long wth the KYC Profle (Frm 1 (At) andthe Declaration (Form + na SoFingege ele omet once pheno aim cbs teOat m oon of04a0 quneHl ABeErIo, 08 culm SBodeia G9 BBRqd emre? omdd odoecome Sgjeed onfoGn (on BBaq gosta & COe! qoealdousTo BEovion gas, gue afeRe fala odode BBeBt Bec Gielen o5Ge8 OCD 20M rod (alo odode: OOm00 gore Bo® meee! dpuGlcc lk a> Beg! @Bms0 0680 wid 90 BEOS®. fang) S7Qsam HopMOkeden= eOrgbgmstd, Aeneby UwBUTatssmE GUVsOdr sIaZH g_PuNONS Urgiang2d Oaténailé SRILCULESUUEDS Parma dog gAMUL some GeLwnDUearuad, serdes efberar Broscfier Crigenpuc OBTLIUMLU SelpLe UNBSTNcsre seo ADYapsetid cHesons elit cuc Oder SLimiseer Sauss Cerawas Saad, dpeosek dD Wsahles Uased SctoD ABLUABBILTS GeI— BIAET SLCUTELUBDS Bier SERUM wad dered Thrsosnd drape, By entering my data, | expressly accept the processing of my personal data as defined inthe privacy polcy ofthe CSE Group and understand that. 25 provided for under any reguaton laying down spectic provisions forthe protacton of persons with regard tothe processing of personal data applicable {ome | am ented to exorcise my dala subjoct igh By sending an emai to the following address: dpo@ese.Ik. e0 soy0 ope 4-98 manor! igen (“CDS Aco Opening Forms” 8 oBbomaa! 9. cou onde! 980 Bec oBbbdo gamted ditt Dou B28 9462 wpe Gee mace gana) on v8 et fc Bove Aad ncn cy CDS Ascun Opeing Ferma goec8 o® meanen aaton!/Oamembon 0 H8, #8 OBE Bel wom (CDS Annu Opening Ferme Sot re. ap) ao Gump grnrer “CDS senke fn ubdrbéid” GumAiutiunen abo WBiwiasd QeniOutinnied BeLOu sOp—x mabe StpnGcdsedinene eran ahs6o UBlOs ops Canctnae- est Se ‘strke ou wichever = iappicale ‘Ginse chee Joe opie) # eomtns sg tod oma mons val min Sr90 0.)

You might also like