l Application l

With this application, we make it easier and hassle-free for you to apply for our comprehensive packs of banking products and services.
We appreciate your time in sharing your information with us, and look forward to serving you better.

Purpose of account, please select:

for personal banking purposes :
Savings Loans Repayment Transactional Investment Payroll
for business purposes or usage

Payroll Pack (Full) Payroll Pack (Lite) Student Pack

1. Current Account Optional Services: 1. Current Account Optional Services: 1. Current Account Optional Services:
2. ATM Card Savings Account 2. ATM Card Savings Account 2. ATM Card Flexi Fixed
3. Credit Card Personal Loan 3. Online Banking Credit Card 3. Online Banking Deposit
4. Online Banking Mortgage Loan 4. SMS Banking Fixed Deposit 4. SMS Banking
5. SMS Banking Fixed Deposit 5. SMS Alerts Flexi Fixed Deposit 5. SMS Alerts
6. SMS Alerts Flexi Fixed Deposit

1 Please tell us about youself Relationship No:

Full Name (Name as per Identity Document) Telephone Number

(Please provide a minimum of 2 numbers by Country Code, Area Code, Number)

Mobile
If you are known by any other name, you must disclose to us in writing Residential
Office

Place of Birth Email Address:

Personal (EMR)
Date of Birth / /
Current Residential Address same as ID
Nationality

Identity Document No. Country Postal Code

Ethnic Type Chinese Malay Indian Other House Type

Owned Mortgaged Rented Employer's
Marital Status Single Married Other Parents Other

Work Type Salaried Self-employed Unemployed No. of years in Current Address Years

Profession Mailing Address same as Residential Address

Clerical Technician Professional Labour
Student Housewife Retiree Other
Uniform/Services Sales/Commission Earner Country Postal Code

Organisation Name/ School Name/ Department Highest Education Primary Secondary

Diploma Undergraduate
Postgraduate
Position Title

Years with organisation Years If married, please fill below:

Date of Joining Expiry Date of contract No. of dependents:

Nature of Business (for self-employed) Spouse's Name

Import Export Manufacturing Wholesaler Name & Address of Employer
Retailer Commission Other
Postal Code
Monthly Income (BND) Occupation: Monthly Income:
0 Not applicable 1 0-1000 2 1001-1500 Nationality:
3 1501-2500 4 2501-4000 5 4001+ Office Tel: Mobile:

Standard Chartered Bank is incorporated in England with limited liability by Royal Charter 1853 Reference Number ZC18 June 2015
The Principal Office of the Company is situated in England at 1 Basinghall Avenue, London, EC2V 5DD
Standard Chartered Bank is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and Prudential Regulation Authority

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 2 Additional Information for Credit Card

Qualifying criteria for credit card: Income Fixed Deposit Card Type
Visa Infinite Platinum Gold Classic
For Income: Master Card Gold Classic
Income credited by employer Income by cash/cheque Co-Brand RBC RBC Gold Hua Ho
Income Account No.:
Name to be embossed on Card (Minimum 5 to Maximum 19 characters)
For Fixed Deposit:
Fixed Deposit Foreign Currency Deposit
Flexi Fixed Deposit Credit Card eStatement Services
Fixed Deposit Deal No. Personal access code (at least 8 characters, consisting of any alphabet,
Link Amount: Currency number and symbol except '&');
Credit Card Limit request:
For FCY FD only Original Amt & Product LTV% Hint to help you remember your access code:
FX Rate BND Amt x LTV%

You must maintain the Income or Fixed Deposit to qualify for a Would you like to have your Credit Card payments deducted from
credit card. Removal/ withdrawal of income credited or Fixed your Standard Chartered Bank Current/Savings Account?
Deposit will automatically disqualify you to maintain your card If yes, please provide account number:

Branch for card collection: Full payment

Gadong Hua Ho Manggis Kuala Belait Minimum payment (Refer Product Disclosure Sheet)

3 Would you like a Supplementary Credit Card?

Full Name (as per Identity Document) Male Female Current Residential Address

Name to be embossed on Card (Minimum 5 to Maximum 19 characters) Postal Code

Name and Address of Employer
Identity / Passport Number
Date of Birth Postal Code
Nationality Annual Income: Relationship:
Mobile:

4 For Priority Banking members only

Household Recognition (applicable to Primary Priority Banking member)
□ I acknowledge that Priority Banking's household and family benefits will be extended to the said applicant

Name and Signature Date Relationship to applicant Relationship no

5 For Bank use only - Branch

Account Name (applicable to joint / children account)

JustOne (BND) Account Number Flexi Fixed Deposit 01506-

Savings1 01501-
Current (Salary)2 01012- Foreign Currency Account Number Currency
3
Current (Non-salary) 01013- Current Savings

ATM card annual fee collected from account: Others Account Number Currency
1 2 3

Master No. Checklist (tick box after completion of below)

CCMS No. Original IC Sighted □ Check validity of IC
ATM Card released by
Relationship No.
Primary New/Existing SDD/EDD
Secondary New/Existing SDD/EDD Online Banking
Secondary New/Existing SDD/EDD SMS Banking registered by
Secondary New/Existing SDD/EDD SMS Alerts

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 6 Declaration
Before you sign this application form, please read our Customer Terms and other terms indicated in the Declaration section of this form, which are
available on our website at www.sc.com/bn. You can request for a physical copy of these terms and conditions by calling us at 2658000.

By signing this application:

• you agree that you have applied for the (“Pack”) that comprises your application for the following: [CASA Account, Online Banking, SMS Alert,
SMS Banking, ATM Card, Credit Card (if applicable)]. You may contact us if you wish to remove any of the products or services in the Pack.
However, if you choose to remove any of the products or services, you will not be entitled to the rewards and benefits that are given to you in
connection with your original application.
• you represent and warrant that you are the true owner of the account and not acting on behalf of any other person.
• you represent and warrant that all information (including any documents) you have given us in connection with this application is correct,
complete and not misleading. If this is not the case, you may be personally liable.
• you acknowledge that we may decline your application without giving you any reason for doing so. If this happens, no contractual relationship
arises between you and us;
• you authorize us to verify any of the information you have given to us or your credit standing from, anyone we may consider appropriate (such
as an authority or credit reference agency);
• you confirm that your personal information provided in this application form and that of your joint account holder (if any) or authorised person
(if any) will apply to the account(s) you hold with us unless you expressly tell us otherwise.
• you confirm that the account operating authority instructed by you in this application form will apply to all accounts opened by you unless you
notify us otherwise in writing.
• you consent to each of Standard Chartered Bank PLC and its subsidiaries and affiliates (including each branch or representative office)
(“Standard Chartered Group”) its officers, employees, agents and advisers disclosing information relating to you (including details of our
banking agreement, the accounts, the products or any arrangement with us) to our head office and any other member of the Standard
Chartered Group in any jurisdiction (“permitted parties”); professional advisers, service providers (whether located in Brunei or outside Brunei)
for the purposes of providing any service to you in connection with this application (including data processing), or independent contractors to,
or agents of, the permitted parties, such as debt collection agencies, data processing firms and correspondents who are under a duty of
confidentiality to the permitted parties, any actual or potential participant or sub-participant in relation to any of our obligations under our
banking agreement between us, or assignee, novatee or transferee (or any officer, employee, agent or adviser of any of them), any credit
reference agency, rating agency, business alliance partner, insurer or insurance broker of, or direct or indirect provider of credit protection to,
or any permitted parties; any court, tribunal or authority (including an authority investigating an offence) with jurisdiction over the permitted
parties; a merchant or member of VISA International or MasterCard International where the disclosure is in connection with the use of a card;
any authorized person or any security provider; anyone we consider necessary in order to provide you with the services in connection with an
account;
• where laws and regulations allow, you consent to us periodically checking your credit status with any credit bureau or credit reference agency.
• you consent to us contacting you at the address, email address and phone numbers you have provided to us, to give you information on other
products and services that we, or our strategic partners, may offer;
• If you are applying for a Personal Loan, you are making an offer to borrow a loan from us for an amount and for a period stated in your
application. If we accept your offer, we will disburse the funds into your account.
• you will automatically be subscribed to our Credit Card eStatement service, you acknowledge all your statements will be sent by email.
Successful delivery is also depends on external factors not within our control and that you must notify us immediately if you have not received
your eStatement on time or if there is any change to your email address.
• you will subscribe to our Online Banking service, you acknowledge your statements can be retrieved from Online Banking and paper
statements will not be sent to your mailing address.
• if you are applying for a Credit Card, you agree that you must maintain a Fixed Deposit or continue to credit your income to an account with us
as a qualifying criterion.
• you have read and understood our Customer Terms and the applicable documents referred to in Part A of our Customer Terms forming our
banking agreement. They are available on our website at www.sc.com/bn or call us at 2658000 for a physical copy. You agree to be bound by
them when using any product we may provide you with. You acknowledge that you are bound by any variation we make to these documents,
in accordance with our banking agreement

□ I wish to unsubscribe _________________________ services. I am aware that I will not be entitled to the rewards and benefits that
are given in connection with the Pack.
Signature of Main Applicant/ Main Cardholder/ Parent/ Guardian Signature of Joint Applicant/ Supplementary Cardholder

Name: Name:
IC No. Date: IC No. Date:

Signature of Joint Applicant/ Account Holder other than Principal Signature of Joint Applicant
Cardmember

Name: Name:
IC No. Date: IC No. Date:

Mode of Operation for Joint Account

Anyone to sign
All to sign
Others (please specify)_____________________________________________
For Bank use only OSC Scanned / Initial: ___________________________________________

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