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2. My FATCA and my eTIN/TIN information have been provided to the Bank Yes No Yes No
and information previously provided remains unchanged.
Note : if answer is NO, customer to complete FATCA & TIN sections below
3. My Nationality, resident status, employment details, contact and personal Yes No Yes No
information previously provided remains unchanged.
Note : if answer is NO, customer to complete a static data change request form.
Services
First Applicant Joint Account Holder
Link to my existing Debit Card number
You will be automatically subscribed to our ElectronicBanking Services, including eStatements, internet banking, SMS banking and
Electronic Alerts. You may use these Electronic Banking Services after activation.
Operating Mandate
Singly Jointly Either/Survival
FATCA Declaration (not require to complete if customer answer YES to question 2 above)
First Applicant Joint Account Holder
1. Are You a US Resident? Yes No Yes No
2. Are You a US Citizen? Yes No Yes No
3. Are You holding a US Permanent Residence Card (Green Card)? Yes No Yes No
I hereby confirm the information provided above is true, accurate and complete. Subject to applicable local laws, I hereby consent for Standard
Chartered PLC or any of its affiliates (collectively ‘‘the Bank’’) to share my information with domestic and overseas tax authorities where necessary
to establish my tax liability in any jurisdiction.
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eTIN Update (not require to complete if customer answer YES to question 2 above)
Nominee information
For Existing Nominee, please provide the existing account no. of same nominee :
For new Nominee, please complete separate nominee application form.
Transactional Profile
Cash Withdrawal
Cash (Including
(Including Online
Online & ATM)
& ATM)
DECLARATION
I/we the following signatory/signatories hereby confirm that the transaction profile declared above is regular and normal transaction of my/our account
or account of the organisation. I/we also confirm that, if needed I/we will amend/update the transaction profile.
Transaction Profile of the customer has been reviewed as per the direction of Bangladesh Financial Intelligence Unit.
Reason for changing/ not changing Anticipated Transaction Profile of the customer:
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I/We hereby declare that I/we have read and understood the Most Important Document (MID) and Terms and Conditions available at www.sc.com/bd.If required I shall
provide additional information at the request of the Bank. I have also read and undertsood Bangladesh Bank’s notice on Money Laundering Prevention Act, 2012 (MLPA,
amended in 2015) and the Anti Terrorism Act, 2009 (ATA, amended in 2013), available for download from www.sc.com/bd, and will co-operate the Bank and the
regulatory authority to prevent money laundering and terrorist financing in the country.
I hereby confirm that upon completion of Standing Order (SO) for Saadiq Hajj Savers account, the entire amount to be transferred to my respective transactional
Standard Chartered account I also, confirm not to withdraw any partial amount from this account and only withdraw the entire accumulated amount at one go.
Date: Date:
Seal: Seal:
For Operations
For Operations Subsidiary Opened Cheque Book Requested
NORKOM AOC Checked Sigcap Updated SMS Banking
Master opened Internet Banking Others
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