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HSBC Bank International Limited – Account Application Form

GETTING STARTED

This form should be used to apply for the following accounts provided by HSBC Bank International Limited:
e Offshore Bank Account e Serious Saver Account e Currency Savings Account e Fixed Rate Saver e Fixed Deposit Account
The information below may help you when completing the form. If, at any stage, you need help to complete it, please call us anytime on
+44 1534 616111 or visit our website at www.offshore.hsbc.com

APPLICATION DETAILS
Please complete this form in black pen and write in BLOCK CAPITALS.
First Applicant
Family name/
Initials
Surname
Please indicate if the account is to be for an individual or joint parties.
INDIVIDUAL ACCOUNT JOINT ACCOUNT

Second Applicant (If ‘JOINT ACCOUNT’ box ticked)


Family name/
Initials
Surname

Which island would you like your account opened in? Jersey Isle of Man
You can choose to have your account opened in the offshore jurisdiction of Jersey or the Isle of Man. We automatically open new offshore
accounts in Jersey unless you specify Isle of Man. For further information, please call us on + 44 1534 616111 or visit www.jerseyfsc.org
(Jersey Financial Services) or www.gov.im/fsc (Isle of Man Financial Services).

Daytime contact (Please include country and area dialing codes)


number
(If we need to contact you to discuss your application)

SECTION 1 TYPE OF OFFSHORE ACCOUNT(S) REQUIRED


1.1 OFFSHORE BANK ACCOUNT
Please tick the currency(ies) you would like your Offshore Bank Account(s) to be held in and whether you require an HSBC Bank debit card
sterling Yes No

US dollar Yes No

euro A debit card is not available with the euro current account

1.2 OTHER ACCOUNTS


Please tick the currency box(es) of the other account(s) required

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


SERIOUS SAVER ACCOUNT FIXED RATE SAVER
sterling US dollar euro sterling US dollar

Term of deposit 3, 6 or 12 months.


CURRENCY SAVINGS ACCOUNT N.B. The minimum opening balance for a
Australian dollar Canadian dollar Hong Kong dollar Fixed Rate Saver account is £25,000 or $25,000.

Swiss franc Japanese yen Other


Upon maturity your deposit plus interest must be paid into either a Current
or Serious Saver account in the same name and currency as your Fixed
Rate Saver account. Please nominate which account you would like your
Fixed Rate Saver account to mature into by ticking the appropriate box:
FIXED TERM DEPOSIT ACCOUNT
sterling US dollar euro
Offshore Bank Account Serious Saver Account
Hong Kong dollar Japanese yen Other
In order to open the nominated account, please also tick appropriate boxes
in sections 1.1 and 1.2.
Please state term of deposit (1, 2, 3, 6, 12 months.
For sterling deposits 2, 3 and 5 year terms are also available.)

Notes
e You can only apply for an Online Bonus Saver Account after becoming a customer and registering for our Internet Banking service.
e Other currencies may be available on request.

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
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HSBC Bank International – ACCOUNT APPLICATION FORM

SECTION 1 TYPE OF OFFSHORE ACCOUNT(S) REQUIRED (Continued)


How we will send you statements – please read carefully
You can receive your account statements in two different ways - either by post to your correspondence address or online via Internet Banking Service.
For joint accounts, the statement preference will be the same for each account holder. Once your account(s) are opened we will send you monthly
paper statements by post. We may charge you for each paper statement we send you, for joint account(s) a paper statement will be sent to each
account holder. Please refer to our Tariff of charges for details on charges for paper statements. If you do not wish to have your paper statements sent
monthly you can change the frequency to one more suitable to your needs, you can request this option when your account(s) have been opened.
You can also register for our Internet Banking Service once your account(s) have been opened. By registering for this service, your statement delivery
preference will automatically be changed so that you will be sent monthly eStatements, which are free of charge. For joints, if one account holder
registers for Internet Banking, the statement delivery preference for each account holder will be changed to eStatements (even for account holders who
have not registered for Internet Banking). You, or any other party on the account can change your eStatement delivery preference back to paper
statements at any time.

TYPE OF OFFSHORE SERVICE REQUIRED

Minimum balance required for the HSBC Premier and HSBC Advance package of banking services

£60,000 or currency equivalent


HSBC Premier customers who hold the Premier status with another
part of the HSBC Group automatically qualify for Premier with us, and £25,000 or currency equivalent
are not required to maintain the minimum balance of £60,000 or
currency equivalent.

Customers need to fund their account(s) with the minimum balance within three months of the opening date. HSBC Advance customers will
be charged a monthly fee for the HSBC Advance service for every month from when they take out this service. If when we review and assess
your relationship balance you fail to meet the minimum balance requirement for the type of service you have selected we will charge an
‘underfunding fee’ in that calendar month. For HSBC Advance customers the ‘underfunding’ fee will be charged in addition to the monthly fee
for that calendar month. If you have HSBC Premier service and you fail to meet the qualification criteria for three consecutive calendar months,
we may convert you to our HSBC Advance service. We will give you 30 days advance personal notice before we do this.
Please refer to the ‘How we calculate your Relationship Balance’ leaflet available at www.offshore.hsbc.com/1/2/international/offshore-
banking/download-centre for further information.

Monthly fee
No monthly fee £15
Monthly underfunding fee
£35 £10

PLEASE SELECT TYPE OF OFFSHORE SERVICE REQUIRED

HSBC Premier Service HSBC Advance Service

ACCOUNT OPENING IN OTHER JURISDICTIONS

We may be able to arrange for a bank account to be opened at the local HSBC branch in the country you are moving to, to service your day-to-day

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


banking needs. If you would like to open a local bank account in the country you are moving to, please call anytime on +44 1534 616111.

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
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HSBC Bank International – ACCOUNT APPLICATION FORM

SECTION 2 PERSONAL DETAILS


(Fields marked with * must be completed)

2.1 NAME Relationship to Applicant 1

APPLICANT 1 APPLICANT 2

Mr Mrs Miss Ms Other Mr Mrs Miss Ms Other


If other, please specify If other, please specify

First name(s)* First name(s)

Family name/Surname* Family name/Surname

Any former names (eg maiden name or names previously used) Any former names (eg maiden name or names previously used)

2.2 HOME ADDRESS 2.2 HOME ADDRESS (Only complete if different from Applicant 1’s home address)
Home address* Home address
PO Box numbers cannot be accepted for a home address. PO Box numbers cannot be accepted for a home address.
A full residential address must be provided, ie house name, street name etc. A full residential address must be provided, ie house name, street name etc.

Post/Zip code* Post/Zip code

Country* Country

2.3 OTHER DETAILS 2.3 OTHER DETAILS


APPLICANT 1 APPLICANT 2

Gender* Male Female Gender Male Female

Date of birth* D D M M Y Y Y Y Date of birth D D M M Y Y Y Y

Town/City of birth* Town/City of birth

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


Country of birth* Country of birth

Nationality* (Citizenship) Nationality (Citizenship)

Mother’s maiden name* Mother’s maiden name

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
4

HSBC Bank International – ACCOUNT APPLICATION FORM

SECTION 2 PERSONAL DETAILS (Continued)

2.4 CORRESPONDENCE ADDRESS (Only complete if different from Applicant 1’s home address).

EMPLOYMENT AND SALARY DETAILS (Fields marked with * must be filled in)
APPLICANT 1 APPLICANT 2
Name of employer* Name of employer
(If you are retired, self employed or unemployed, please state here) (If you are retired, self employed or unemployed, please state here)

Employer’s business* (If you are self-employed, please provide your Employer’s business (If you are self-employed, please provide your
business name and describe the nature of your business) business name and describe the nature of your business)

Job title* Job title

Start date with current employer* M M Y Y Y Y Start date with current employer M M Y Y Y Y

Annual salary (or sterling equivalent)* Annual salary (or sterling equivalent)
Up to £29,999 £30,000 to £49,999 Up to £29,999 £30,000 to £49,999

£50,000 to £99,999 £100,000 to £250,000 £50,000 to £99,999 £100,000 to £250,000

over £250,000 over £250,000

2.5 CONTACT DETAILS WE MAY NEED TO CONTACT YOU TO OPEN YOUR ACCOUNT

APPLICANT 1 APPLICANT 2

Telephone numbers Telephone numbers


Work* (Please include country and area dialling codes) Work (Please include country and area dialling codes)

Home* (Please include country and area dialling codes) Home (Please include country and area dialling codes)

Mobile* Mobile

Email* Email

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


Are you moving soon? Yes No Are you moving soon? Yes No

If yes, which country are you moving to? If yes, which country are you moving to?

Country Country

Date of move D D M M Y Y Y Y Date of move D D M M Y Y Y Y


Alternative contact telephone number Alternative contact telephone number
(Please include country and dialing codes) (Please include country and dialing codes)

FOR EXISTING CUSTOMERS OF HSBC


If you are an existing customer of HSBC, please provide the following details:
HSBC Premier customer HSBC Advance customer Other
Branch name: Account number:

Branch sort code: Country:

- -

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
5

HSBC Bank International – ACCOUNT APPLICATION FORM

SECTION 3 REGULATORY DETAILS


(Fields marked with * must be filled in)

A REASONS FOR OPENING ACCOUNT*


Please tell us how you plan to use your account(s) with us:
Main banking relationship Savings for school fees Receipt of monthly salary Savings for retirement

Payment of living expenses Other (please specify)

B INITIAL FUNDS TO BE DEPOSITED INTO THE ACCOUNTS*


Please provide us with an indication of the amount of money that will be deposited into your account(s) during the first three months of them being opened. Note that you need to
fund your account(s) with at least £60,000 or currency equivalent to qualify for our HSBC Premier service, or £25,000 or currency equivalent for our HSBC Advance service. HSBC
Advance monthly fee is £15. If you are already an HSBC Premier customer with another HSBC Group company, you are not required to maintain this balance.

£25,000 to £59,999 Above £60,000 to £99,999 £100,000 to £249,999 £250,000 to £499,999 £500,000 and above*
Service charge Premier, no service charge

*For an initial deposit of £500,000 or above, please provide documentary evidence detailing the source of funds, such as a bank statement or share portfolio summary.
In addition, if the initial deposit relates to a recent sale of assets (eg property, shares, business), receipt of bonus, inheritance or gift, please provide documentary evidence
of the transaction such as a solicitor letter, contract note or employer letter.

C REASONS FOR BANKING OFFSHORE*


Living/working outside country of domicile Taxation efficiency Safe Haven for Savings Overseas Investment

Other (please specify)

Geographical sphere of the activity* (please enter the countries you expect to send and receive funds from and the nature of the activity in each case)

D SOURCE OF FUNDS*
Please tell us where your money is coming from:
Salary/Bonus/Commission Pension Sale of shares/investments Property sale

Inheritance Other (please specify)

Notes
We may require additional information regarding source of funds and wealth in order to meet due diligence requirements of the local regulator. We will contact you if this is
required, however, if you wish to include copies of any relevant information with your application, this may assist with the account opening process.

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


E ANNUAL TURNOVER*
Please provide us with an indication of the amount of money (sterling equivalent) that you estimate will be credited to your account(s) over the next 12 months after your initial
deposit has been made (ie annual turnover):
Nil (initial £1 to £24,999 £25,000 to £59,999 £60,000 to £99,999 £100,000 to £249,999 £250,000 to £499,999 £500,000 and above
deposit only)

F DETAILS OF YOUR MAIN BANKERS*

Name

Address

Account Number

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
6

HSBC Bank International – ACCOUNT APPLICATION FORM

SECTION 4 YOUR INFORMATION


4.1 CREDIT REFERENCE AGENCIES
We may share information with credit reference agencies to verify your identity and suitability for an account, using information from the Electoral Register (or similar if you
are a non-UK resident) and other public sources.
If you apply for an offshore current account or credit, we may use details of your credit history to assess your ability to meet your financial commitments. The credit
reference agencies will record details which will form part of your credit history whether or not you proceed with your application. If you make several applications within a
short period of time this may temporarily affect your ability to obtain credit. Where you have agreed, we may share details of how you manage any offshore accounts or
borrowing from us with credit reference agencies.
If we make demand for repayment following default and you fail to repay the full amount due or to make and keep to acceptable proposals for repayment within 28 days
we may (in the absence of any genuine dispute about the amount owed) register the default with the credit reference agencies. This may affect your ability to obtain
further credit.
If you make a joint application for an offshore current account or credit, an association linking your financial records with those of your fellow applicant(s) will be created by
the credit reference agencies. The credit history of your associates may be taken into consideration in any future application for credit. The association will continue to link
your credit histories unless and until you successfully file a notice of disassociation with the credit reference agencies.

4.2 CRIME PREVENTION AND DEBT RECOVERY


To recover debt, prevent crime, verify your identity and meet our legal obligations, we may exchange information (both within the Channel Islands, the Isle of Man inside or
outside the European Economic Area) with other members of the HSBC Group and, where appropriate, with credit reference, debt recovery, fraud prevention and law
enforcement agencies, and other relevant organisations including other lenders.
Your information may be processed for the purposes of complying with applicable laws including anti-money laundering and anti-terrorism laws and
regulations and fighting crime and terrorism. This may require the disclosure of information to Channel Islands, the Isle of Man, and where appropriate inside and outside
the European Economic Area governmental or regulatory authorities or to any other person we reasonably think necessary for these purposes.

4.3 GENERAL USE AND SHARING OF YOUR INFORMATION


The HSBC Group may collect, use and share relevant information about you, your transactions, your use of our products and services, and your relationships with the
HSBC Group:
• to process applications you make;
• to supply you with products and services you request; and
• for credit assessment, customer service, market research, behavioural scoring, product analysis, insurance, audit and administrative purposes.
This may include information provided by you or someone acting on your behalf. Where appropriate (for example if you have relationships with other members of the HSBC
Group in other countries) this information may be shared with the HSBC Group outside of the Channel Islands, Isle of Man, and also inside or outside of the European
Economic Area.
We may use other members of the HSBC Group and/or third parties to provide services on our behalf which may include the processing of information about you.
Whether it is processed in the Channel Islands the Isle of Man, inside or outside the European Economic Area, in accordance with data protection legislation, your
information will be protected by a strict code of secrecy and security which all members of the HSBC Group, their staff and third parties are subject to.

4.4 MISCELLANEOUS
Details of the credit reference and fraud prevention agencies we use can be found on our website www.offshore.hsbc.com/1/2/international/offshore-banking/download-centre

SECTION 5 REPORTING OR RETENTION TAX

Important information for EU residents only


If you live in the EU (including the UK) and have savings with HSBC Bank International Limited, you will be taxed on the interest earned on those savings under the European
Savings Directive (Retention Tax Request). Alternatively, you can request us not to tax your interest but to report your personal account and interest details to the revenue
authority where you live (Reporting Request). See our website www.offshore.hsbc.com/1/2/international/offshore-banking/European-Savings-Directive for more
information, or call us on +44 1534 616111.

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


If you decide to choose the Reporting Request, tick Box A below. If you would prefer the Retention Tax Request, tick Box B.
Failure to choose an option will result in the application of the Retention Tax Request. For joint applications, each applicant MUST tick either A or B below.

APPLICANT 1 APPLICANT 2

A – REPORTING REQUEST AUTHORITY A – REPORTING REQUEST AUTHORITY


I wish to choose the Reporting option for ESD purposes: I wish to choose the Reporting option for ESD purposes:
I understand that personal details of all my affected accounts and interest I understand that personal details of all my affected accounts and interest
earnings will be sent annually to the island’s tax authorities and they will earnings will be sent annually to the island’s tax authorities and they will
pass the information onto the revenue authorities in my country of residence. pass the information onto the revenue authorities in my country of residence.

OR OR
B – RETENTION TAX REQUEST AUTHORITY B – RETENTION TAX REQUEST AUTHORITY
I wish to choose the Retention Tax option for ESD purposes: I wish to choose the Retention Tax option for ESD purposes:

If you are resident in the UK but not domiciled there and do not intend to transfer any of the offshore interest paid from your offshore account back to the UK, you may qualify
for exemption. If you are resident in another EU country but are not domiciled in that country you may also qualify for exemption. We suggest that you seek guidance from
your local tax adviser.
If you think that you may be exempt from reporting or retention tax, please see our website www.offshore.hsbc.com/1/2/international/offshore-banking/European-Savings-
Directive to understand the action you should take or call us on +44 1534 616111.

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
7

HSBC Bank International – ACCOUNT APPLICATION FORM

SECTION 6 BANK MANDATE, DECLARATIONS AND SIGNATURES


6.1 I/We request to open the account(s) detailed on page 1 in my/our name(s). I/We agree to be bound by the HSBC Bank International Personal Banking Terms of Business,
Tariff of Charges, and any Additional Conditions as made available online at www.offshore.hsbc.com/1/2/terms. I/We confirm that the information given above is correct
and that I am/we are 18 years of age or over
6.2 If I am/we are transferring my/our bank account(s) to you, I/we authorise you [subject to the credit available on my/our account(s)] to pay to my/our previous bankers
any sums they claim to be owing by me/us to them, and the amount of any cheques drawn on them, any cash machine or debit card transactions except for any that
I/we may have asked you not to pay, and deduct the amounts from my/our account(s).
6.3 I/We understand and accept that my/our personal data may be used in accordance with the Information about Products Services and Promotions section below and
the Your Information section, detailed in the booklet HSBC Bank International Limited Personal Banking Terms of Business.
6.4 I/We understand and accept that my/our account instructions may be given in accordance with the booklet HSBC Bank International Limited Personal Banking Terms
of Business, allowing me/us to take advantage of your telephone, internet and fax banking services.
6.5 I/We understand that my/our accounts can be registered and viewed on your Internet Banking service and I/we will be issued with a Personal Banking Number (PBN)
and Personal Identification Number (PIN) which will allow me/us to access my/our accounts using your telephone and Internet Banking services.
6.6 I/We understand that to prevent crime and to verify my/our identify you may exchange information both within the Channel Islands, Isle of Man and where appropriate
in and outside the European Economic Area with other members of the HSBC Group.
6.7 Please be advised that customers who hold deposits with HSBC Bank International Limited in Jersey, Guernsey and the Isle of Man, and who are resident in Hong Kong
are not protected by the Hong Kong Deposit Protection Scheme, nor the Hong Kong Special Administrative Region Government's Exchange Fund. If you are a resident of
Hong Kong, we suggest you read the Hong Kong Deposit Protection Board www.dps.org.hk for further guidance on the Scheme you will also need to tick the box below
to accept you understand that your deposits held by HSBC Bank International are not protected, failure to not accept HSBC Bank International have advised you, may result
in your application being delayed or declined.
By ticking the box I/We understand that my/our deposits held with HSBC Bank International in Jersey, Guernsey and the Isle of Man are not protected by the Hong
Kong Deposit protection scheme nor the Hong Kong Special Administrative Region Government's Exchange Fund
6.8 I/We understand that HSBC Bank International Limited has the right to refuse this account application.
6.9 By signing this application form, I/We agree that once my/our accounts are opened you will send me/us monthly paper statements by post until I/any of us register for
Internet Banking when my/our delivery preference will automatically be changed to receiving monthly eStatements. I/We understand that you may charge for each
paper statement as set out in the Tariff of Charges, and that eStatements are free of additional charge. I/We understand that after my/our statement preference has
changed to eStatements, I/any of us can change the statement delivery preference at any time, and that for joint accounts the statement delivery preference will be
the same for all of us.

INFORMATION ABOUT PRODUCTS, SERVICES AND PROMOTIONS AND MARKET RESEARCH


If you agree, the HSBC Group may use and share relevant information about you, your transactions and your relationships with the HSBC Group to give you information
about products, services (including mortgages and credit cards these services will be provided by HSBC Bank plc in the UK) and promotions available from members of the
HSBC Group and selected third parties which may interest you by post telephone, electronic and other means. The HSBC Group may share relevant information about you,
your transactions and your relationship with third party market research agencies who may invite you (by post telephone, electronic and other means) to take part in market
research activities for the HSBC Group. The HSBC Group may also exchange, analyse and use relevant information about you in the way described above to ensure that
promotional content displayed to you on screen when you log on to an HSBC Group website is more likely to be relevant and of interest. If you do not wish to be contacted
for market research purpose please let us know. By completing this application you will be consenting to the use of your information for this unless you tick the appropriate
box(es) below to indicate that you do not wish to receive such information.
no post no telephone no email no mobile messaging
We may also contact you with important service information via secure e-message, If you are registered for Internet banking and also mobile message.

6.10 PLEASE SIGN THE APPLICATION


By signing this application, you agree that we can use your information in the way set out above and in our ‘HSBC Bank International Limited Personal Banking Terms of Business.
Please ensure that you have INCLUDED THE NECESSARY IDENTIFICATION DOCUMENTS LISTED ON PAGE 8.
We will then contact you by email or post to welcome you to HSBC Bank International and advise you of your account details. Please visit the
‘Let us help you – Moving money in’ section of our website, where you will find an Inward Payment Instruction form to complete and pass to your current bankers to transfer
your money to us.

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


Signature of Customer (APPLICANT 1) Signature of Customer (APPLICANT 2)

 

Date of signature D D M M Y Y Y Y Date of signature D D M M Y Y Y Y

Please return your application and other documents to:


HSBC Bank International Limited, PO Box 39, HSBC House, Ridgeway Street, Douglas, Isle of Man IM99 1BU.
(If you intend to return your application by courier, please remove ‘PO Box 39’ from the address).
Issued by HSBC Bank International, a trading name of HSBC Bank International Limited, HSBC House Esplanade St Helier Jersey JE1 1HS.
HSBC Bank International is regulated by the Jersey Financial Services Commission for Banking, General Insurance Mediation, Investment and Fund Services
Businesses and licensed by the Guernsey Financial Services Commission for Banking, Collective Investment Schemes and Investment Business. Licensed by the
Isle of Man Financial Supervision Commission.
Copies of latest audited accounts are available on request.

FOR OFFICE USE ONLY

How introduced to bank


Potential customer number CIN
code (IB) (mandatory) 1 0 6
Marketing Source Code (1N) Introducing Staff HUB ID

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.
8

HSBC Bank International – ACCOUNT APPLICATION FORM

WHAT WE NEED FROM YOU – HELP US TO OPEN YOUR ACCOUNT QUICKLY

APPLICATION FORM
We require a fully completed and signed application form. If you are applying for a joint account, APPLICANT 1
we require signatures from all individual parties. APPLICANT 2
I have fully completed and
signed this application form
PROOF OF IDENTITY
A full clear certified* copy of your valid Passport or National Identity Card is acceptable. The APPLICANT 1
certified copy must show your name, your photograph, your Passport or National Identity Card APPLICANT 2
number, your signature, your date and place of birth and the issue and expiry dates. If you supply
a certified copy of your National Identity Card, this must be photocopied on both sides. Please see I have enclosed a correctly
below for guidance on how to get your Passport or National Identity Card correctly certified. certified copy of my Passport
or National Identity Card
PROOF OF ADDRESS
One original document (certified* copies accepted) from each applicant, dated during the last three APPLICANT 1
months confirming your residential address (PO Box or business addresses are not acceptable). APPLICANT 2
Where both applicants share the same family name and residential address, one document
will suffice. The document can be a gas/water/electric bill, most recent bank/mortgage/credit card I have enclosed an original
statement (online printed statements are not accepted), telephone bill (landline only), driving or correctly certified copy of
licence, National Identity Card or local authority bill (last 12 months). A document used to prove a document proving my
your address must be different to the document proving your identity. residential address

EXISTING BANK STATEMENTS


We will need your most recent month’s main bank account statements, showing transactions and APPLICANT 1
salary/pension payments. Online printed statements are acceptable, although not for proving your APPLICANT 2
address. Temporary transaction lists are not acceptable.
I have enclosed an original or
correctly certified copy of an
acceptable bank statement

*CERTIFICATION OF DOCUMENTS
The following people can certify photocopies of your documents:
e Licensed bank official† e Lawyer or Notary Public** e Accountant or Tax Adviser**
e Actuary** e A member of the Judiciary or a Senior Civil Servant
**Must be a member of a recognised professional body
†Please note that HSBC branches in the UK will only certify your Proof of Address or Passport if they are introducing you to us, or you are known to them.

One of the above people must certify the documents in English and include the following details on all the documents they certify:
1. Where the document being certified is proof of residential address they must write ‘I confirm that this is a true and accurate copy of the original
document that I have seen’. Where the document being certified is proof identity and contains a photograph, the certifier must also write ‘I
confirm that this is a true and accurate copy of the original document that I have seen and that the photograph bears a true likeness to the holder’.
2. They must sign and date the certified document.
3. They must state their name and address in BLOCK CAPITALS and include their professional position or capacity, eg lawyer.
4. They must state their contact details, eg telephone number or email address (for use in the event of a query).
5. Your relationship with the certifier must be of a professional rather than a personal nature.

MC8407/SJ/2206403 © HSBC Bank International Limited 2010. All Rights Reserved.


Certifier Details – Please provide details of the person certifying your documents

Certifier Name

Address

Profession Telephone
Number

OTHER IMPORTANT INFORMATION


e Documents must be dated within the last three months and be from different sources. If you are providing original documents that need to be
returned to you, please tell us.
e If your signature(s) is/are not on the key passport pages, a specimen signature must be provided before the passport copy is certified.
e We will only accept documents in English or a certified translation.

PLEASE TAKE CARE TO FOLLOW THE ABOVE INSTRUCTIONS. AN INCORRECTLY COMPLETED FORM OR INELIGIBLE DOCUMENTS MAY
DELAY YOUR APPLICATION.
PLEASE RETURN YOUR APPLICATION TO: HSBC Bank International Limited, PO Box 39, HSBC House, Ridgeway Street, Douglas, Isle of Man IM99 1BU.
(If you intend to return your application by courier, please remove ‘PO Box 39’ from the address)

If you need help completing this form, call us anytime on +44 1534 616111.
To help us to continually improve our service, and in the interest of security, we may monitor and/or record your communications with us.

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