CORPORATE ACCOUNT OPENING FORM - ICICI · PDF file · 2016-11-22CORPORATE ACCOUNT OPENING FORM BUSINESS PARTICULARS ... Public Listed Company Partnership Trust Non - Government Organization

CORPORATE ACCOUNT OPENING FORM

BUSINESS PARTICULARS

Name of the Company/ Establishment:

Date of Incorporation/Registration: ( D D M M Y Y Y Y )

Incorporation / Registration No.:

Country of Incorporation / Registration:

Country of Operation:

Registered Address:

Postal code: Email:

Tel No.: Fax No.:

Mailing Address (If different from Registered Address):

Postal code: Email:

Tel No.: Fax No.:

Any previous Company Name since Inception?: Yes No If yes, please specify: _____________________________________________

BUSINESS PROFILE

Business Entity Type

Public Listed Company Partnership Trust Non - Government Organization

Private Limited Company Club / Society / Association Others (Please specify:______________________________________)

Nature of Business

Agriculture / Fishing / Mining Manufacturing Building & Construction Transportation & Communication

General Commerce (Export / Import / Trading) Financial Institutions Professional Services

Trust / Nominee / Fiduciary Service Charity Casino & Gaming Jewellery Dealer

Money Changer / Remitter Real Estate Agent / Broker

Cash Intensive Business (Restaurant / Convenience Stores) Others (please specify:_______________________________________)

Association the entity may have with other countries / jurisdictions:______________________________________________________________________

Major Source of Wealth

Business Operations Funds from Owners Investment Proceeds

Others (please specify:____________________________________________________________________________________________________________)

Source of Funds: ______________________________________________________________________________________________________________

Estimated Annual Revenue

<USD250,000 USD250,001 – USD1,000,000 USD1,000,001 – USD5,000,000

USD5,000,001 – USD 25 million >USD25.0 million (Please specify:_________________________________________________)

TRANSACTION PROFILE

Purpose of Account opening

Deposits Investments in bonds / structured products / CIS

Leveraged investments/Secured Loans / Credit facilities Third party remittances

Others (Please specify:____________________________________________________________________________________________________________)

Anticipated Annual Banking Relationship size

<USD75,000 USD75,001 – USD 200,000 USD250,001 – USD 500,000 USD500,001 – USD1,000,000

USD1,00,001 – USD5,000,000 USD5,000,001 – USD1,000,000 > USD1,000,000 (Please specify:_______________________)

Anticipated no of investment/banking transactions per annum

<5 5-10 10-20 20-50 >50 (Please specify:____________________________________________________________)

Expected Monthly Volume

Cash S$0 S$1 – S$50, 000 Others (Please specify:_________________________________________________________)

Wire Transfer S$0 S$1 – S$50,000 Others (Please specify:_________________________________________________________)

Cheques / Drafts S$0 S$1 – S$50,000 Others (Please specify:_________________________________________________________)

ADDITIONAL INFORMATION

Does the customer have any other relationships of related parties (related parties may be individuals or coporate) with the Singapore branch?

Yes (Please specify Customer ID:_________________________________________) No

Does the customer have any existing relationship with ICICI Bank or its branches?


Does the company issue bearer shares? Yes No

Are there nominee shareholders in the company? Yes No

Are there nominee director in the company? Yes No

Senior Public Figure Declaration

I/ We hereby declare that:

I/ We nor any of my/ our shareholder(s) and/ or beneficial owner(s) hold, have ever held and are not actively seeking to hold or being

considered for the position of a senior public figure

I/We nor any of my/ our shareholder(s) and/ or beneficial owner(s) currently hold have held, the position of senior public figure.Residential Status

Singapore Resident Singapore Non-Resident

GST Number (For Resident Only and if applicable)

Instructions for Customers:

• Please complete this form in English using BLACK ink, BLOCK CAPITALS and tick wherever appropriate. • Any overwriting or alteration should be countersigned (full signature only). • All fields are mandatory, incomplete forms may not be processed.

Page 1 of 19

Singapore

Registered address - 9 Raffles Place, #50-01 Republic Plaza, Singapore 048619 Company Reg No.T03FC6380G

PSTUDIO 2_ICICI_590597_SK_Size 297 mm (H) x 210 mm (W)_Singapore AOF Corporate form

RB

/AO

/CO

RP

/151

0

BUSINESS PARTICULARS

Name of the Company/ Establishment:

Date of Incorporation/Registration: ( D D M M Y Y Y Y )

Incorporation / Registration No.:

Country of Incorporation / Registration:

Country of Operation:

Registered Address:

Postal code: Email:

Tel No.: Fax No.:

Mailing Address (If different from Registered Address):

Postal code: Email:

Tel No.: Fax No.:

Any previous Company Name since Inception?: Yes No If yes, please specify: _____________________________________________

BUSINESS PROFILE

Business Entity Type

Public Listed Company Partnership Trust Non - Government Organization

Private Limited Company Club / Society / Association Others (Please specify:______________________________________)

Nature of Business

Agriculture / Fishing / Mining Manufacturing Building & Construction Transportation & Communication

General Commerce (Export / Import / Trading) Financial Institutions Professional Services

Trust / Nominee / Fiduciary Service Charity Casino & Gaming Jewellery Dealer

Money Changer / Remitter Real Estate Agent / Broker

Cash Intensive Business (Restaurant / Convenience Stores) Others (please specify:_______________________________________)

Association the entity may have with other countries / jurisdictions:______________________________________________________________________

Major Source of Wealth

Business Operations Funds from Owners Investment Proceeds

Others (please specify:____________________________________________________________________________________________________________)

Source of Funds: ______________________________________________________________________________________________________________

Estimated Annual Revenue

<USD250,000 USD250,001 – USD1,000,000 USD1,000,001 – USD5,000,000

USD5,000,001 – USD 25 million >USD25.0 million (Please specify:_________________________________________________)

TRANSACTION PROFILE

Purpose of Account opening

Deposits Investments in bonds / structured products / CIS

Leveraged investments/Secured Loans / Credit facilities Third party remittances

Others (Please specify:____________________________________________________________________________________________________________)

Anticipated Annual Banking Relationship size

<USD75,000 USD75,001 – USD 200,000 USD250,001 – USD 500,000 USD500,001 – USD1,000,000

USD1,00,001 – USD5,000,000 USD5,000,001 – USD1,000,000 > USD1,000,000 (Please specify:_______________________)

Anticipated no of investment/banking transactions per annum

<5 5-10 10-20 20-50 >50 (Please specify:____________________________________________________________)

Expected Monthly Volume

Cash S$0 S$1 – S$50, 000 Others (Please specify:_________________________________________________________)

Wire Transfer S$0 S$1 – S$50,000 Others (Please specify:_________________________________________________________)

Cheques / Drafts S$0 S$1 – S$50,000 Others (Please specify:_________________________________________________________)

ADDITIONAL INFORMATION

Does the customer have any other relationships of related parties (related parties may be individuals or coporate) with the Singapore branch?


Does the customer have any existing relationship with ICICI Bank or its branches?


Does the company issue bearer shares? Yes No

Are there nominee shareholders in the company? Yes No

Are there nominee director in the company? Yes No

Senior Public Figure Declaration

I/ We hereby declare that:

I/ We nor any of my/ our shareholder(s) and/ or beneficial owner(s) hold, have ever held and are not actively seeking to hold or being

considered for the position of a senior public figure

I/We nor any of my/ our shareholder(s) and/ or beneficial owner(s) currently hold have held, the position of senior public figure.Residential Status

Singapore Resident Singapore Non-Resident

GST Number (For Resident Only and if applicable)

Page 2 of 19

Singapore



RB

/AO

/CO

RP

/151

0

Singapore

Page 3 of 19Registered address - 9 Raffles Place, #50-01 Republic Plaza, Singapore 048619 Company Reg No.T03FC6380G


Personal Details:

Unique ID No.

Date of birth

Nationality

Contact No.

Current Residential Address

Occupation / Employment Details:

Name of Beneficial owner including all aliases

Details of any other relationship (single or joint) with ICICI Bank Limited(If yes, please provide Customer ID)

Designation in organization(Proprietor, Partner, Director, etc.)

Nature of occupation / employment

Estimated annual income of the owner

Major Source of Income / Wealth of the owner

Estimated Net invested assets of owner* (All assets less the liabilit ies. The residential home is not to be considered).

Owner / Controller 1

Self-employed / Business

Salaried

Retired

Student

Housewife

Others (Please specify__________________)

Upto USD 100,000

USD 100,001 – USD 250,000

USD 250,001 – USD 500,000

USD 500,001 – USD 1,000,000

>USD 1,000,001 – USD 5,000,000

Greater than USD 5,000,000

(Please specify________________________)

Salary

Income from Business

Pension / Retirement savings

Investment proceeds

Inheritances

Spouse/Parent/Relatives

Gift


Upto USD 250,000

USD 250,001 – USD 500,000

USD 500,001 – USD 1,000,000


(Please specify________________________)


Self-employed / Business

Salaried

Retired

Student

Housewife


Upto USD 100,000

USD 100,001 – USD 250,000

USD 250,001 – USD 500,000

USD 500,001 – USD 1,000,000

>USD 1,000,001 – USD 5,000,000


(Please specify________________________)

Salary

Income from Business

Pension / Retirement savings

Investment proceeds

Inheritances

Spouse/Parent/Relatives

Gift

Others (Please specify_________________)

Upto USD 250,000

USD 250,001 – USD 500,000

USD 500,001 – USD 1,000,000


(Please specify________________________)

RB

/AO

/CO

RP

/151

0

Term Deposits

Type With Premature Withdrawal Type With Premature Withdrawal

Without Premature Withdrawal * Without Premature Withdrawal *

Currency: Amount: Currency: Amount:

Tenor: Months Tenor: Months

#Interest payment: On maturity Annual #Interest payment: On maturity Annual

Semi Annual Semi Annual

APPLICATION OF ACCOUNT

Current Account

SGD USD EUR GBP AUD

Others (Please specify:_______________________________________________________________________________)

Page 4 of 19

Singapore



Proof of Income


Salary Slip

Income Tax Return

Relationship value/ net worth letter from banks

Audited financial statement of the business

Others (Please specify:_________________)


Salary Slip

Income Tax Return

Relationship value/ net worth letter from banks

Audited financial statement of the business

Others (Please specify:_________________)

* The Fixed Deposit, without the option of premature withdrawal, does not have premature withdrawal facility i.e. the Fixed Deposit cannot be closed by the depositor before expiry of the term of such deposit. However, the Bank may allow premature withdrawal of these deposits in following exceptional circumstances: in the event of any direction from any statutory and/or regulatory authority or deceased claim settlement cases. In the event of premature withdrawal of these deposits under abovementioned exceptional circumstances, the Bank will not pay any interest on the principal amount of the deposit. Any interest credited or paid upto the date of such premature closure will be recovered from the deposit amount.

RB

/AO

/CO

RP

/151

0

Mode of Funding

Debit my/our account No. with ICICI Bank Singapore branch

Remittance from remitting bank ____________________________________________________________, bank address _________________________

_____________________________________________________ and remittance reference No. _____________________________________________________

of currency and amount_______________________________________________________________________________________________

(The reference number shall help us in identifying your funds and enable us to open your deposit account. In absence of the reference number, we may not be able to identify your funds easily which may lead to delays in opening your deposit account).

Chequebook Request (only for SGD account)

Chequebook required Yes No

Name to appear on Chequebook

Maturity Instructions (Applicable only for Term Deposits)

Renew principal plus interest on maturity date for *days/week(s)/month(s)/year(s) at the prevailing interest rate, with other terms

of the term deposit remaining the same.

Renew principal on maturity date for *days/week(s)/month(s)/year(s) or to mature on

at the prevailing interest rate and pay interest #; with other terms of the term deposit remaining the same.

# Repay principal and interest by

Credit ICICI Bank Account No.

Telegraphic Transfer:

Name __________________________________________________________Account No______________________________________________________

Bank ____________________________________________________________________________________________________________________________

*Charges may be applicable

Page 5 of 19

Singapore



RB

/AO

/CO

RP

/151

0

Personal Data Notice & Consent

I/ We (“Customer”) hereby authorise, agree, consent and allow ICICI BANK LIMITED, Singapore Branch (the “Bank”), and ICICI Bank Limited, India and/ or any of its affiliates, branches or subsidiaries (collectively referred to as “ICICI Entities”), and their employees, agents, and third party service providers to collect, use, disclose, process and/ or market my/ our personal data in relation my/ our use or availing of or access to any of the accounts of the Bank (“Accounts”) and related services/facilities, in accordance with the provisions given below:

1. The Bank shall need to collect, use, disclose and/or process the Customer’s personal data to process, administer and/or manage the Customer’s relationship with the Bank, Such personal data includes information about the Customer set out in his/her application forms and related documents, and any other personal information provided by him/her, possessed by the Bank or that the Bank obtains about the Customer, whether now or in the future. The Customer’s personal data includes, inter alia the Customer’s name, identification number, address and personal contact and transaction details.

2. The Customer’s data may be collected, used, disclosed and/or processed for one or more of the following purposes (collectively referred to as “Purposes”):

(a) considering and processing of applications for Accounts, banking facilities and services by the Customer, and the daily operation, managing, maintaining or administering of the services and/ or credit facilities provided to/ availed by the Customer(s);

Page 6 of 19

Singapore


SHAREHOLDING UNDERTAKING AND DECLARATION

ICICI Bank Limited, Singapore Branch9, Raffles Place# 50-01 Republic PlazaSingapore 048619

Dear Sirs:

In consideration of ICICI Bank Limited, Singapore Branch (hereinafter referred to as “ICICI Bank”) agreeing to establish a banking relationship with us (the “Company“), we do hereby agree, confirm, undertake and declare that at the start of and during the entire period/ tenure of the banking relationship of the Company with ICICI Bank:

(i) The shareholding pattern of the Company as detailed in Annexure A hereunder is and shall continue to remain correct and updated to reflect our

true and up-to-date records as of ( D D M M Y Y Y Y ). The Company declares and confirms that

all control over and beneficial interest in the Company is vested only in shares and no transfer of its shares is effective unless such transfer has

been registered with the Company (For the purposes of this clause, “transfer” includes all manners of transfer in or charge over the ownership of the shares and transfers of any beneficial interest in the share of the Company, and, “control”, together with its grammatical variations when used with respect to the Company, means the power to direct the management and policies of such Company, directly or indirectly, whether through the ownership of the vote carrying securities, by contract or otherwise howsoever.).

(ii) so long as the Company has a banking relationship with ICICI Bank:-

(a) the Company shall, immediately upon issuance/allotment by the Company of any shares (whether present or future), inform ICICI Bank of details (as per Annexure A) of the issuance/allotment of such shares;

(b) the Company shall upon, recognizing and/ or registering any transfer of shares, both present and future, (as detailed in Annexure A) in the capital of the Company inform ICICI Bank of the details of such transfer of shares, within 15 calendar days of such transfer/ recognition/registration or prior to carrying out any such transaction through or related to the relationship with ICICI Bank, whichever is earlier;

(c) All requisite approvals and other actions required to be taken by the Company in connection with the execution of this undertaking and the performance by the Company of its obligations hereunder have been taken and this undertaking will constitute the its legally valid, binding and enforceable obligations.

The Company agrees and affirms that it is on the faith of its aforesaid agreements, confirmations, declarations and undertakings that ICICI Bank has agreed to establish a banking relationship with the Company. In the event of failure by the Company to comply with any terms contained in herein or if any statement hereto is or becomes false or misleading, ICICI Bank shall be entitled to treat the banking relationship as void ab initio or terminate its banking relationship forthwith with the Company, at its sole discretion. The Company acknowledges that ICICI Bank shall be at liberty to refuse to carry out or suspend any transactions relating to such banking relationship until it has completed its due diligence pursuant to any change in the control in or over the beneficial interest of any nature whatsoever in the Company.

The Company further agrees and confirms, for the avoidance of doubt, that the term “banking relationship”, when used in herein means opening, operation and maintenance of a banking account with ICICI Bank (in accordance with its prevailing standard procedures and policies) and/or extending such other banking services/ facilities as may be requested by the Company and agreed by ICICI Bank from time to time (as per such terms and conditions as stipulated and in accordance with its prevailing standard procedures and policies of ICICI Bank). Nothing contained herein shall be construed to create an obligation on ICICI Bank to provide any of its products and services (including without limitation, any credit facilities) to the Company, which shall be provided only if and when approved by ICICI Bank in accordance with its prevailing standard procedures and policies.

This undertaking shall be governed and construed in accordance with the laws of Singapore and we hereby irrevocably submit to the non-exclusive jurisdiction of the courts of Singapore in the event of any dispute hereunder.

Annexure A - Details of Shareholding

Name of Shareholder No. of Shares Percentage of shareholding Paper/Electronic

*Please provide details if required on additional page for substantial ownership and duly signed by Authorised Signatory


(b) carrying out Customer’s instructions or responding to any enquiry given by (or purported to be given by) the Customer or on Customer’s behalf;

(c) contacting the Customer or communicating with him/her via phone/voice call, text message and/or fax message, email and/or postal mail for the purposes of administering and/or managing their relationship with the Bank including, but not limited to, communicating information related to Customer’s details or the relationship details. The Customer acknowledges and agrees that such communication by the Bank could be by way of the mailing of any correspondence, documents or notices to the Customer, which could involve disclosure of certain personal data about the Customer to bring about delivery of the same as well as revelation of the same information on the external cover of envelopes/mail packages or other forms of communication (whether electronic or otherwise);

(d) carrying out due diligence or other screening activities (including background, anti-money laundering (AML) and “know-your-client” (KYC) checks) in accordance with legal or regulatory obligations or the Bank’s risk management procedures that may be required by law or that may have been put in place by the Bank;

(e) conducting credit checks (including without limitation upon an application for consumer credit and upon periodic review of the credit) and data verification;

(f) to prevent or investigate any fraud, unlawful activity or omission or misconduct, whether relating to the Customer’s relationship with the Bank or any other matter arising from such relationship and whether or not there is any suspicion of the aforementioned;

(g) to enforce the rights of the Bank, contractual or otherwise;

(h) creating and maintaining the Bank's credit and risk related models;

(i) complying with or as required by any applicable law, governmental or regulatory requirements of any relevant jurisdiction, Including all applicable requirements under the U.S. Foreign Account Tax Compliance Act, and meeting the requirements to make disclosure under the requirements of any law binding on the Bank and ICICI Entities and/or for the purposes of any guidelines issued by regulatory or other authorities, whether in Singapore or elsewhere, with which the Bank is expected to comply;

(j) complying with or as required by any request or direction of any governmental authority; or responding to requests for information from public agencies, ministries, enforcement directorate, statutory boards or other similar authorities;

(k) enabling an actual or proposed assignee of the Bank, or participant or sub participant of the Bank's rights in respect of the Customer to evaluate the transaction intended to be the subject of the assignment, participation or sub participation;

(l) conducting research, analysis and development activities including development of financial services or related products for Customers' use and to improve the Bank’s services;

(m) storing, hosting, backing up (whether for disaster recovery or otherwise) of Customer’s personal data, whether within or outside Singapore;

(n) to comply with contractual arrangements by or between financial industry self-regulatory, financial industry bodies, associations of financial services providers or other financial institutions, including assisting such institutions to conduct credit checks and collect debts, and any dispute investigations;

(o) to comply with any obligations, requirements, policies, procedures, measures or arrangements for sharing data and information within the Bank and ICICI Entities (as defined herein below), and any other use of data and information in accordance with any programmes of the ICICI Entities for compliance with sanctions or prevention or detection of money laundering, terrorist financing or other unlawful activities;

(p) ensuring ongoing creditworthiness of Customers;

(q) designing financial services or related products for Customers’ use;

(r) determining the amount of indebtedness owed to or by Customers;

(s) collecting amounts outstanding from Customers, and bills providing security for Customers’ obligations;

(t) complying with or as required by any request or direction of any governmental authority; or responding to requests for information from public agencies, ministries, enforcement directorate, statutory boards or other similar authorities;

(u) storing, hosting, backing up (whether for disaster recovery or otherwise) of Customers’ personal data, whether within or outside Singapore, and enabling the Bank to centralise or outsource its data processing and other administrative operations to ICICI entities or third parties engaged by the Bank (whether within or outside Singapore) for any such services/operations;

(v) any other purposes permitted by law; and

(w) all Purposes relating to any of the above.

3. While the Customer’s data shall be kept confidential, the Bank may need to disclose the Customer’s personal data to third parties, (whether located within or outside Singapore), for one or more of the above Purposes. In this regard, the Customer hereby

acknowledges, agrees and consents to the disclosure of Customer’s personal data to such third parties (whether located within or outside Singapore) for one or more of the above Purposes. Without limiting the generality of the foregoing, such third parties may include:

(a) the ICICI Entities (as defined above);

(b) auditors, professional advisers and any other person(s) under a duty of confidentiality to the Bank or ICICI Entities;

(c) any exchange, market, credit bureaus, agencies, tax authorities, central information bureaus, enforcement directorate, statutory bodies or other any other authority or regulatory body having jurisdiction over the Bank or ICICI Entities or over any transactions effected by the Customer or for the Customer's account;

(d) any party lawfully authorised by law to make such demand or request;

(e) any person with whom the Bank or ICICI Entities contracts or proposes to contract with regard to the sale or transfer or sharingof any of its rights, obligations or risks under these terms;

(f) any person (including any employee, agent, vendor, contractor, debt collection agency or third party service provider) with whom the Bank or ICICI Entities contract/s or propose/s to contract with regard to the provision of services in respect of the Customer's account(s) or facilities (as the case may be), or in connection with the operation of the Bank's or ICICI Entities’ business, or setting up of and maintenance of its/ their computer systems;

(g) to enable the Bank to centralise or outsource its data processing and other administrative operations to ICICI Entities or third parties engaged by the Bank (whether within or outside Singapore) for any such services/operations (including any agents, contractors or third party service providers that process Customers personal data on the Bank’s behalf, including but not limited to those which provide administrative or other services to the Bank such as mailing houses, telecommunication companies, information technology companies and data centers);

(h) in case of a wire transfer to the beneficiary bank to whom the transfer is being made;

(i) a drawee bank providing a copy of a paid cheque (which may contain information about the payee) to the drawee;

(j) a person making payment into the Customer's Account (by providing a copy of a deposit confirmation slip or similar advice which may contain the name of the Customer);

(k) any party giving or proposing to give a guarantee or third party security to guarantee or secure the Customer;

(l) in case of a wire transfer, the beneficiary bank to whom the transfer is being made;

(m) credit reference agencies and, in the event of default, debt collection agencies; and

(n) any person or party to whom the Bank or ICICI Entities is/are under an obligation to make disclosure under the requirement of any law binding on the Bank or ICICI Entities.

4. From time to time, it shall be necessary for the Customer to supply the Bank with his/her personal data in connection with the opening, continuation and/or administration of Accounts or the provision of banking facilities and services. Failure to supply such data may result in the Bank being unable to provide any of the aforesaid services/ facilities.

5. Data may be transferred overseas pursuant to the provisions of this clause. The information disclosed pursuant to this clause may be subject to further disclosure by the recipient to other parties in accordance with the laws of the country in which the recipient is located.

6. The Customer hereby agrees and consents that the Bank shall be entitled, in connection with the Customer's application for any Account, facilities or services provided by the Bank, or during the course of the Customer's relationship with the Bank, to obtain and procure information pertaining to the Customer or any of his/ her accounts, legal or financial position from whatever legitimate sources available to the Bank. Unless otherwise expressly stated, and to the extent permitted by law, the Customers’ consents contained in this clause shall survive the termination or expiry of the term/tenure of the relationship between the Bank and Customers (including the closing of Accounts, or the termination of any services or facilities that may be provided by the Bank).

7. The Customer has the right to withdraw the consent given to the Bank to use and disclose the Customer’s data. The Bank will process the Customer’s request within a reasonable time from such a request for withdrawal of consent being made, and will thereafter not collect, use and/or disclose the Customer’s personal data in the manner stated in the Customer’s request. However, withdrawal of consent could result in certain legal consequences arising from such withdrawal. In this regard, depending on the extent of the withdrawal of consent for the Bank to use/ process the Customer’s personal data, the Customer’s relationship with the Bank may be discontinued. The costs, expenses or losses arising out of discontinuation or in relation to discontinuation of the relationship shall be borne by the Customer. The Customer can provide his/her withdrawal of consent in part or whole to the Bank’s data protection officer.

8. For the avoidance of doubt, in the event that Singapore personal data protection law or any other applicable law permits an organisation such as the Bank and ICICI Entities to collect use and/or disclose Customer’s personal data without Customer’s consent, such permission granted by the law shall continue to apply.

9. The Customer may request to access and/or correct his/her personal data currently in the Bank’s possession or control by submitting a written request to the Bank. The Bank will need enough information from the Customer in order to ascertain the Customer’s identity as well as the nature of the Customer’s request, so as to be able to deal with the Customer’s request. The Customer should submit his/her access and/or correction requests to the Bank’s data protection officer.

10. MARKETING AND PROMOTIONAL INFORMATION: The ICICI Bank Limited, Singapore branch (the “Bank”) and the head office, affiliates or any other branches or subsidiaries of ICICI Bank Limited (“ICICI Entities”) intend to, may or shall, at their discretion, collect, use, disclose and/or process the Customer’s personal data that the Customer had previously provided or to ICICI Bank Singapore branch, may now provide or may in future provide the Bank with and/or that the Bank/ ICICI Entities and/or which data the Bank/ ICICI Entities possesses/ possess about the Customer from time to time, for the purpose of providing the Customer with marketing, advertising and promotional information, materials and/or documents relating to products and/or services (including products and/or services of third party merchants whom the Bank or ICICI Entities may collaborate or tie up with) that the Bank and/or ICICI Entities may be selling, marketing, offering or promoting, whether such products or services exist now or are created in the future (“Marketing Purpose(s)”). Notwithstanding the foregoing, Marketing Purposes herein shall be limited to business-to-business communication(s) for corporate customers of the Bank.

(a) The Bank and ICICI Entities intend to, may or shall, at their discretion send to the Customer such marketing, advertising and/ or promotional information in relation to any Marketing Purpose to the Customer by way of:

(i) postal mail and/or electronic transmission to the Customer’s email address(es);

(ii) Singapore telephone numbers by way of voice calls, call / phone call, SMS/MMS (text or fax messages) and/or fax to the Customer’s designated Singapore telephone number, if the Customers’ expressly provide their consent to the same at the time of account opening or under the terms and conditions applicable to the Customers Accounts.

(b) The Bank and ICICI Entities may or shall, at their discretion disclose personal data about the Customer to the Bank’s/ ICICI Entities’ third party service providers or agents, which may be located in or outside of Singapore, for any Marketing Purpose; and the Customer also consents to such third party service providers or agents of the Bank/ ICICI Entities for processing Customer’s personal data (including sending the Customer such

marketing, advertising and promotional information through the above modes of communication) for any Marketing Purpose for the Bank and/ or ICICI Entities.

I have read and agreed to the above, including as to how my personal data may be collected, used, disclosed and processed.

RB

/AO

/CO

RP

/151

0






Page 7 of 19

Singapore






















































CUSTOMER DECLARATION FOR WITHHOLDING TAX PURPOSES

Please tick only one

The control and management of the company’s business is exercised in Singapore

We carry on business in Singapore or have a permanent establishment in Singapore and the control and management of the company’s

business is exercised outside Singapore

We have a permanent establishment in Singapore but have been granted a waiver from withholding tax by the Inland Revenue Authority

of Singapore(“IRAS”). Please refer to the certified true copy of the letter fro IRAS attached for your records.

The control and management of the company’s business is exercised outside Singapore and

(a) We do not have a permanent establishment in Singapore, and

(b) We do not carry on business in Singapore

1. We hereby declare that the information given in this declaration form is true and correct.

2. We undertake to promptly notify ICICI BANK LTD, SINGAPORE OFFSHORE BRANCH (“the bank”) in writing of any change of information declared

above.

3. We agree that we shall be solely responsible for ensuring the accuracy and completeness of the information declared above and the bank shall

not be responsible for any loss or damage suffered by us as a result of the above information being inaccurate or incomplete in any way. We

further agree to indemnify the Bank in full against any claim, demand, action or proceeding which may be against the Bank and/or any damage,

liability. Loss and expense (including legal costs on a fill indemnity basis), which the Bank may incur or suffer directly or indirectly in acting or

relying upon

4. We agree and understand that the Bank may, based on the information provided above, deduct withholding tax from our account, as required

by IRAS. We authorize the Bank to deduct such amount and agree that we will not make any claims on the Bank in this regard.

Definition of permanent establishment in Section 2 of Singapore Income Tax Act (Chapter 134)

“permanent establishment” means a fixed place where a business is wholly or partially carried on including –

(a) a place of management

(b) a branch;

(c) an office;

(d) a factory

(e) a warehouse;

(f) a workshop;

(g) a farm or plantation;

(h) a mine, oil well, quarry or other place of extraction of natural resources;

(i) a building or work site or a construction, installation or assembly project, and without prejudice to the generality of the foregoing, a person shall

be deemed to have a permanent establishment in Singapore if that person –

(j) carries on supervisory activities in connection with a building or work site or a construction, installation or assembly project; or

(k) has another person acting on that person’s behalf in Singapore who –

(i) has and habitually exercises an authority to conclude contracts;

(ii) maintain a stock of goods or merchandise for the purpose of delivery on behalf of that person; or

(iii) habitually secures orders wholly or almost wholly for that person or for such other enterprises are controlled by that person.

RB

/AO

/CO

RP

/151

0

FATCA SELF-CERTIFICATION FORM FOR ENTITIES

Information provided on this form will be used by ICICI Bank Limited, Singapore branch (“the bank”) to comply with the Foreign Account Tax Compliance Act (FATCA) provisions and the regulations and guidance that operationalize the Agreement Between the Government of the United States of America and the Government of Singapore to Improve International Compliance and to Implement FATCA (US-Singapore IGA). FATCA and the US-Singapore IGA may require the bank to report certain information about your account to the Inland Revenue Authority of Singapore and other relevant authorities.

Please note that nothing in this form constitutes tax advice on FATCA. For any such advice on the legislation or its implications on you, kindly contact your professional tax consultant or attorney.

Please complete, where applicable, the relevant sections below in relation to all relevant accounts and provide any additional information as may be required.

Part 1 – Entity / Organisation Information

Entity Details:

Name of Entity / Organisation___________________________________________________________________________________________________________

Country of Incorporation / Organisation__________________________________________________________________________________________________

Permanent / Registered Address: (Do not use a P.O. box or an ‘in care of address’)

Address:______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________

Country:___________________________________________________ Postal Code:_______________________________________________________________

Mailing Address (if different from above):

Address:______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________


Part 2 – Tax Residence Information

Please indicate the Entity’s tax residence. If resident in more than one country, please provide all countries and associated tax identification numbers.

Country of tax residence Tax identification number

1

2

3

Note: If you have indicated above tax residence in the United Statesi, please also provide a completed and signed Form W-9.

Part 3 – FATCA Classification

3.1 If you are a Registered Financial Institution, please choose from below:

(a) Singapore or other FATCA Partner Jurisdiction Financial Institutionii

(b) Registered Deemed Compliant Foreign Financial Institution

(c) Participating Foreign Financial Institution

Please provide your Global Intermediary Identification Number (GIIN):____________________________________






Page 8 of 19

Singapore






















































3.2 If you are a Financial Institutioniii but unable to provide a GIIN, please choose from below:

(a) Sponsored Financial Institution that has not yet obtained its own GIIN but is sponsored by another entity that has registered as a Sponsoring Entity. If applicable, please provide:

Sponsoring Entity’s name: __________________________________________Sponsoring Entity’s GIIN:______________________________

(b) Trustee Documented Trust. Please provide:

Trustee’s name: ____________________________________________________Sponsoring Entity’s GIIN:______________________________

(c) Certified Deemed Compliant Sponsored, Closely Held Investment Vehicle


(d) Certified Deemed Compliant, as defined under the Treasury Regulations

(e) Certified Deemed Compliant, or otherwise Foreign Financial Institution (including a foreign financial institution deemed compliant under Annex II of an IGA, except for a Trustee Documented Trust or Sponsored Financial Institution).

(f) Non-reporting IGA Foreign Financial Institution (including an foreign financial institution treated as a registered deemed-compliant foreign financial institution under an applicable Model 2 IGA)

(g) Non-Participating Foreign Financial Institution

3.3 If you are an Exempt Beneficial Owneriv, please confirm below:

(a) Exempt Beneficial Owner

3.4 If you are a Non-Financial Foreign Entity (NFFE), please confirm below:

(a) Active NFFEv

(b) Direct Reporting NFFE Please provide: Entity’s GIIN:____________________________________________

Name of Sponsoring Entity:_______________________________________Sponsoring Entity’s GIIN:________________________________

(c) Passive NFFEvi

There are no US Controlling Persons

There are US Controlling Persons. Please provide the details of all US Controlling Persons in the table below:

Full Name Date of Place Full residence address Country(ies) of Tax Birth of birth tax residence identification number

Part 4 – Certification and Signature

I/We declare, as an authorised signatory of the Entity, that the information provided in this form is, to the best of my/our knowledge and belief, accurate and complete. I/We undertake to advise the recipient promptly and provide an updated Self-Certification form within 30 days where any change in circumstance occurs, which causes any of the information contained in this form to be inaccurate or incomplete.

Notes:

i. For purposes of this Self Certification, tax resident in the United States includes US persons. US person is defined as a US citizen or resident individual, a partnership or corporation organised in the US or under the laws of the US or any State thereof, a trust if (i) a court within the US would have authority under applicable law to render orders or judgments concerning substantially all issues regarding administration of the trust, and (ii) one or more US persons have the authority to control all substantial decisions of the trust, or an estate of a decedent that is a citizen or resident of the US.

ii. FATCA Partner Jurisdiction Financial Institution is a Financial Institution in a jurisdiction that has in effect an agreement with the US to facilitate the implementation of FATCA.

iii. Financial Institution means a Custodial Institution, Depository Institution, an Investment Entity, or a Specified Insurance Company. (US-Singapore IGA Article 1(g) and draft IRAS e-Tax Guide Section 3)

iv. The term ‘Exempt Beneficial Owner’ means any entity that is one of the following:

a) governmental and government-linked entities;

b) Central Bank;

c) international organisations;

d) qualifying funds; or

e) investment entity wholly-owned by an Exempt Beneficial Owner. (US-Singapore IGA, Annex II, Section I and draft IRAS e-Tax Guide Section 7.2)

v. An ‘Active NFFE’ means any NFFE that meets any one of the following criteria:

a) Less than 50 percent of the NFFE’s gross income for the preceding calendar year or other appropriate reporting period is passive income and less than 50 percent of the assets held by the NFFE during the preceding calendar year or other appropriate reporting period are assets that produce or are held for the production of passive income;

b) The stock of the NFFE is regularly traded on an established securities market or the NFFE is a Related Entity of an Entity the stock of which is traded on an established securities market;

c) The NFFE is organized in a US Territory and all of the owners of the payee are bona fide residents of that US Territory;

d) The NFFE is a non-US government, a political subdivision of such government, a public body performing a function of such government, a government of a US Territory, an international organization, a non-US Central Bank of issue, or an Entity wholly owned by one or more of the foregoing;

e) Substantially all of the activities of the NFFE consist of holding (in whole or in part) the outstanding stock of, and providing financing and services to, one or more subsidiaries that engage in trades or businesses other than the business of a Financial Institution;

f) The NFFE is not yet operating a business and has no prior operating history, but is investing capital into assets with the intent to operate a business other than that of a Financial Institution; provided, that the NFFE shall not qualify for this exception after the date that is 24 months after the date of the initial organization of the NFFE;

g) The NFFE was not a Financial Institution in the past five years, and is in the process of liquidating its assets or is reorganizing with the intent to continue or recommence operations in a business other than that of a Financial Institution;

h) The NFFE primarily engages in financing and hedging transactions with or for Related Entities that are not Financial Institutions, and does not provide financing or hedging services to any Entity that is not a Related Entity, provided that the group of any such Related Entities is primarily engaged in a business other than that of a Financial Institution;

i) The NFFE is an ‘excepted NFFE’ as described in relevant US Treasury Regulations; or

j) The NFFE meets all of the following requirements:

a. It is established and maintained in its country of residence exclusively for religious, charitable, scientific, artistic, cultural, or educational purposes;

b. It is exempt from income tax in its country of residence;

c. It has no shareholders or members who have a proprietary or beneficial interest in its income or assets;

d. The applicable laws of the Entity’s country of residence or the Entity’s formation documents do not permit any income or assets of the Entity to be distributed to, or applied for the benefit of, a private person or non-charitable Entity other than pursuant to the conduct of the Entity’s charitable activities, or as payment of reasonable compensation for services rendered, or as payment representing the fair market value of property which the Entity has purchased; and

e. The applicable laws of the Entity’s country of residence or the Entity’s formation documents require that, upon the Entity’s liquidation or dissolution, all of its assets be distributed to a governmental Entity or other non-profit organization, or escheat to the government of the Entity’s country of residence or any political subdivision thereof. (US-Singapore IGA, Annex I, Section VI(B)(4) and draft IRAS e-Tax Guide Section 6.3)

vi. A ‘Passive NFFE’ means any NFFE that is not an (i) Active NFFE, or (ii) a withholding foreign partnership or withholding foreign trust pursuant to relevant US Treasury Regulations. (US-Singapore IGA, Annex I, Section VI(B)(3) and draft IRAS e-Tax Guide Section 6.2)

vii. The term ‘Controlling Persons’ means the natural person who exercises control over an entity. In the case of a trust, such term means the settlor, the trustees, the protector (if any), the beneficiaries or class of beneficiaries, and any other natural person exercising ultimate effective control over the trust. In the case of a legal arrangement other than a trust, such term means persons in equivalent or similar positions. The term ‘Controlling Persons’ shall be interpreted in a manner consistent with the Financial Action Task Force Recommendations. (US-Singapore IGA Article 1(hh) and IRAS e-Tax Guide Section 3)

You may download IRAS e-tax Guide and US-Singapore IGA referred to in notes from below links:

IRAS e-tax Guide: http://www.iras.gov.sg/irasHome/uploadedfiles/e-Tax_Guide/e-Tax%20Guide-Compliance%20Requirements%20of%20SG- US%20IGA%20on%20FATCA.pdf

US-Singapore IGA: https://www.iras.gov.sg/irashome/uploadedFiles/Quick_Links/Tax_treaties/FATCA-Singapore_IGA.pdfR

B/A

O/C

OR

P/1

510






Entity Details:




Address:______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________



Address:______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________





1

2

3













Page 9 of 19

Singapore




































































(a) Active NFFEv



(c) Passive NFFEvi






Notes:






b) Central Bank;

























B/A

O/C

OR

P/1

510






Entity Details:




Address:______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________



Address:______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________





1

2

3













Page 10 of 19

Singapore




































































(a) Active NFFEv



(c) Passive NFFEvi






Notes:






b) Central Bank;

























B/A

O/C

OR

P/1

510






Page 11 of 19

Singapore






















































RB

/AO

/CO

RP

/151

0






Page 12 of 19

Singapore






















































RB

/AO

/CO

RP

/151

0

INDEMNITY RELATING TO INSTRUCTIONS GIVEN BY FAX, TELEPHONE AND OTHER FORMS OF ELECTRONIC COMMUNICATIONS

Notwithstanding anything to the contrary contained in any other document/agreement, I/We, the undersigned (as duly authorised signatories), hereby request, agree, consent and authorise ICICI BANK LIMITED(the “Bank” or “you” or “your”), to act and rely on any instructions or communications for any purpose (including but not limited to the instructions/communications pertaining to the operation of all my/ our accounts or to any other services/ facilities or services that may be provided by you to me/ us from time to time) which may from time to time) whether they be or purport to be given by telephone, facsimile, untested telexes and faxes, telegraph, cable or any other form of electronic communication by us (including such instructions/ communications as may be or purported to be given by those authorised to operate my/ our account(s) with the Bank) (“Instructions”).

We understand and acknowledge that there are risks involved in sending the Instructions to you via telephone, facsimile, untested telexes and faxes, telegraph, cable or any other form of electronic communication and hereby agree that all risks shall be fully borne by me/ us and we assume full responsibility for the same, and the Bank will not be liable for any losses or damages or costs or expenses arising upon your acting, or your failure to act, wholly or in part in accordance with such Instructions.

In consideration of you agreeing, subject to the terms and conditions hereunder, to act upon the Instructions as aforesaid, I/ we hereby irrevocably agree and undertake:

a. that you shall be entitled to act or refuse to act as you see fit, without incurring any liability whatsoever to us or to any other person, upon any Instructions for any purpose which may from time to time be or be purported to be given by telephone, facsimile, untested telexes and faxes, telegraph, cable or any other form of electronic communication by us (including such Instructions as may be or be purported to be given by those authorised to operate my/ our account(s) with the Bank), even if such Instructions or communications are not followed up by written confirmation to you;

b. that you are not required to verify the identity of the person giving Instructions or make any independent investigation of the authority given to such person, or to verify the genuineness of any signature(s) which in your opinion appears to be that of any person authorised by me/ us to operate my/ our account(s) with you;

c. not to make any claim against you by reason of or on account of you having so acted or you having acted wrongly or mistakenly or of your failure to act wholly or in part in accordance with the Instructions;

d. that you shall be entitled (but not obliged) to keep records of our Instructions given or made by telephone, facsimile, untested telexes faxes, telegraph, cable or any other form of electronic communication in such form, physical or electronic, as you may deem fit, and your records shall be conclusive and binding on us. You shall be entitled to dispose of or destroy any such records at any time as determined by you in accordance with your standard procedures and policies;

e. that you shall be entitled to require any Instruction in any form to be authenticated by use of any password, identification code or test as may be specified by you from time to time and we shall ensure the secrecy and security of such password, code or test and we shall be solely responsible for any improper use of the same;

f. that, notwithstanding the above, you may, under circumstances determined by you in your discretion, require from us confirmation of any Instructions in such form as you may specify before acting on the same; and

g. We shall indemnify you and keep you indemnified from and against all claims, either by us or any other, actions, demands, liabilities, costs, charges, damages, losses, expenses and consequences of whatever nature (including legal fees on a full indemnity basis) which may be brought or preferred against you or that you may suffer, incur or sustain by reason of or on account of your having so acted whether wrongly or mistakenly or not, or of you failing to act wholly or in part in accordance with the Instructions and terms of this letter.

h. that this letter shall be governed and construed in accordance with the laws of Singapore and we hereby irrevocably submit to the non-exclusive jurisdiction of the courts of Singapore in the event of any dispute hereunder.






TERMS AND CONDITIONS

We, as the customer, hereby agree and confirm that we have received and read a copy of ICICI Bank Limited, Singapore Branch’s (the “Bank”) General Terms and Conditions Governing Account(s) and Facilities in relation to the account(s), services and / or facilities availed by me/ us from the Bank (“Terms and Conditions”). We hereby agree, undertake and confirm to be bound by the aforesaid Terms and Conditions, as may be amended from time to time, for the account(s), services and/ or facilities which we are now being opened and pursuant to our establishing our relationship with the Bank. In the event of any inconsistency between the provisions of this form and the Terms and Conditions, the provisions of this form shall prevail.

We understand that the our relationship and account(s) with the Bank will be opened and maintained on the basis of this statement/declaration made by us.

We further declare, confirm, and agree:

a) that all the particulars and information given in this application form are true, correct, complete and upto date in all respects and I/ we have not withheld any information;

b) that no petition, proceeding, suit or the like has been presented for our winding up or liquidation or analogous proceedings nor have our creditors entered into any such arrangement;

c) that we have not at any time defaulted under any loan taken by us from any other person. We further agree and confirm that any false/misleading information given by us, or suppression of any material fact hereunder will render our account liable for termination and further action.

We also hereby agree to indemnify the Bank and its successors or assigns, if any representation or declaration or statements made hereunder by us is incorrect, false or misleading in any of its particulars. We will deliver the full amount specified in this contract on the delivery date or within the period agreed with the Bank and the Bank may, at its discretion, set-off any undelivered balance for our account(s) at the rate applicable at the time of such set-off. In the event that we are unable to meet the engagement arising out of any other exchange contract or fail to supply or maintain applicable margin, if any, as required by the Bank, or suspend payment or become bankrupt or commit any act of bankruptcy or the Bank decides in its absolute discretion (where permitted, after consultation with us) that due to adverse movements in exchange rates we are unlikely to fulfil our obligations hereinabove, the Bank reserves the right to close out this contract by buying in for our account notwithstanding that the last day of settlement may not have arrived and any difference arising thereon shall be payable by us forthwith. This contract is not assignable without the Bank's prior written consent. The Bank shall be entitled to set-off or apply any monies due to us arising out of any dealings with us in the reduction or full satisfaction of any liability whether present or future of us to the Bank, notwithstanding that the monies due to us and our liability may not be of the same currency. In case of availing the service of submitting the instruction through fax, we shall provide a prior written fax indemnity in original and we shall also ensure that original of fax is received by the branch within three (3) working days of each fax instruction. These conditions are in addition to the provisions of the Terms and Conditions and may only be varied in writing and signed by mutual agreement of both parties.

We understand that the following conditions would additionally apply to the Call Deposit/Current Account: The Current Account/Call Deposit account shall at all times be maintained by us with credit balance and no overdraft facility will be available in connection with the same. There would be no interest paid on credit balances in the current account. The Current Account/Call Deposit account can only be opened in such currency and with such minimum average balance as the Bank may stipulate from time to time. The Current Account/Call Deposit account and amounts lying to the credit therein are non-transferable and no right, title or interest therein or any part thereof can be transferred or secured by us to or in favour of any person without the prior written consent of the Bank. Interest is calculated on the credit balance(s) maintained in the Call Deposit account at the end of each day at the rate as may be determined by the Bank from time to time in accordance with its standard procedures and policies. Interest so calculated shall be credited to the Call Deposit on a monthly basis within three (3) business days after the end of each calendar month. The Bank reserves the right to impose service charges on accounts and the services in connection therewith as may be determined by the Bank in accordance with its standard procedures and policies, including without limitation any charges which may be permitted or suggested pursuant to the rules of any regulatory body or organization of which the Bank is a member. The charges will be levied at transaction level and shall be grossed up for applicable tax or statutory levy, if any. For the avoidance of doubt, the balances lying to the credit of our Current Account/Call Deposit account shall also be subject to the provisions of Section I, Clause 8 (Banker's Lien and Right of Set Off) of the Terms and Conditions. Minimum average balance term deposit for Current Account/Call Deposit shall be allowed to be broken, withdrawn or utilised only after closure of Current Account/Call Deposit account. The Bank will not be responsible for not acting on incomplete Current Account/Call Deposit instructions. An instruction will not be considered complete unless it has clearly specified currency and amount, beneficiary details, beneficiary bank details and beneficiary's bank correspondent bank details (including address, SWIFT code etc.) etc.

I. Deposit Insurance Scheme

Singapore dollar deposits of non-bank depositors are insured by the Singapore Deposit Insurance Corporation, for up to S$50,000 in aggregate per depositor per Scheme member by law. Foreign currency deposits, dual currency investments, structured deposits and other investment products are not insured.

II. Declaration of Non-evasion of tax and pertaining to Sanctions

To,

ICICI Bank Limited Singapore Branch, 9 Raffles Place, #50-01 Republic Plaza Singapore – 048619 (“ICICI Bank”).

By signing this application form, I/We, in addition to accepting the Terms and Conditions (as defined above), hereby further affirm, agree confirm and undertake that I/We have read, understood and agree to abide and be bound by the Terms and Conditions (GTC) (including but not limited to Clauses 41 (OFAC and other sanctions) and Clause 42 (Non-evasion of tax)) of ICICI Bank, as made available on ICICI Bank’s website (www.icicibank.com.sg) and as amended and updated from time to time

Page 13 of 19

Singapore


III. Declaration relating to Tax Compliance:

1. I/We confirm that:

i. I/We are aware of Singapore’s commitment to safeguard its financial system from being used to harbour or launder tax evasion monies or proceeds from serious tax offences

ii. I/We have not committed or been convicted of any serious tax crimes.

iii. I/We agree to hold harmless, release and agree to indemnify ICICI Bank in the event of non-compliance with or breach of the aforementioned confirmations.

iv. I/We understand and agree that I/We remain fully responsible for our own tax affairs and ensure that both I/we and my/our accounts maintained with ICICI Bank are in compliance with the tax laws of the relevant jurisdiction within which I/we reside, are domiciled in or are tax residents of;

v. I/We acknowledge and agree that I/we remain fully responsible for taking independent advice from a tax expert in the jurisdiction of my tax residence or any other similarly qualified adviser or person, and acknowledge that ICICI Bank shall neither be responsible for nor provide any tax advice to me/us in this regard.





















































RB

/AO

/CO

RP

/151

0






























To,





























































Page 14 of 19

Singapore



RB

/AO

/CO

RP

/151

0






























To,










For and on behalf of_______________________________________________________________________________________(the “Company”)

Authorized Signatory 1 Authorized Signatory 2

Signature Signature

Name: Name:

Designation: Designation:

Date: Date:

Place: Place:

*Please affix stamp/Seal of company/Establishment

We confirm that we have read, understood and agree to all the declarations, undertakings, confirmations, affirmations and information provided above namely Shareholding Undertaking and Declaration, FATCA Certification, Personal Data Notice & Consent, Indemnity Relating to Instructions Given by Fax, Telephone and other Forms of Electronic Communications and Terms and Conditions (and the declarations thereunder) and our signature hereunder signifies my consent and agreement to be bound by all of the aforementioned declarations, undertakings, confirmations, affirmations and information.




















































Page 15 of 19

Singapore



( D D M M Y Y Y Y ) ( D D M M Y Y Y Y )

RB

/AO

/CO

RP

/151

0

Customer Type Required Documents

Sole proprietorship • Photocopy of all passports / NRICs (both sides) of all working directors and authorised signatories.

• Original / Certified True Copy of Board of Directors’ resolution to (i) establish banking relationship and open account; and (ii) authorise all persons to act on behalf of company in establishing and conducting business relations with ICICI Bank Limited.

• Certified True Copy of list of all shareholders and directors.

• Records in an independent company registry or evidence of business registration such as Certified True Copy of Certificate of Incorporation or other documents evidencing incorporation.

• Structure of the sole proprietor's business (where applicable)

Partnerships and unincorporated bodies • Photocopy of all passports / NRICs (both sides) of all working partners and authorised signatories.

• Original / Certified True Copy of Partners' / Customers' Decision Making Body's resolution to establish banking relationship and open account; and authorise all persons to act on behalf of partnership in establishing and conducting business relations with ICICI Bank Limited.

• Certified True Copy of Certificate of Registration / Establishment or other documents evidencing registration / establishment.

• Partnership deed or Certified True Copy of list of all partners.

• Membership with relevant professional body

• Ownership and control structure

Companies • Photocopy of all passports / NRICs (both sides) of all working directors and authorised signatories.




• Certificate of incumbency, certificate of good standing, share register, as appropriate

• Memorandum and Articles of Association


Public sector bodies, government, state- • Photocopy of all passports / NRICs (both sides)owned companies and supranationals of all working directors and authorised signatories.

(other than sovereign wealth funds) • Original / Certified True Copy of Board of Directors’ resolution to (i) establish banking relationship and open account; and (ii) authorise all persons to act on behalf of company in establishing and conducting business relations with ICICI Bank Limited.

• Name of the home state authority and nature of its relationship with its home state authority


Clubs, Societies and Charities • Original / Certified True Copy of Board of Directors’ resolution to (i) establish banking relationship and open account; and (ii) authorise all persons to act on behalf of company in establishing and conducting business relations with ICICI Bank Limited.

• Constitutional document

• Certificate of registration

• Records in a relevant and independent registry in the country of establishment

• Names of all trustees (or equivalent)


Trust and Other Similar Arrangements • Photocopy of all passports / NRICs (both sides) of all settlors, trustees, authorised(e.g. Foundations, Fiducie, signatories and named beneficiaries.

Treuhand and Fideicomiso) • Original / Certified True Copy of trustees' resolution to establish banking relationship and open account ; and (ii) authorise all persons to act on behalf of trust in establishing and conducting business relations with ICICI Bank Limited.

• Original / Certified True Copy of Trust Deed / Probate of Will creating Trust Subsidiary Deed evidencing appointment of current trustees.

• Certified True Copy of list of all trustees and beneficial owners.

• Records in a relevant and independent registry in the country or jurisdiction of constitution

DOCUMENTS TO BE SUBMITTED WITH RELATIONSHIP OPENING FORM

Page 16 of 19

Singapore



RB

/AO

/CO

RP

/151

0

Customer Type Required Documents

Sole proprietorship • Photocopy of all passports / NRICs (both sides) of all working directors and authorised signatories.




• Structure of the sole proprietor's business (where applicable)

Partnerships and unincorporated bodies • Photocopy of all passports / NRICs (both sides) of all working partners and authorised signatories.

• Original / Certified True Copy of Partners' / Customers' Decision Making Body's resolution to establish banking relationship and open account; and authorise all persons to act on behalf of partnership in establishing and conducting business relations with ICICI Bank Limited.

• Certified True Copy of Certificate of Registration / Establishment or other documents evidencing registration / establishment.

• Partnership deed or Certified True Copy of list of all partners.

• Membership with relevant professional body


Companies • Photocopy of all passports / NRICs (both sides) of all working directors and authorised signatories.




• Certificate of incumbency, certificate of good standing, share register, as appropriate

• Memorandum and Articles of Association


Public sector bodies, government, state- • Photocopy of all passports / NRICs (both sides)owned companies and supranationals of all working directors and authorised signatories.

(other than sovereign wealth funds) • Original / Certified True Copy of Board of Directors’ resolution to (i) establish banking relationship and open account; and (ii) authorise all persons to act on behalf of company in establishing and conducting business relations with ICICI Bank Limited.

• Name of the home state authority and nature of its relationship with its home state authority


Clubs, Societies and Charities • Original / Certified True Copy of Board of Directors’ resolution to (i) establish banking relationship and open account; and (ii) authorise all persons to act on behalf of company in establishing and conducting business relations with ICICI Bank Limited.

• Constitutional document

• Certificate of registration

• Records in a relevant and independent registry in the country of establishment

• Names of all trustees (or equivalent)


Trust and Other Similar Arrangements • Photocopy of all passports / NRICs (both sides) of all settlors, trustees, authorised(e.g. Foundations, Fiducie, signatories and named beneficiaries.

Treuhand and Fideicomiso) • Original / Certified True Copy of trustees' resolution to establish banking relationship and open account ; and (ii) authorise all persons to act on behalf of trust in establishing and conducting business relations with ICICI Bank Limited.

• Original / Certified True Copy of Trust Deed / Probate of Will creating Trust Subsidiary Deed evidencing appointment of current trustees.

• Certified True Copy of list of all trustees and beneficial owners.

• Records in a relevant and independent registry in the country or jurisdiction of constitution

Checked and Verified by RM/Bank Official To be filled by back - office team. Affix rubber stamp and sign in the box below

Sign: Document Scrutinizer Finacle Checker

Name:

Employee ID:

RM Code: Finacle Maker Approver

Date:

I hereby confirm that the customer has signed For currency conversions only (please attach the Fx Online deal ticket print out).in my presence Strike out if not applicable.

Deal Ref. No.:

Date:

Page 17 of 19

Singapore



BNK Banks

CBK Central Banks

BK MDB Multilateral Development Banks

HO Head Office

BR ICICI Branches

SB ICICI Subsidiaries

OMA Official Monetary Authorities

IO International Organisations-IO

27 NBFI – Others-(27 Financial Institution)

FI FICH NBFI - Clearing Houses (FICH - Financial Inst. Clearing House)

CSC Corporates - Securities Companies-CSC

FISGX NBFI - member companies of SGX (FISGX - Financial Inst. SGX Member Co)

SB Subsidiary SB (ICICI Subsidiaries)

CPVTL Corporates - Private Listed

CPVTU Corporates - Private Non Listed (remain as 16-Private Sector)

C 25 Singapore statutory authorities are statutory boards (25-Singapore Statutory Authorities)

CPUBT Corporates - Public Non Listed (26- Singapore Govt /Controlled Cos)

CPUBV Corporates - Public Listed (15 - Public Sector)

Customer Type (CT) Please tick the type applicable

Money not kept in client account or

trust account.

Money kept in trust account?

Money kept in client account?

Constitution Code (CC)

Code Description

21 Joint Sector (PUB and PVT) (21-Joint Sector (PUB & PVT)

MNYCH Money Changers-MNYCH

RA Remittance Agents-RA


GO CAS Casino-CAS

PB Pawn Brokers-PB


GOV Governments- (11 Central Government Sovereign)

13 Quasi Government Bodies (13-Quasi-Govt Bodies –Sovereign)

17 Partnership (17- Partnership)


PF RA Remittance Agents-RA

PB Pawnbrokers-PB

CAS Casinos-CAS

R 18 18-Individuals

PB Pawnbrokers-PB

CAS Casinos-CAS

SP MNYCH Money Changers-MNYCH


SP Sole Proprietor -SP

NPO Non Profit Organisations-NPO

RI Religious Institutions-RI

TU Trade Unions-TU

SO CA Consumer Associations-CA

14 Co-operative Sector (14 -Co-Operative Sector)

23 Societies

Assoc Associations

CLUB CLUBS-Clubs

T 24 Trusts (24-Trusts)





P


CPVTU Corporates - Private Non Listed (remain as 16-Private Sector)R

B/A

O/C

OR

P/1

510

Page 18 of 19

Singapore



BNK Banks

CBK Central Banks

BK MDB Multilateral Development Banks

HO Head Office

BR ICICI Branches

SB ICICI Subsidiaries

OMA Official Monetary Authorities

IO International Organisations-IO

27 NBFI – Others-(27 Financial Institution)

FI FICH NBFI - Clearing Houses (FICH - Financial Inst. Clearing House)


FISGX NBFI - member companies of SGX (FISGX - Financial Inst. SGX Member Co)




C 25 Singapore statutory authorities are statutory boards (25-Singapore Statutory Authorities)



Customer Type (CT) Please tick the type applicable

Money not kept in client account or

trust account.

Money kept in trust account?

Money kept in client account?

Constitution Code (CC)

Code Description

21 Joint Sector (PUB and PVT) (21-Joint Sector (PUB & PVT)




GO CAS Casino-CAS

PB Pawn Brokers-PB


GOV Governments- (11 Central Government Sovereign)

13 Quasi Government Bodies (13-Quasi-Govt Bodies –Sovereign)

17 Partnership (17- Partnership)


PF RA Remittance Agents-RA

PB Pawnbrokers-PB

CAS Casinos-CAS

R 18 18-Individuals

PB Pawnbrokers-PB

CAS Casinos-CAS

SP MNYCH Money Changers-MNYCH


SP Sole Proprietor -SP

NPO Non Profit Organisations-NPO

RI Religious Institutions-RI

TU Trade Unions-TU

SO CA Consumer Associations-CA

14 Co-operative Sector (14 -Co-Operative Sector)

23 Societies

Assoc Associations

CLUB CLUBS-Clubs

T 24 Trusts (24-Trusts)





P



CommercialActivitiesComapaniesnot underP&C

RB

/AO

/CO

RP

/151

0

LIST OF ACCOUNTS OF ICICI BANK LIMITED SINGAPORE BRANCH

You can remit money to the following accounts depending on the remitting currency. Please mention the following details to your remitting bank.

US Dollar AccountBank of New YorkNew YorkAccount No.: 890-0518-480SWIFT: IRVTUS3NCHIPS UID No.: 411804Fed Routing No.: 021000018

Singapore Dollar AccountUnited Overseas BankSingaporeAccount No.: 101-399-1818SWIFT: UOVBSGSG

British Pound AccountNational Westminster Bank PlcLondonAccount No.: 4400010000232Sort Code: 600004SWIFT: NWBKGB2L

Euro AccountABN Amro FrankfurtAccount No.: DE82502304005602826009SWIFT: ABNADEFFFRA

Japanese Yen AccountBank of Tokyo - Mitsubishi UFJ LtdTokyo, JapanAccount No. : 653-0464449

Hong Kong Dollar AccountHang Seng BankHong KongAccount No.: 250-012580-001SWIFT: HASEHKHH

Australian Dollar AccountNational Australian BankMelbourne, VictoriaAccount No.: 1803-080985-500SWIFT: NATAAU33033

Swiss Franc AccountUnion Bank of SwitzerlandZurichAccount No.: 0230-92323.05JSWIFT: UBSWCHZH80H

Canadian Dollar AccountToronto Dominion BankTorontoAccount No.: 0360 - 01 -2295724SWIFT: TDOMCATTTOR

Page 19 of 19

Singapore



RB

/AO

/CO

RP

/151

0