Scribd Logo
Upload

Welcome to Scribd!

  • UTA-Account Opening Form

    Uploaded by

    daya
    5 views12 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    5 views12 pages

    UTA-Account Opening Form

    Uploaded by

    daya

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 12
    HongLeongBank 3 HongLeong|slamic Bank Personal Account Application Form Gorang Permohonan Akaun Peribadi Protecod by IM up o RNZS0,000 foreach deposi. ciindung on HM seat R250 000 bagi etp pendopost. Please complete this form clearly and mark“ where applicable ila lengkapkan borang inl dengan elas dan tandakan “Y "di mana yang berkenaan _ A eacent/savings Account Akaun Sernaso/Simpanan Fixed veposit Deposit Tetap [islamic islamic ‘Purpose of Account Opening juan Fembukaan Akaun - a AL swiogs sinpanen D salary 6a (ting txpenses Pelion T tnvestment Pelsburan Dred FcitesKerakan Kredit C) Edation Pendian 1 Remitancekiman Wag Business transaction TiansatsPemiagaon —C) athers Lain EIEN cast arrcarvinonow vagin 2) : PARTA= Personal Details utiranPedbadi = F Name (as per New WRIC/Passport) 1 Me tock Ms ck Fees Puan others Lainsin ‘Nama (seperti dalam KP Baharu/Pasport) New NRIC No,/Passport No. No, KP Bahary/No,Pasport 10 Details (Passport Holdes) Issuing Country Negara Pengelur tian 9 Pemenang Pasport) Date of sue Ta Dikeluatkat 124 Bate of Beng Toi Famnat O09 18 8 Date of Birth Tank Laie ay Nationality Warganegara Ci Malaysian malaysia Clothers taimain: PR of other Country Penduduk Tetap Negara Asing | C] Yes Ya [No tidak Reside > 182 days in Malaysia (calendar year) ‘Tinga di dalam Malaysia» 12 ha (Laon Kalenday | CI ¥es ¥9 0 No Tidak ‘Bumiputra Taaf Bumiputr Di Bumiputra El Non-tumiputra Bukan Bumiputra ‘Gender Jantina Ci Mate telak Li Femate pevempuan Race Bangs2 [Malay Melayu C)chinese Cina Clindian india CJothers tain-lain ‘Marital status Tarot Peskahwinan Single Buiang [] Married Berkahwin [] OWvorced Rexcerai Widowed Janca/Duda Home Address Alamat Rumah ity Bandar Postcode Poskod State Negeri Country Negara Correspondence Address Alina Su Cy same as home address City oandar Postcode roskod Sama dengon alamot rumah State Negeti Country Negara Home Tel. No. No. Tel, Ruma Country Cade Kod Negara Country Code Kod Negara | a _ 4 Note: This mobile phone number will be automatically registered to receive Transaction Authorisation Code (TAC), whichis required to complete selected transactions via Hong Leong ‘Mobile Phone No, Wo Tel Giniit Pestne rorinper fe ater eh Nota Nvuhoe tl hii akan lidaflarkan secara autamatk ante menerina Kod Pengesahan Transaks! (TAC yana dlpetukan untuk melakukan transakstterplh melalulPecharkan Dalam Taian dan ‘Muda Alin Hong Leong Connect Note: this account will be automatically enrolled for e-statement, and this e-mail address will automatically be registered to receive email statement. Noa Akaun to akan didaftrkac untuk espenyata secara autornatik, dan alamat e-mel ini akan Aidaftarkan secara automatk untuk menerima penyata e-mel E-mall Addcess Alamat Emel Paar Employment details Butiran Pekerjaan ‘Occupation Pekerj2an| C1 employer C1 Government Employee/civil Servant Majkan Pekarja Kerajaan/Penjawat Avan cap liqaenk Y9pe SE PERERA C1 seltemployed Private sector Employee Leslee nieial aia Bekerja Send Pokera SektorSwast 1 unemployed 1 Retiree/Housewife/student Pesava/Suni Rumah Tangga/Pelajar Tidak Bekeria Employer Name Nara Najkan Employer's Nature of Business Jens Pemiagaan Majin 1 Nittiads Cl RM240,000 RMI20,000, RM200,000 Rum240,000 ‘PART C-FATCA Declaration for Primary Applicant Pengakuan FAICA untuk Pemohon Utama Please complete the following section to provide your FATCA (“Foreign Account Tax Compliance Act") status declaration: sila lengkapkan seksyen yang berkut untuk memibe pengakuan FATCA (‘AktaPeratuhan Cukal Akaun Asin’) anda ‘Yerva No Tidak 2) At east one of the below tems is applicable tom oo Sekang-rangaya salah salu buan di Dowah adalah besaitan dengan sya + tam aus. étizen Saya adalah sorang warganegara AS. + Yam aus. resident Saya adalah sorang pemastauin AS + tholda US. green card Saya meregang kad ju AS. 8) At least one ofthe below items is applicable to me: oo Sekurangrkuangnya sal at btian Dawah i aslah berkaitan dengan sy: + twas born inthe US. saya daikan dia. + thave a current Us. residence or mailing adress including a US. RO. Box address. Saya mempunyalalamatkedlaman sta alamatsuat-menyurat erase di A, termasukalamat Pet Surat Peabat Pos AS. + thave aU. telephone numbe Saya mempuayel nombortlelon AS + ony have a“hold mail” or “in cave of” address that is my sole addvess. Saya hanya mempunya slat “hold mail” atu lam jagsan yang mecupakan stusatunyo alamat saya, Note: Nota: IW you have answered YES for (A), please complete a Form W-9. Jka anda telah menjowab YA bag (8), sa lengkapkan Borg W:3, if you have answered NO for (A) and YES for (8), lease complete a Form W-30EN. }Wa anda telah menjawab TAK bagi (A) dan VAbagi (8), sil engkapkan Borang W-BBEN PART - Common Reporting Standard Self Certification for Primary Applicant Perauan Bi tandard Pelapran untuk Pemohon Utama {hereby confirm that have read the Definition contained in Annexute 1 af this form and hereby declare as follows: Saya mengesahkan bakaw saya telah membaca Detinis yang terkandung dalam Lampian 1 i borag ini dan menisytharkan sepert best: ‘ce you ONLY a Malaysian tax resident? Adakch anda pemastautncukai Malaysia SAHAJA? Chvesva ——) No Tidak" “you have answered NO, please request and complete an additional form “Annexure 2~ Self Certification of Tax Residency Status”. Jikaanda menjawab TIOAK, sila minta dan lengkapkan lembaran tambahan “Lampiran 2 Perakuan Di Taraf Cukal Pemastautin’ (EERIE sown areica renown ceasana Existing HLB/HUSB customers: Pelanggan HLB/HLISD sedia ada: Please use this form to update your information. Simply fill n your new I¢/Passport and the updated information. Sila guna orang int untuk mengemaskini mallumat anda: Lengkapkan borang ini dengan no KP baharufpasport dan maldumattetki PARTA-Personal Details Butiran Peribadi Relationship to Primary Applicant: Hubungan dengan Pemohon Utama, 1 Spouse Pasangan Tl other Relative Saudaio C1 F 1 Parent ibu bapa nd Kawan I child Anak other tain sibling Adik Bera Name (as per New NRIC/Passport) Nama (seperti dalam KP Bahacu/Pasport) CO Mrndk CMs ck CMs Puan Clotherstain-tan New NRIC No,/Passport No. No. KP Bahacu/No. Pasport 10 Details (Passport Holder) Butizan D (Pemegang Paspert) Issuing Country Negara Pengehia: Date of tsue Tari Dikeuarkan Date of Expiry Date of Birth Tak Lahr | Nationality Warganegara Gy Malaysian Wataysia Dlothers ainain: PR of other Country Pendk Telap Negara Asig | [Yes Va No rida Reside > 182 days in Malaysia (calendar year) Tinggal di dalam Malaysia > 182 har (tahun Kalenday) | CI Yes Yo non wf omit Toa umiata Cl ewripa wpm tan rip Gender antina C1 mate telat female Peerpuan Race Bangsa Malay Melayu Clehinese Gna /Endian ie others ainsi [Marital status Taal Petkahwinan single Bujang vorced Berceral J Widowed janda/Duda Ci mad in 20,000, Home AddeessAlamat Rumah City Bandar / Postcode Paskod state Negeri country Negara ‘Correspondence Address Alamat Surat Menyat 1] Same as home address ity Bandar / Postcode Poskod Sama dengan alamat rumah stateNeged country Negara ome Tel. No, No. Te. Rumah Country Cade Kod Negara Mobile Phone No. No Tel Smt Country Code od Negara mall Address lanai Emel 7 ssrorseeresercrmenle 4 = Occupation Pekan ; 1 Employer Government Employee/civil Servant wakan Pekerja Kerajaan/Penjawat Awam Jens Pekerjaan | C1 Selt-tmptoyed Private sector Employee Employment type ens Pekeson Bekerja Send Poker Sektor swasta 1 Unemployed 1 Retivee/Housewife/Student Tidak Bekey Pesata/Suri Rumah Tangga/Pelajar Employer Name Nam ia Employer's Nature of Business Jes Perniagsanbajkan L 7 UO Nittiads Ld

    You might also like