.~ tiIi 3ii!f; iIkT~ Bank ofBaroda

India's International Bank

APPLICATION FOR OPENING INDIVIDUAL ACCOUNT(Current Deposit I Fixed Deposit)

The Branch Manager

All prospective customers are required ta complete this application form for the account or accounts they require;

branch

Dear Sir/Madam,

We request you to open and account in my/our name(s) styled as:

Title of account:

First applicant - personal details

Title: (Mr./Mrs./Miss/Ms.)

Surname:

Forenames:

Date of birth:

Nationality:

Passport no.

Place of issue:

Date of issue:

Expiry date:

National Insurance No.:

Mother(s Maiden Name:

(If the applicant is not issued with any Passport, full particulars ofalternative identification documents be accepted and certified copies be lefton record, as permitted per current guidance notes issued by JMLSG,inassociation with BBA)

Employment Status (Please tick as appropriate)

D Employed

D Pensioner

D Other

D Self-Employed

Signature

For office useAccount No.:

Proof of identity exhibited and copy verified:

Proof or residence exhibited and copy verified:

Date all formalities completed:

Officer's Signature Date:

Manager's signature: Date:

Second applicant - personal details

Title: (Mr.lMrs./Miss/Ms.)

Surname:

Forenames:

Date of birth:

Nationality:

Passport no.

Place of issue:

Date of issue:

Expiry date:

National Insurance No.:

Mother(s Maiden Name:

(If the applicant is not issued with any Passport, full particulars ofalternative identification documents be accepted and certified copies be lefton record, as permitted per current guidance notes issued by JMLSG,inassociation with BBA)

Employment Status (Please tick as appropriate)

D Employed

D Pensioner

D Other

D Self-Employed

Signature

* Name and address of Employer (if applicable)

* If self-employed(Pleasestate your Occupation/profession, Name & address Of yourBusiness & expected Turnover/sales)

* Gross annual income?

* Permanent address:

Home Tel. NO:

Work Tel. no:

E-mail address:

• Name and address of Employer (if applicable)

* If self-employed(Pleasestate your occupation/profession, Name & address of yourBusiness & expected TUrnover/sales)

* Gross annual income?

* Permanent address

Home Tel. NO:

work Tel. no:

E-mail address:

* Full correspondence address (If different from permanent address), If correspondence address is of person other than your own, pleasestate nisznerName and your RelationShip with hlmlher. Pleaseprovide evidence of address of recipient of the correspondence similar to oneyou have provided for YOurself),

Address:

correspondence recipient's Name & Relationship (if applicable)

* Please state the purpose for which the account will be maintained:

* Marital status:

* Residential status

§ Owner-occupier

Living with Parents

Other (Give details)

DTenant

Details of present Bank or Building Society accountsName of Bank of Building Society

Branch:

sort code: D D-D D-D DAccount number

Signature

* Marital status:

* Residential status

§ Owner-occupier

Living with Parents

other (Give details)

D Tenant

Details of present Bank or Building Society accountsName of Bank of Building Society

Branch:

sort Code: DO-DO-DOAccount number

Signature

DECLARATION(for non-resident only)

ACCOUNTHOLDERS:

(first name, last name)

Held with: BANK OF BARODA28 Rue de la tot1Q40 BRUSSELS

certify:

1. Not to have in Belgium its/their domicile, administrative centre ofits/their wealth, head office, principal place of business, nor seat ofmanagement or administration.

2. Not to have assigned said funds to the exercise of a professionalactivity in Belgium.

3. I/We declare that I/wE are the Beneficial Owner of the funds that arebeing/or will be deposited from time to time in my/our account andthat these funds in all or any part of it are in no way linked in anymanner howsoever or are process of any illegal activities/criminalconduct and do not constitute Money laundering.

4. I/We are aware of my/our obligation and undertake to inform thebank promptly of any change in my/our circumstances and providemissing or updated information as appropriate relating to thisaccount.

Date:

Place:

(SIGNATURES)

Joint Applicant's Declaration

(FOrthis section ''We/us'' refers to the customer, and "You" refers to the sankIn case of joint application the following shall apply:

We request you to open an account or accounts in our joint names, or to continue the joint accountalready opened. We authorise you, until you receive notice in writing from any of us to the contrary,

1. TO pay and debit to any such account ail cheques, orders to pay, bills ofexchange, and promissory notes drawn, signed, accepted or made by*.,--- --: of us, whether the accounttsi be in credit or overdrawn or shallbecome overdrawn by reason of such debiting.insert

"either""anyone" 2."and«worasappropriate

TOgrant at the request of * of us, overdraft, loan or othercredit facilities or accommodation for our joint account and by way of securitytherefore, to accept as duly signed or executed on behalf of all of us anydocument creating or evidencing any charge, mortgage or pledge over or inrespect of any securities, deeds or other articles in our joint names.

3. To pay against the signature of * of us any monies heldto the credit of any deposit account in our joint names:

4. To deliver against the signature of * of us, any securities,deeds or other articles held in our joint names by way of security or for safecustody otherwise.

We agree that, in the event of the death of any of us, you are to payor deliver to the order of thesurvivor or survivors of us, all monies, securities, deeds and other articles standing to the credit of orheld for any account In our joint names.

We hereby agree that we shall be jointly and severally responsible for any overdraft, loan or othercredit facilities or accommodation which shan be granted in our joint names or for our joint account,together with ail interest, commission and other banking charges and expenses.

We understand that in case of term deposit with operating instructions "either or survivor" or"former or survivor", premature termination/payment without any penal charges will be allowed to thesurvivor in the event of the death of the either of the depositors or former as the case may be onsubmission of death certificate of the deceased depositor along with application without obtainingconsent of the legal heirs of the deceased depositor."

The Bank may, on receipt of a written application from "the first named/thesecond named etc. of us"/"either or survivor of us" OR "any of us or survivors or survivor of US",in itsabsolute discretion and subject to such terms and conditions as the Bank may stipulate, (al grant aloan/advance against the security of the term deposit receipt to be issued in our joint names or e» makepremature payment of the proceeds of the deposit to the "the first named or the second named ofuS"/"either or survivor of us "/"any one of us or survivors or survivor of us".

Please sign belowa) I accept the terms and conditions that apply to the account and that I have asked for and you have

agreed to provide me with.

b) Where this application is for a joint account I/We accept the terms of the joint applicants extradeclaration.

Name: signature Date: _

Name: signature nate. _

Name: Signature Date:, _

Name: Signature Date:, _

Bank of BarodaRue de ta tot 281040 BrusselsBelgium

Re : a/c no. _

Dear Sirs,

This is to request you and authorize you to act upon any instructions/messages/applicationsor letters etc. sent to you by Facsimile (Fax)or telecopies for transfer offunds/documents/or any other transactions.

We hereby agree than upon receipt of the facsimile, Bank of Baroda, as a securityprocedure, shall telephonically confirm with any of the authorized signatories, theauthenticity of communication and on receiving such confirmation, shall be able toconclusively rely on it for the authenticity of the communication.

In consideration of your acting upon our faxed letters/messages/ instructions/applicationsetc. in lieu of original, we hereby further agree and undertake to hold you harmless and tofull indemnify you from and against ail losses, claims, costs or damages, which you maysustain or incur by reasons of your acting upon our fax or in case the telefax of authorizedsignature is fraudulent or forged

We further agree and undertake to submit a written confirmation of this fax messageimmediately after faxing the same to you and in the event the original is not received byyou, or not sent by us/misplaced/lost in transit, we hereby agree to your considering the faxmessage as equivalent to the original letter/message. In the event there is any discrepancyor variance between the faxed message and the original written confirmation, we agree tohold you harmless and indemnify you for relying on the faxed message and the signatureappearing on themessage.

We further agree and undertake to pay you and make good any loss or damage or expensesyou may be put to or incur in reliance on the faxed instructions, messages, applications orletters etc. immediately upon your making a demand and hereby waive any defense orcounterclaim based on your relying on faxed message/letterlinstruction/application and orthe signature appearing on them.

Yours faithfully,

IFOR TRANSFER OF USD ($) FUNDS 3

To remit USDto JP Morgan Chase Bank N.A., New York(Swift Address: CHASUS33),ABA 021000021for credit of account number: 822839346 of Bank of Baroda, Brussels(SWIFTAddress: BARBBEBB)for ultimate credit to account number:Of beneficiary's name: (Ultimate Beneficiary>.

IFOR TRANSFER OF CBP (E) FUNDS 3

TO remit GBPto Bank Of Baroda, London(Swift Address: BARBGB2U,Sort Code: 70-08-04For credit of account number:1000-660198-002 of Bank of Baroda,Brussels (SWIFTAddress: BARBBEBB)for ultimate credit to accountnumber:Of beneficiary's name: (Ultimate Beneficiary).

IFOR TRANSFER OF EUR (€) FUNDS ~

TOremit EURto KBCBank, Brussels(Swift Address: KREDBEBB),For credit of account number:BE88480900182741 of Bank of Baroda, Brussels (SWIFTAddress:BARBBEBB)for ultimate credit to account number: ----,--------::-:---,-Of beneficiary's name: (Ultimate Beneficiary).

Dear Customer / Visitor,

Above are the details of instructions to be given to your bankers for transferring funds in eachcurrency to Bank of Baroda - Brussels branch. Please transmit these details to your banker fortransferring funds easily to our Branch.

For any question, please don't hesitate to contact us.

BANK OF BARODA, BRUSSELS

Documents required for opening Individual/Joint account for residents of Belgium

1. Account opening form along with specimen signature card, duly signed bythe account holders.

2. Latest copies of Passport.3. Copy of Resident Card of Belgium.4. utility bill for address proof.5. One latest photograph.

Account Holder to visit personally to branch with prior appointment for openingthe account along with the originals of above documents for verification.

******

Documents required for opening Individual/Joint account for non-residents, duly attested byanyone of our branches

1. Account opening Form along with specimen signature card, duly signed bythe account holders.

2. Latest copies of passport, duly certified by anyone of our branches.3. One latest passport size Photograph.4. utility bill for address proof.5. Faxundertaking as per format.