Strictly Private & Confidential 1002990189 +4HNKND 2022.07.29 2: PRINCIPAL Account No. Reference No. Application Date ‘Apply via Mylnfo BS CIMBBANK CIMB FastSaver Account Opening Application Form ("Personal") IMPORTANT NOTES For this savings account, the minimum intial deposit i $$1,000. Initial Deposit: ‘For single aocount- Transfer via FAST from your indvidual account wih another bank in Singapore + Forjoint account - Transfer vie FAST from each applicant’ personal account with another bank in Singapore Please ensure thatthe signature on the personel cheque corresponds with the signature onthe application farm, NOTICE AND CONSENT IN RESPECT OF PRODUCTS ANDIOR SERVICES OFFERED BY CIMB BANK BERHAD UW agree and consent that CIMB Blank Berhad (collectively CINE") may collect, use, disclose and procoss myiour personal Information provided by melus to CINB, for one or more purposes stated in CIMM's Personal Data Protection Terms and Condlions including for the purposes of sending metus marketing, advertising and promotional information (Marketing Messages") about other Productsservices that CIM and its afiates, related corporations and third party service providers may be offering or which CIMB believes may be of interest or benef to melus (Marketing Purpose’), by way of: Contact Method Preference (Principal) - MUHAMMAD NOOR NASAlI BIN AHMAD 1 Voice cat Text ttessages: SMS/WhalsApp/Other messaging platform Contact Method Preference (Joint) OD Voice cat (Text Messages: SMS/WhatsApp/Other messaging platform Note: Please indicate your consent tothe above, and preference forthe mode of communication, by checking inthe applicable box(es) above. In tho event that no indication is mede onthe above, CINE reserves is right to send Marketing Messages to your Singapore telephone ‘number registered with CIM ("Registered Number if you have an ongoing relationship with CIMB orf the Registered Number isnot registered with the National Do Not Call Regist, Ont Out for Marketing Messaces via postal mall andlor electronic transmission to my email address(es): ‘You have the right to opt out of receiving such messages. Please vis our afc CIM SG wedsie Io find out Now. If you do not exercise your Nght to opF out, you wil be deemed to have consented to receiving such messages by CIM, My Account ‘Account Type: INDIVIDUAL APPLICATION Purpose of Account + TRANSACTIONAL Signing Condon: SINGLY ‘Source of Funds ort Deposit: SALARY About Myself Name : MRMUHANMAD NOOR NASAII Residential Address: B JALAN LARKIN PE! Lot 9S) BIN AHMAD 110 FAPAPARTMENT SALIN INI} 0 EB Buk iy CHARGG ANG Hanyu Pinyin Name Maing Aatoss + SAME AS RESIDENTIAL ADDRESS NRICiPossportNo, + €90405105927 Passport Expiy Dato gant FIN Number + M9085719T FIN Number Expiry Date: 05/22/2024 FEC ANGOR Date of Bith + 5104/1969 Occupation ENGINEER Gender 2 MALE Name of Company: TUV SUD PSBNationaity : MALAYSIA Singapore PR. No Country of Demi SINGAPORE Place of Birth (Province/State): MALAYSIA Race 2 MALAY Marta Status MARRIED ATM 2 NO About Joint Applicant Name Hanyu Pinyin Name NRICIPasspent No, FIN Number Dato of ith ender Nationality Singapore PR County of Domicte Place of Bith (ProvncrState) Race Marital Status Promotion / Referral Details Referred by Promotional Code (if any) : Strictly Private & Confidential Reference No. : 1-4HNKND Natu of Business: ENGINEERING Otice No. Home No, 460196400061 Mobile No. 19595470545 Email + NASAIIRAY988@GMAIL.COM Primary Source of: EMPLOYMENT Wealth Residential Addeess Passport Expiry Dato FIN Number Expiry Date: ‘Occupation Name of Company Nature of Business Offce No. Home No. Mobile No. Emai Primary Source of Wealth am HisHer NRIC No. By submiting the Referrers personal data, you represent and warrant tht: () you have obtained the Referrer’ consent o prove us withthe Referrers personal data; and (I) you have read, understood and agree to abide and be bound by the applicable terms and Conditions governing the relevant CIM referal programme and/or promotion avalable af ou oficial CIMB SG wabste. U.S. Tax Declaration Under Foreign Account Tax Compliance Act (FATCA) (Principal Applicant - MUHAMMAD NOOR NASAII BIN AHMAD) Nome Nationality ‘County of Binh Residency ‘Are you a US. Resident? (rcuding a current werk permit) ‘re you a US. itz ora Ciizon of US Tettory? Do you hols a U.S. Permanent Resident Card (Green Card)? Taxpaye dentcation Number (TIN) MUHAMMAD NOOR NASAII BIN AHMAD MALAYSIA +: MALAYSIA 1 SINGAPORE No 2 NO No U.S. Tax Declaration Under Foreign Account Tax Compliance Act (FATCA) (Joint Applicant) NameStrictly Private & Confidential ona Reference No. :1-4HNKND ‘County of Bich Residency ‘re you a US. Resident? (inching a eurent work pei) ‘Are you a US. Ciizon or @Ctzen of US Tertory? 10 you hold a U.S. Permanant Resident Card (Green Card)? Taxpayer Identification Number (TIN) Common Reporting Standard (CRS) Self-Certification (Principal Applicant - MUHAMMAD NOOR NASAIil BIN AHMAD) Tax Residence Information ification Number (TIN) or FIN or equivalent is unavallabi ‘state reason CountryiJurisiction of Tax Residence Taxi equivalent Pl SINGAPORE 30557107 Common Reporting Standard (CRS) Self-Certification (Joint Applicant ) Tax Reslence Infomation Countryilurisdiction of Tax Residence Tax identification Number (TIN) or _—_—IFTIN or equivalent is unavailable, equivalent please state reason Deposits Insurance Scheme Singapore dolar deposits of non-bank depositors and monies and deposits denominated in Singapore dollars under the Supplementary Retirement Scheme are insured by the Singapore Deposit Insurance Corporation, for up to $875,000 in aggregae per depositor per ‘Scheme member by aw. Foreign currency deposits, dual currency investments, stuctured deposits and other investment products are ‘ot neuro ‘Advisory from the Singapore Police Force - Warning ‘Your account should be for your own use and you are responsible for al transactions made through your account. ‘You may be failtting criminal actvties such as money laundering andlor unlicensed money lending if you 1 Knowingly alow other people to operat, access andlor contra of your account; andor 2. Knowingly receive money from strangers, dubious sources, or other unveriied sources. ‘You can be prosecuted forthe relevant offences i your account Is used to receive or transfer money linked to criminal actives. Those offences cary @ punishment of a fine andlor imprisonment ‘You should make the necessary application to your financial inttuton i you wish to authorise the operation, access andlor contol of your account oa third party. fallure todo so would subject your account to additonal sk mitigation measures, and in some cases, ‘Yur nancial institution may terminate or restrict your use of your account and other related accounts you may have wth your financial instttion Ine acknowledge that we have read and agree to all he above. Dectaration - CMB FastSaver Account 1. INWe confirm hat we have read and understood CIM Bank Berhad, Singapore Branch's ("CIM Bank” or “the Bank” or "CIMB. Singapore") Terms and Conalons Governing the Operations of Deposits Account end. applicable, the promotion Terms and Conditions for the Promotion that Uwe have incicaled above end agree to abide and be bound by these terms and conditions, We have read, understood and retained @ copy of the Terms and Conditions Goveming Electronic Banking Services, E- Statements and E-Alerts, and any other toms and conditions relating tothe Bank's products or services (all as may be ammondod fom timo to time) ana agree to be bound by them. IWe agrco that CIMB Bank may vary, aller and amend any terms anc ‘condtions in ts sole dscretion. Copies of al terms and conditions mentioned above are avalible t any branch of CIMB Bank or at our official CIMB SG website 2. lWe understand that mylour submission ofthis application and acceptance ofthis application by CIMB Bank shal in no way be consttued 8s spproval of mylour application and that CIM Bank reserves the right not to approve this application without giving ‘any reasons whatsoever 8. We confirm that there fas been no slatuiory demand served on melus, and that there has been no legal proceedings commenced against melus at the time of this application. (We declare that Iiwe are not undischarged bankrupt or of unsound mind 4 We ropresent and warrant that myfour funds do not oignate from, nor will hey be routed through, an account maintained at 2 Foreign Shell Bank, or a bank organised or chartered under the laws of a Non-Cooperative Jurisdeton. 5. We declare that information given inthis application is true and correct and that we have not willy witheld any facts. We ‘warrant that al copies of documents submited to CIM Bank ae tre copies and belong to CIMB Bank absolutely. Ie‘Strictly Privato & Contidential Reference No. : 1-4HNKND authorise CIMB Benk to obtain and very any information onlrom melus with or from any credit reference agencies, financial insttuions or any other paties, for any purposes which the Bank deems fi. We agree to promly provide any information or representations deemed necessary by CIMB Bank fo verification, in its sole lscrotion, to comply with antiemeney laundering reguations countering the Financing of Terrorism and related responsibilities ftom time to time. Le acknowledge that inthe event of delay or falure to produce any information or representations required by CCIMB Bank for verification purposes, CIMB Bank may take such actions asin is sole discretion deemed necessary, including, without imitation, to refuse to accept tis appicaton andior the funds.. UW undertake to keep CIM Bank informed of any changes In my/our particulars glven In this application | MWe declare and confirm that we amare the beneficial owner(s) and that lwo emiare transacting for myour own account and not on behalf of any other person or entity. We authorise CIMB Bank to disclose, ot any ime and without lablty to me/us, any Information relating to malus oF any of my/our accounts (as defined in the Banking Act Chapter 19), to any oft branches, subsidiaries, representative offices, alates and agonis of the Bank and thi party selected by hom wherever situate, or confidential use in connection with he provision of Products or Services to metus. For Collection at Branch: Customer's Acknowledgement For ATM Card & Pin Mailer (if applicable). | hereby acknowledge receipt ‘ofthe ATM Card issued to me by CIMB Bank. | have read and understoad the Terms and Conalons governing the use ofthis new card and agree to be bound by them. IW confi that myfour personal account shall only be used for mylaur personal non-business purposes (such 2s savings, investment, education and personal or fving expenses) We undertake to open, maintain or establish a separate business oF ‘non-personal account for business, associa, sociey. or trading purposes‘Strictly Private & Confidential Roferonce No. : 1-4HNKND ‘Common Reporting Standard (CRS) Setf-Certfication 1. Ie understand that the information supplied by mel is subjct tothe terms and conditions governing the Account Holder's relationship with CIMB and its related and associated corporations (eallctvely “CIMB Group") soln out how CIMB may use and share the information supplied by metus. 2. I/We acknowledge thatthe information contained inthis for and information regarding the Account Halder(s) and any Reportable Accounts) may be provided directly or indirectly to any relevant tax author, including ofthe countyjurisdtion in ‘which this accounts is/are maintained and exchanged wih ax authorities of another countryurisdicion or countis/ursaictons in which the Account Holder may be resident for tax purposes pursuant fo agreements between competent authodies to ‘exchange financial account Information 43. INWe certty that Ie arvare the Account Holder or amare authorized to sign forthe Account Holder, ofthe account) to which this form relates and we declare that all statements made in this declaration are tothe best of mylour knowledge and bei, correct and complete 4, ifthere is change in circumstances that facts the tax residence ofthe Account Holder(s) or causes tho information contained herein to become incorect or incomplete, we understand that live amare obligated to inform CIMB of the charge in {eroumstances wihin 30 days ofits occurence and to provide a suitably updated se-certiicaton, Declaration Relating to Tax and Other Serious Offences lie dectare and confirm that 1, hwe arvare responsible for mylour own tax afais and ensuring thal both Ie and mylour Aacount(s) (9s defined Inthe CIMES ‘Terms and Conditions Governing the Operations of Deposits Account ("T&Cs") maintained with CIMB Singapore, ae in ‘compliance with the tax laws ofthe relevant jurisdiction within which Uwe reside, amare domiciled or tax citzons of: i. to the best of mylaur knowledge, liwe have not wilfully committed nor have been convicted of any sevious tax crimes Ti Uwe acknowledge end agree that ie should take advice from a tax expert in the jurisdiction of mylour tax residence and ‘acknowledge thal CIMB Singapore does not provide tax advice to melus; i, Uwe agree to provide copies of the relevant documents where necessary to CIMB Singapore upan request; and Iv. wo agroo that CIMB Singapore may, where required, distose any and alinformation in accordance with Clause 15.1 of the TACs, 2, Should there be any change in hese circumstances, live undertake to immediately notily CIMB Singapore in accordance with Clause 2.6 and Clause 9.1(0) of the T&Cs. 3, Uwe also agree to hold harmless, release and agree to indemnity CIMB Singapore, is shareholders, officers, owners, directors, employee successors, heirs and assigned from any and all ably asing from CIN Singapore's reliance on te declarations made by metus. U.S. Tax Declaration Under Foreign Account Tax Compliance Act (FATCA) 1. Me hereby confirm the information provided is tue, accurate and complete 2. Subject tothe applicable local laws, ve hereby consent fr CIM Bank Berhad, Singapore Branch, its parent or uate holding company or any of ts aflates (incuding ranches) (collectively as "CIME") to share myfour information with domestic ‘or overseas regulalors or tax authorities where necessary to establish myrou tax kabiliy in anythe relevant jurisdiction. 3, Where required by domestic or overseas regulators or tax authorities, we also understand and agree that CIMB may be Fequired to obtain addtional documents andlor forms, which lve wil sign, ie amare subject the relevant jrsdichon's requirements. 4. Where required by domestic or overseas regulators or tax authorities, Ive understand and agree that CIM may withhold, and ay out, rom mylour accounts) such amounts as may be required according to applicable laws, regulations, guidelines andlor ‘groements with regulators or authorities and directives ‘5. Wie also agres and undertake tonoifyCIMB (within 30 calendar days), oF provide th information If raquested by CIMB, ‘here isa change In any information which Uwe have provided to CIM, DECLARATION (IMPORTANT: PLEASE READ BEFORE SIGNING) + We have read and understood the declarations sat out inthe overeat We afirm the sald declarations and agree to abide and be bound by the matters stated therein, 2, MyiOur personal data mayiwil be disclosed by CIMB, i engaged, tots third party service providers (including lawyersilaw rms), which may be outside of Singapore, for processing my/our personal data for IMB or one or more ofthe Purposes. 2. IWe represent and warrant thal lwe amare the user andlor subscriber ofthe telephone numbers) proved by melus to CIMB, and tha we have read and understood and agree to al ofthe above provisions, incuding the Personal Data Protection Act (PDPA) 2012 Terms and Conditions, svallable at cur official CIM SG website,Strictly Private & Confidential Reference No. : 1-4HNKND. Principal Applicant Name: MUHAMMAD NOOR NASAII BIN AHMAD Signature‘Strictly Private & Confidential Reference No. : 1-4HNKND Joint Applicant Name SignatureStrictly Private & Confidential Reference No. : 1-HNKND ‘CUSTOMER ACCOUNT NO. ‘DATE ACCOUNT OPENED: CHANNEL OFS USE PRINCIPAL APPLICANT {JOINT APPLICANT IWPUT BY: ‘APPROVED BY" "ATTENDED BY: RTE: DATE DATE: ‘e00e RATING Pancra [wre [eer | nor wey PREP Ret t co ‘oc ew oa Nonter i coo ma DyeeO ne [uns er 0 "aT or 4 JON ce oe ery Perr Reet t APPLICANT wer ‘ce: nw 8 ene coD Me Cree One [ws rer “a "aRT or lt