12
G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UW ..................................................... kvLv| ZvwiLt Rbve, wi‡jkbwkc g¨v‡bRvi †m±i †KvW t GmweGm-2 wmGgGmGgB †KvW Avwg/Avgiv Avcbvi kvLvq GKwU wnmve †Lvjvi Rb¨ Av‡e`b KiwQ| Avgvi/Avgv‡`i, cÖwZôv‡bi Ges wnmv‡ei we¯ÍvwiZ Z_¨ wb‡gœ cÖ`vb KiwQ t G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UW wnmve †Lvjvi Av‡e`b dig kixqvn& wfwËK Bmjvgx e¨vsK ..........................................................................kvLv A-e¨w³K wnmve Export Import Bank of Bangladesh Limited 1. wnmv‡ei bvg (evsjvq) t .................................................................................................................. In English (BLOCK LETTER) t .................................................................................................................. 2. cÖwZôv‡bi aib [wUK () wPý w`b] t GKK gvwjKvbv Askx`vix †hŠ_ D‡`¨vM cÖvB‡fU wjt †Kv¤úvwb cvewjK wjt †Kv¤úvwb miKvix Avav-miKvix/¯^vqËkvwmZ Uªv÷ GbwRI/GbwcI K¬ve/†mvmvBwU wkÿv cÖwZôvb agx©q cÖwZôvb Ab¨vb¨ (wbw`©ófv‡e D‡j ø L Ki‡Z n‡e) ............................................................................. 3. wnmv‡ei cÖK…wZ [wUK () wPý w`b] t gy`vivev mÂqx AvgvbZ Avj-Iqvw`qvn& PjwZ AvgvbZ gy`vivev we‡kl †bvwUk AvgvbZ Gdwm Ab¨vb¨.............................................. 4. gy`ªv [wUK () wPý w`b] t UvKv Wjvi BD‡iv cvDÛ Ab¨vb¨.................................................. 5. wnmve †Lvjvi D‡Ïk¨ t 6. cÖwZôv‡bi wVKvbv t (K) wbeÜbK…Z wVKvbv t .................................................................................................................. (L) e¨emv¯’j/Awd‡mi wVKvbv t evsjvq t .................................................................................................................. In English t .................................................................................................................. (M) KviLvbv/wkí cÖwZôv‡bi wVKvbv t .................................................................................................................. 7. †UªW jvB‡mÝ b¤^i t ................................................................ ZvwiL t Bmy¨Kvix KZ…©cÿ t .................................................................................................................. 8. wbeÜb b¤^i t ................................................................ ZvwiL t 9. wbeÜb KZ…©cÿ I †`k t .................................................................................................................. (†`kx/we‡`kx Dfq ai‡Yi Rb¨) 10. B-wUAvBGb (E-TIN) b¤^i t .................................................................................................................. 11. f¨vU †iwRt b¤^i/BIN (hw` _v‡K) t .................................................................................................................. 12. e¨emv msμvšÍ Z_¨ t (K) e¨emvi aiY t †UªwWs †mev Drcv`b (L) cY¨ ev †mevi aiY t .................................................................................................................. (M) evwl©K Uvb©Ifvi t .................................................................................................................. (N) cÖwZôv‡bi wbU m¤úwË t .................................................................................................................. (O) Rwg Ges KviLvbv feb e¨wZ‡i‡K ¯’vqx m¤ú‡`i g~j¨ cÖwZ¯’vcb e¨qmn t....................................................................... (P) cÖwZôv‡b wb‡qvwRZ kÖwgK/Kgx©i msL¨v t cyiæl t........................... gwnjv t........................... †gvU t.......................... DDMMYYYY DDMMYYYY DDMMYYYY GB-116 Export Import Bank of Bangladesh Limited www.eximbankbd.com wnmve b¤^i t BDwbK Kv÷gvi AvBwW †KvW t

Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

  • Upload
    others

  • View
    17

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UW..................................................... kvLv|

ZvwiLt

Rbve,

wi‡jkbwkc g¨v‡bRvi†m±i †KvW t

GmweGm-2wmGgGmGgB †KvW

Avwg/Avgiv Avcbvi kvLvq GKwU wnmve †Lvjvi Rb¨ Av‡e`b KiwQ| Avgvi/Avgv‡`i, cÖwZôv‡bi Ges wnmv‡ei we¯ÍvwiZ Z_¨ wb‡gœ cÖ`vb KiwQ t

G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UW

wnmve †Lvjvi Av‡e`b dig

kixqvn& wfwËK Bmjvgx e¨vsK..........................................................................kvLv

A-e¨w³K wnmve

Export Import Bank of Bangladesh Limited

1. wnmv‡ei bvg (evsjvq) t ..................................................................................................................

In English (BLOCK LETTER) t ..................................................................................................................

2. cÖwZôv‡bi aib [wUK (√) wPý w`b] t GKK gvwjKvbv Askx`vix †hŠ_ D‡`¨vM cÖvB‡fU wjt †Kv¤úvwb cvewjK wjt †Kv¤úvwb miKvix Avav-miKvix/¯^vqËkvwmZ Uªv÷ GbwRI/GbwcI K¬ve/†mvmvBwU wkÿv cÖwZôvb agx©q cÖwZôvb Ab¨vb¨ (wbw`©ófv‡e D‡j øL Ki‡Z n‡e) .............................................................................3. wnmv‡ei cÖK…wZ [wUK (√) wPý w`b] t gy`vivev mÂqx AvgvbZ Avj-Iqvw`qvn& PjwZ AvgvbZ gy`vivev we‡kl †bvwUk AvgvbZ Gdwm Ab¨vb¨..............................................4. gy`ªv [wUK (√) wPý w`b] t UvKv Wjvi BD‡iv cvDÛ Ab¨vb¨..................................................5. wnmve †Lvjvi D‡Ïk¨ t 6. cÖwZôv‡bi wVKvbv t (K) wbeÜbK…Z wVKvbv t ..................................................................................................................

(L) e¨emv¯’j/Awd‡mi wVKvbv t evsjvq t ..................................................................................................................

In English t ..................................................................................................................

(M) KviLvbv/wkí cÖwZôv‡bi wVKvbv t ..................................................................................................................

7. †UªW jvB‡mÝ b¤^i t ................................................................ ZvwiL t Bmy¨Kvix KZ…©cÿ t ..................................................................................................................

8. wbeÜb b¤^i t ................................................................ ZvwiL t9. wbeÜb KZ…©cÿ I †`k t ..................................................................................................................

(†`kx/we‡`kx Dfq ai‡Yi Rb¨)10. B-wUAvBGb (E-TIN) b¤^i t ..................................................................................................................

11. f¨vU †iwRt b¤^i/BIN (hw` _v‡K) t ..................................................................................................................

12. e¨emv msµvšÍ Z_¨ t (K) e¨emvi aiY t †UªwWs †mev Drcv`b (L) cY¨ ev †mevi aiY t ..................................................................................................................

(M) evwl©K Uvb©Ifvi t ..................................................................................................................

(N) cÖwZôv‡bi wbU m¤úwË t ..................................................................................................................

(O) Rwg Ges KviLvbv feb e¨wZ‡i‡K ¯’vqx m¤ú‡`i g~j¨ cÖwZ¯’vcb e¨qmn t.......................................................................

(P) cÖwZôv‡b wb‡qvwRZ kÖwgK/Kgx©i msL¨v t cyiæl t........................... gwnjv t........................... †gvU t..........................

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

GB-116

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

wnmve b¤^i t

BDwbK Kv÷gvi AvBwW †KvW t

Page 2: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

(Q) D‡`¨v³vi aiY t cyiæl gwnjv gvwjKvbvi nvi t cyiæl t % gwnjv t %

hw` †Kvb bvix e¨w³ gvwjKvbvaxb ev †cÖvcÖvBUix cÖwZôv‡bi †ÿ‡Î ¯^Ë¡vwaKvix ev †cÖvcÖvBUi nb wKsev ÔAskx`vix cÖwZôvbÕ ev ÔR‡q›U óK †Kv¤úvbx‡Z wbewÜZ cÖvB‡fU †Kv¤úvbxi cwiPvjK ev †kqvi †nvìviM‡Yi g‡a¨Õ Ab~¨b 51% (kZKiv GKvbœ fvM) As‡ki gvwjK nb Zvn‡j wZwb bvix D‡`¨v³v wn‡m‡e cwiMwYZ n‡eb Ges H D‡`¨vMwU bvix D‡`¨vM wn‡m‡e we‡ewPZ n‡e| D‡j øL¨, †Kvb cÖwZôv‡b †Kvb bvix D‡`¨v³vi gvwjKvbvi GKK ev GKvwaK bvix Askx`vi ev †kqviavixi Ask kZKiv 51 fvM ev Zvi AwaK n‡j H cÖwZôvb‡K bvix D‡`¨v³v cÖwZôvb wn‡m‡e MY¨ Ki‡Z n‡e| [GmGgBGmwWwc mvKy©jvi b¤^i-1, ZvwiL t 07 Rvbyqvix, 2016]

(R) Ab¨vb¨ Z_¨ (cÖ‡hvR¨ †ÿ‡Î) t .......................................................................................................................

13. MÖvn‡Ki Ab¨vb¨ e¨vsK wnmv‡ei Z_¨ (hw` _v‡K) t

14. cwiPq`vbKvixi Z_¨ t (miKvix/Avav miKvix/¯^vqËkvwmZ/÷K gv‡K©‡U wj‡÷W †Kv¤úvwb e¨ZxZ Ab¨vb¨ cÖwZôv‡bi wnmve †Lvjvi †ÿ‡Î cÖ‡hvR¨|)

(K) bvg t ....................................................................................................................

(L) wnmv‡ei bvg t ....................................................................................................................

(M) wnmve b¤^i t ............................................. kvLvi bvg t...................................................

(N) MÖvn‡Ki mv‡_ cwiwPwZi m~Î/m¤úK© t..................................................................................................................

(O) †hvMv‡hvM gva¨g t †dvb b¤^i t .................................. †gvevBj b¤^i t ...............................................

(P) cwiPq`vbKvixi ¯^vÿi I ZvwiL t .........................................................................

cwiPq`vbKvixi Z_¨ cÖZ¨qbKvix Kg©KZ©vi bvg I ¯^vÿi (mxj I ZvwiLmn)

15. cÖv_wgK Rgvi cwigvY t ...................................(K_vq)......................................................................

16. A‡_©i Drm/Drmmg~n (mywbw`©ó I we¯ÍvwiZ D‡j øL Ki‡Z n‡e) t......................................................................................

17. wnmve cwiPvjbvKvix msµvšÍ †NvlYv I ¯^v¶i tAvwg/Avgiv GB g‡g© wbðqZv cÖ`vb KiwQ †h, Avwg/Avgiv wnmve msµvšÍ hveZxq wbqgvejx/kZ©vejx c‡owQ Ges D³ wbqgvejx/kZ©vejx †g‡b Pj‡Z eva¨ _vKe| Avwg/Avgiv mÁv‡b †NvlYv KiwQ †h, Dc‡ivwj øwLZ Z_¨vw` mZ¨| Avwg/Avgiv cÖ`Ë Z‡_¨i AwZwi³ mswk øó †h †Kv‡bv cÖ‡qvRbxq Z_¨/`wjjvw` e¨vs‡Ki Pvwn`v †gvZv‡eK mieivn Kie|

Av‡e`bKvix/Av‡e`bKvixM‡Yi ¯^vÿi, bvg, c`ex I ZvwiL

1g Av‡e`bKvixi ¯^vÿi 2q Av‡e`bKvixi ¯^vÿi 3q Av‡e`bKvixi ¯^vÿi 4_© Av‡e`bKvixi ¯^vÿi

ïaygvÎ e¨vs‡Ki e¨env‡ii Rb¨ gšÍe¨ t.................................................................................................................................................................

wnmve †Lvjvi mswk øó Kg©KZ©v(bvghy³ mxjmn ¯^v¶i I ZvwiL)

Acv‡ikb g¨v‡bRvi(bvghy³ mxjmn ¯^v¶i I ZvwiL)

Aby‡gv`bKvix Kg©KZ©v (wi‡jkbwkc g¨v‡bRvi)(bvghy³ mxjmn ¯^v¶i I ZvwiL)

e¨vs‡Ki bvg kvLv

(K)........................................

(L)........................................

(M)........................................

(K)........................................

(L)........................................

(M)........................................

AvgvbZ wnmve wewb‡qvM wnmve Ab¨vb¨AvgvbZ wnmve wewb‡qvM wnmve Ab¨vb¨AvgvbZ wnmve wewb‡qvM wnmve Ab¨vb¨

cwiPvwjZ wnmv‡ei cÖK…wZ [ wUK (√) wPý w`b ]

D D M M Y Y Y Y

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

Page 3: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

(wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi GB Ask Avjv`vfv‡e c~iYc~e©K wnmv‡ei g~j As‡ki mv‡_ mshy³ Ki‡Z n‡e )

G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UWkixqvn& wfwËK Bmjvgx e¨vsK

............................................................................kvLvwnmve †Lvjvi dig t e¨w³ msµvšÍ Z_¨vejx

Export Import Bank of Bangladesh Limited

e¨w³i Av‡jvKwPÎ

ZvwiLt

wnmv‡ei bvg (evsjvq) t .......................................................................................................................1.

In English (BLOCK LETTER) t .......................................................................................................................

wcZvi bvg (evsjvq) t .......................................................................................................................In English (BLOCK LETTER) t .......................................................................................................................

2. MÖvnK/†ewbwdwmqvj Ibvi/wnmve cwiPvjbvKvixi bvg t .......................................................................................

3. wnmv‡ei mv‡_ m¤úK© t [cÖ‡hvR¨ †ÿ‡Î wUK ( ) wPý w`b]

cÖ_g Av‡e`bKvix wØZxq Av‡e`bKvix Z…Zxq Av‡e`bKvix cwiPvjKAskx`vi GKK ¯^Z¡vwaKvix wnmveavix bvevjK AwffveK GUwb© †nvìviwnmve cwiPvjbvKvix Uªvw÷ †ewbwdwmqvj Ibvi Ab¨vb¨............................

gvZvi bvg (evsjvq) t .......................................................................................................................In English (BLOCK LETTER) t .......................................................................................................................

¯^vgx/¯¿xi bvg (evsjvq) t .......................................................................................................................In English (BLOCK LETTER) t .......................................................................................................................

ˆeevwnK Ae¯’v t weevwnZ AweevwnZ weaev/wecZœxK Ab¨vb¨.............................................

8. RvZxqZv t

9. †iwm‡WÝ ÷¨vUvm [wUK ( ) wPý w`b] t

10. Rb¥ ZvwiL t 12. ag© [wUK ( ) wPý w`b] t13. wj½ [wUK ( ) wPý w`b] t

GKK GKvwaKRvZxqZv-1t ......................................... 2t....................................... (hw` _v‡K)

(we‡`kx bvMwiK n‡j wfmvmn cvm‡cv‡U©i Kwc Avewk¨Kfv‡e mshy³ Ki‡Z n‡e)

†iwm‡W›U bb-†iwm‡W›U(cÖ‡qvRbxq †ÿ‡Î e¨vsK KZ©„K MvBWjvBÝ di d‡ib G·‡PÄ Uªvb‡RKkbm&& Gi wb‡`©kbv AbymiY Ki‡Z n‡e)

4.

5.

6.7.

†ckv (c`exmn we¯ÍvwiZ) t ........................................................................................................................

11. Rb¥¯’vb (†`kmn) t.................................................

14.15. gvwmK Avq (e¨w³K wnmv‡ei †ÿ‡Î) t .................................................................................................................

(15 b¤^i µwg‡Ki †ÿ‡Î we¯ÍvwiZ D‡j øLc~e©K cÖ‡hvR¨ †ÿ‡Î e¨vs‡Ki Pvwn`v †gvZv‡eK `wjjvw` cÖ`vb Ki‡Z n‡e|)16. cwiwPwZcÎ t (K) RvZxq cwiPqcÎ b¤^i t ............................................................................................................................. (L) cvm‡cvU© b¤^i t ....................................................................................... †gqv` t (M) Rb¥ wbeÜb mb`cÎ b¤^i t ......................................................................................................................... (N) B-wUAvBGb (E-TIN) b¤^i t .................................................................................................................... (O) WªvBwfs jvB‡mÝ b¤^it ................................................................................ †gqv` t (P) Ab¨vb¨ (wbw`©ófv‡e D‡j øL Ki‡Z n‡e)t ......................................................................................................

Bmjvg wn›`y Lªxóvb †eŠ× Ab¨vb¨ ....................cyiæl gwnjv Z…Zxq wj½

[K ‡_‡K M µwg‡K ewY©Z `wjjvw` n‡Z Avewk¨Kfv‡e †h †Kvb GKwU `wjj cÖ`vb Ki‡Z n‡e| Z‡e Rb¥ wbeÜb mb` cÖ`vbc~e©K wnmve †Lvjvi †ÿ‡Î Rb¥ wbeÜb mb`c‡Îi AwZwi³ MÖvnK/wnmve cwiPvjbvKvixi Av‡jvKwPÎmn Ab¨ †h †Kvb cwiwPwZcÎ cÖ`vb Ki‡Z n‡e| bb-†iwm‡W›U Ges we‡`kx bvMwiK‡`i †¶‡Î mswk øó wfmvmn cvm‡cv‡U©i Kwc Avewk¨Kfv‡e cÖ`vb Ki‡Z n‡e| Av‡jvKwPÎmn cwiwPwZcÎ bv _vK‡j †m wel‡q e¨vs‡Ki mš‘wó mv‡c‡ÿ mgv‡Ri MY¨gvb¨ e¨w³1 KZ…©K cÖ`Ë cwiP‡qi cÖZ¨qbcÎ cÖ`vb Ki‡Z n‡e| D³ cwiwPwZcÎ ev cÖZ¨qbcÎ MÖvnK/wnmve cwiPvjbvKvixi Av‡jvKwPÎmn (Av‡jvKwP‡Îi Dc‡ii c„‡ô mZ¨vwqZmn) n‡Z n‡e| GQvov, cÖ‡Z¨K e¨vsK h_vh_fv‡e MÖvn‡Ki cwiwPwZi wel‡q wbwðZ nIqvi j‡ÿ¨ e¨vs‡Ki mš‘wó mv‡c‡ÿ Dc‡ii N n‡Z P µwg‡K ewY©Z `wjjvw`mn AwZwi³ Av‡iv †Kvb `wjjvw` Ges GB di‡g Dwj øwLZ Z_¨vw`i AwZwi³ Z_¨ msMÖn Ki‡Z cvi‡e|]

wnmve b¤^i t

BDwbK Kv÷gvi AvBwW †KvW t

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

Page 4: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

17. eZ©gvb wVKvbv (Avevm¯’j) evsjvq t .......................................................................................................................

In English t .......................................................................................................................

18. ¯’vqx wVKvbv t .......................................................................................................................

19. †ckvMZ wVKvbv t .......................................................................................................................(MÖvnK/wnmve cwiPvjbvKvixi Kgc‡ÿ 1wU wVKvbvi Proof of Address Gi ¯^c‡ÿ Valid Documents cÖ`vb Ki‡Z n‡e)

1. ............................................................................................

2. ............................................................................................

21. Riæix cÖ‡qvR‡b †hvMv‡hv‡Mi Rb¨ g‡bvbxZ e¨w³ t

22. †µwWU KvW© msµvšÍ Z_¨ (hw` _v‡K) tBmy¨Kvix cÖwZôvb/e¨vsK (GKvwaK n‡j mKj e¨vs‡Ki bvg) t

MY¨gvb¨ e¨w³ ej‡Z msm` m`m¨, wmwU K‡c©v‡ik‡bi †gqi, †WcywU †gqi I KvDwÝjiMY, RvZxq †eZb †¯‹‡ji 9g I Z`~aŸ© †MÖ‡Wi †M‡R‡UW Kg©KZ©v, cvewjKwek¦we`¨vj‡qi wkÿK, Dc‡Rjv cwil‡`i †Pqvig¨vb I fvBm †Pqvig¨vb, BDwbqb cwil‡`i †Pqvig¨vb, †cŠimfvi †gqi I †cŠi KvDwÝjiMY, †emiKvixwek¦we`¨vj‡qi Aa¨vcK, †emiKvix K‡j‡Ri Aa¨ÿ, †emiKvix D”P we`¨vj‡qi cÖavb wkÿK, RvZxq ˆ`wbK cwÎKvi m¤úv`K, †bvUvwi cvewjK,AvavmiKvix/¯^vqËkvwmZ/ivóªvqZ¡ ms¯’vi RvZxq †eZb †¯‹‡ji 7g ev Z`~aŸ© †MÖ‡Wi Kg©KZ©vMY Ges evsjv‡`k e¨vs‡Ki RvZxq †eZb †¯‹‡ji 9g I Z`~aŸ© †MÖ‡WiKg©KZ©vMY‡K eySv‡e|

bvgt ...........................................................................................................................................................

wVKvbvt .......................................................................................................................................................

wnmveavix/wnmve cwiPvjbvKvixi mv‡_ m¤úK© t ..................... †gvevBj b¤^i t....................... B-†gBj t ..........................

(K) ¯’vbxq (Local Card) t

(L) AvšÍR©vwZK (International Card) t

23. AvgvbZKvix hw` bb-†iwm‡W›U evsjv‡`kx nq (AbyMÖnc~e©K wb‡gœi Z_¨mg~n c~iY Kiæb) t

cvm‡cvU© b¤^i t......................... Bmy¨i ZvwiL t Bmy¨Kvix KZ…©cÿ t ......................................

Bmy¨i ¯’vb t .....................wfmvi ZvwiL (cÖ‡hvR¨ †¶‡Î)t wfmvi ˆeaZvi †gqv`t

wfmv Bmy¨Kvix KZ…©c¶ t .............................. †ckv t ...................... we‡`‡ki wVKvbv t .............................................24. evsjv‡`k `~Zvevm KZ…©K Aby‡gv`b (ïaygvÎ hviv we‡`k †_‡K wnmve Lyj‡Z AvMÖnx) t

(cÖ‡qvRbxq †¶‡Î e¨vsK ev kvLv KZ…©K ÒMvBWjvBÝ di d‡ib G·‡PÄ Uªvb‡RKkÝÓ Gi wb‡`©kbv AbymiY K‡i Z_¨ msMÖn Ki‡Z n‡e|)

mxj I ¯^v¶i (evsjv‡`k `~Zvevm) Av‡e`bKvixi ¯^v¶i (bvg I ZvwiL mn)

wnmve †Lvjvi mswk øó Kg©KZv©(bvghy³ mxjmn ¯^vÿi I ZvwiL)

Acv‡ikb g¨v‡bRvi(bvghy³ mxjmn ¯^v¶i I ZvwiL)

Aby‡gv`bKvix Kg©KZ©v (wi‡jkbwkc g¨v‡bRvi)(bvghy³ mxjmn ¯^vÿi I ZvwiL)

20. †hvMv‡hvM [wUK ( ) wPý w`b] t (K) wVKvbv t (L) †Uwj‡dvb b¤^i t

(M) †gvevBj b¤^i t

(N) B-†gBj t .........................................................

eZ©gvb ¯’vqx †ckvMZ

(1) evmv t ....................................

(1) ............................................

(2) Awdm t ........................................

(2) ..................................................

(O) d¨v· b¤^i t ...................................

D D M M Y Y Y Y

D D M M Y Y Y Y D D M M Y Y Y Y

Page 5: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

ZvwiLt

G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UW

wnmve †Lvjvi dig t m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile)Ae¨w³K wnmve (Non-personal Account)

kixqvn& wfwËK Bmjvgx e¨vsK..........................................................................kvLv

Export Import Bank of Bangladesh Limited

1. wnmv‡ei bvg (evsjvq) t ..................................................................................................................

In English (BLOCK LETTER) t ..................................................................................................................

2. gvwmK m¤¢ve¨ Avq t ..................................................................................................................

3. gvwmK m¤¢ve¨ Uvb©Ifvi (cÖwZôv‡bi †ÿ‡Î) t ...............................................................................................................

e¨vs‡Ki e¨env‡ii Rb¨evsjv‡`k dvBb¨vwÝqvj B‡›Uwj‡RÝ BDwb‡Ui wb‡`©kbv †gvZv‡eK MÖvn‡Ki m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) ch©v‡jvPbv Kiv n‡jv|

Avwg/Avgiv wbgœ¯^v¶iKvix (MY) G g‡g© wbðqZv cÖ`vb KiwQ †h, m¤¢ve¨ ‡jb‡`‡bi AbywgZ gvÎv Avgvi/Avgv‡`i cÖwZôv‡bi ¯^vfvweK cÖK…Z †jb‡`b | Avwg/Avgiv Av‡iv wbðqZv cÖ`vb KiwQ †h, cÖ‡qvRb‡ev‡a Avwg/Avgiv m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv ms‡kvab/nvjbvMv` Kie|

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i(bvg, c`ex Ges ZvwiLmn)

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i(bvg, c`ex Ges ZvwiLmn)

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i(bvg, c`ex Ges ZvwiLmn)

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i(bvg, c`ex Ges ZvwiLmn)

cÖZ¨qbKvix e¨vsK Kg©KZ©vi bvghy³ wmjmn ¯^vÿi I ZvwiL

MÖvn‡Ki m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) cwieZ©b Kiv/bv Kivi KviY t

†jb‡`‡bi weeiY

bM` Rgv (AbjvBb I GwUGg mn)UªvÝdvi/BÝUªy‡g›U Gi gva¨‡gd‡ib BbIqvW© †iwgU¨vÝißvwb eve` cÖvßBO (cyuwR evRvi) wnmve n‡Z Rgv/¯’vbvšÍiAb¨vb¨ (wbw`©ófv‡e)....................... me©‡gvU t

gvwmK m¤¢ve¨ Rgvi msL¨v gvwmK m¤¢ve¨ †gvU Rgvi cwigvY GKK m‡e©v”P Rgvi cwigvYRgv t

†jb‡`‡bi weeiY

bM` D‡Ëvjb (AbjvBb I GwUGg mn)UªvÝdvi/BÝUªy‡g›U Gi gva¨‡g cwi‡kvad‡ib AvDUIqvW© †iwgU¨vÝAvg`vwb eve` cwi‡kvaBO (cyuwR evRvi) wnmv‡e Rgv/¯’vbvšÍiAb¨vb¨ (wbw`©ófv‡e)....................... me©‡gvU t

gvwmK m¤¢ve¨ D‡Ëvj‡bi msL¨v gvwmK m¤¢ve¨ †gvU D‡Ëvj‡bi cwigvY GKK m‡e©v”P D‡Ëvj‡bi cwigvYD‡Ëvjb t

D D M M Y Y Y Y

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

wnmve b¤^i t

BDwbK Kv÷gvi AvBwW †KvW t

Page 6: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UW

MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)(cÖwZôv‡bi wnmve †Lvjvi †ÿ‡Î e¨envh© )

kixqvn& wfwËK Bmjvgx e¨vsK..........................................................................kvLv

Export Import Bank of Bangladesh Limited

1. wnmv‡ei bvg t ..................................................................................................................

2. wnmv‡ei cÖK…wZ t ..................................................................................................................

3. cÖwZôv‡bi cÖK…wZ (we¯ÍvwiZ) t ..................................................................................................................

4. cÖwZôv‡bi wbU m¤úwË (Net worth) t ..................................................................................................................

5. A‡_©i Drm/Drmmg~n (we¯ÍvwiZ) t ..................................................................................................................

6. A‡_©i Drm wbwðZ Kivi †ÿ‡Î †hme `wjjvw` msMÖn Kiv n‡q‡Q t (K)...............................................................................................................................................................

(L)................................................................................................................................................................

(M)................................................................................................................................................................

msM„nxZ `wjjvw` hvPvB Kiv n‡q‡Q wK bv? t nu¨v bv 7. cÖwZôv‡bi wVKvbv (mg~n) wKfv‡e hvPvB Kiv n‡q‡Q (we¯ÍvwiZ)?.........................................................................................

8. wnmv‡ei cÖK…Z myweav‡fvMx (Beneficial Owner) wba©viY Kiv n‡q‡Q wK-bv? nu¨v bv DËi nu¨v n‡j cÖ‡Z¨K cÖK…Z myweav‡fvMxi Òe¨w³ msµvšÍ Z_¨vejxÓ msMÖn Ki‡Z n‡e|

(†Kv¤úvbxi †ÿ‡Î 20% ev Gi AwaK GKK †kqvi †nvìvi Gi we¯ÍvwiZ Z_¨vw` msMÖnc~e©K †KIqvBwm m¤úv`b Ki‡Z n‡e| GQvovI †Kv¤úvwbi wbqš¿YKvix †kqvi‡nvìvi Gi we¯ÍvwiZ Z_¨vw` msMÖnc~e©K †KIqvBwm m¤úv`b Ki‡Z n‡e|)

Kwc M„nxZ hvPvBK…Z [wUK (√) wPý w`b]

9. B-wUAvBGb (E-TIN) b¤^i t .......................................................... (cÖ‡hvR¨ †ÿ‡Î)10. f¨vU †iwRt b¤^i t........................................................................ (cÖ‡hvR¨ †ÿ‡Î)11. cÖwZôv‡bi wbeÜb b¤^i t................................................................ (cÖ‡hvR¨ †ÿ‡Î)12. Ab¨vb¨ bw_ t.............................................................................. (cÖ‡hvR¨ †ÿ‡Î)13. we‡`kx †Kv¤úvbx/cÖwZôv‡bi wnmve †Lvjvi D‡Ïk¨ t (cÖ‡hvR¨ †ÿ‡Î)....................................................................................

(K) mswk øó wbqš¿YKvix KZ…©c‡ÿi bvg t...................................................................................................................

(L) Aby‡gv`b msµvšÍ Z_¨ t..................................................................................................................................

14. MÖvnK/cÖwZôv‡bi mv‡_ †Kvb Politically Exposed Person (PEP)/cÖfvekvjx e¨w³ (IP)/AvšÍR©vwZK ms¯’vi cÖavb ev D”P ch©v‡qi Kg©KZ©v Ges Zv‡`i cwiev‡ii m`m¨ ev close associates mswk øó wK bv (weGdAvBBD KZ©„K RvixK…Z mvK©yjv‡i ewY©Z msÁv Abymv‡i)?

nu¨v bv DËi nu¨v n‡jÑ

(K) wmwbqi g¨v‡bR‡g›U n‡Z Aby‡gv`b †bqv n‡q‡Q wK bv? nu¨v bv (L) MÖvn‡Ki gy‡LvgywL mvÿvrKvi †bqv n‡q‡Q wK bv? nu¨v bv

15. mswk øó AvBb, wewagvjv I mvK©yjv‡ii Av‡jv‡K MÖvn‡Ki bvg RvwZms‡Ni wbivcËv cwil‡`i wewfbœ †iRy‡jk‡bi AvIZvq mš¿vmx Kv‡h©, mš¿vmx Kv‡h© A_©vq‡b I e¨vcK aŸsmvZ¥K A¯¿ we¯Ív‡ii A_©vq‡b RwoZ m‡›`‡n ZvwjKvfz³ †Kvb e¨w³ ev mËv Ges evsjv‡`k miKvi KZ©„K ZvwjKvfz³ †Kvb e¨w³ ev wbwl× †NvwlZ mËvi bv‡gi ZvwjKvi mv‡_ hvPvB evQvBc~e©K †Kvbiƒc wgj cvIqv wM‡q‡Q wKbv? nu¨v bv

DËi nu¨v n‡j G welqK M„nxZ e¨e¯’vi weeiY t

D D M M Y Y Y YZvwiL t wnmve b¤^i t

BDwbK Kv÷gvi AvBwW †KvW t

Page 7: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

16. wi¯‹ †iwUs t

(K) cÖwZôv‡bi e¨emvi aiY/Kg©KvÛ tµwgK bs cÖK…wZ wi¯‹ †¯‹vi wUK (√) wPý w`b

01. Ry‡qjvix/¯^‡Y©i e¨emv/g~j¨evb avZzi e¨emv 5 02. gvwb †PÄvi/Kzwiqvi mvwf©m/†gvevBj e¨vswKs G‡R›U 5 03. wi‡qj G‡÷U †Wfjcvi/G‡R›U 5 04. wbg©vb cÖKí †cÖv‡gvUvi/wVKv`vi 5 05. Ad‡mvi/bb †iwm‡W›U K‡c©v‡ikb 5 06. †iu‡¯Íviv/evi/bvBU K¬ve/AvevwmK †nv‡Uj/cvj©vi e¨emv 5 07. Avg`vwb/ißvwb I Avg`vwb/ißvwb G‡R›U 5 08. Mv‡g©›Um e¨emv/Mv‡g©›Um G‡·mwiR/c¨v‡KwRs/evwqs nvDR 5 09. †kqvi/÷K wWjvi, †eªvKvi, †cvU©‡dvwjI g¨v‡bRvi, gv‡P©›U e¨vsKvi 5 10. GbwRI/GbwcI 5 11. Rbkw³ ißvwb e¨emv 5 12. Pjw”PÎ cÖ‡hvRbv/cwi‡ekbv ms¯’v 5 13. A‡¯¿i e¨emv 5 14. †gvevBj †dvb Acv‡iUi/B›Uvi‡bU A_ev K¨vej wUwf Acv‡iUi 5 15. Rwg/evwo †Kbv‡ePvi †eªvKvi (cÖvwZôvwbK) 5 16. e¨vsK/wjwRs/dvBb¨vÝ †Kv¤úvwb 5 17. cwienb Acv‡iUi 5 18. BÝy¨‡iÝ/†eªvKv‡iR G‡RwÝ 5 19. agx©q cÖwZôvb/ms¯’v I wkÿv cÖwZôvb 5 20. Uªv÷ 5 21. e¨emv (†c‡Uªvj cv¤ú/wmGbwR †÷kb) 5 22. ZvgvK I wmMv‡i‡Ui e¨emv 5 23. mdU&&Iq¨vi e¨emv 5 24. wkc †eªwKs e¨emv 5 25. e¨emv (wK¬qvwis I diIqvwW©s G‡R›U) 4 26. e¨emv (wWjvi/wWw÷ªweDUi/G‡R›U) 4 27. e¨emv (Bb‡Ww›Us) 4 28. e¨emv (AvDU‡mvwm©s) 4 29. B‡f›U g¨v‡bR‡g›U 4 30. PvU©vW© GKvDb‡U›U 4 31. K‡c©v‡iU Kv÷gvi 4 32. j dvg©/BwÄwbqvwis dvg©/KÝvj‡UwÝ dvg© 4 33. R¡vjvbx I we`y¨r Drcv`b †Kv¤úvwb 4 34. wcÖ›U/B‡jKUªwbK wgwWqv 4 35. Uªv‡fj G‡R›U/Uz¨wiRg †Kv¤úvwb 4 36. A‡UvwWjvi (wiKwÛkÛ Mvox) 4 37. †d«BU/wkwcs/Kv‡M©v G‡R›U/wmGÛGd G‡R›U 438. A‡Uv cÖvBgvwi (bZzb Mvox) e¨emv 4 39. evox wbg©vY mvgMÖxi e¨emv 4 40. e¨emv (Pvgov I PvgovRvZ cY¨) 4 41. †UwjKwgDwb‡Kkb †Kv¤úvwb 4 42. †PBb †÷vi/kwcs gj 4 43. †U·UvBj/w¯úwbs 3

Page 8: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

44. we‡bv`bKvix cÖwZôvb/cvK© 3 45. †gvUi cvU©m/IqvK©mc Gi e¨emv 3 46. e¨emv-G‡R›U 3 47. e¨emv (Jla cÖ¯‘Z I evRviRvZKiY) 3 48. wngvwqZKiY e¨emv (†Kvì †÷v‡iR) 3 49. e¨emv (wngvwqZ Lv`¨) 3 50. e¨emv (nvW©Iq¨vi) 3 51. e¨emv (weÁvcb) 3 52. mvwf©m †cÖvfvBWvi 3 53. Kw¤úDUvi/†gvevBj †dv‡bi wWjvi 2 54. †cvwëª/†WBwi/wdwks dvg© 2 55. G‡MÖv weR‡bm/ivBm wgj weR‡bm/†efv‡iR 2 56. Drcv`bKvix (A¯¿ e¨ZxZ) 2 57. †`vKvb (LyPiv e¨emv) 2 58. Ab¨vb¨ (mywbw`©ófv‡e D‡j øL Ki‡Z n‡e)................................................ 1-5

cwigvY (UvKvq) wi¯‹ †¯‹vi wUK (√) wPý w`b 0-1 †KvwU 0 >1 †KvwU - 3 †KvwU 1 >3 ‡KvwU 3

(MÖvn‡Ki SuywK wbiƒc‡Yi †ÿ‡Î MÖvn‡Ki †ckvi we¯ÍvwiZ Z_¨ we‡k ølYKiZt e¨emv‡qi †ÿ‡Î e¨emv‡qi cÖK…wZ, A‡_©i gvÎv, e¨emv‡qi GjvKv, e¨emv‡qi AvKvi, wnmv‡ei cÖK…Z myweav‡fvMx BZ¨vw`mn Ab¨vb¨ we‡kl w`K we‡ePbvq wb‡q MÖvnK‡K D”P ev wb¤œ SuywK m¤úbœ wn‡m‡e †kªYxKiY Ki‡Z n‡e| Gme welqmg~n we‡ePbvq wb‡q MÖvnK †f‡` 25-57 b¤^i †ÿ‡Î ewY©Z †¯‹vi A‡cÿv D”PZi †¯‹vi cÖ`vb Ki‡Z cvi‡e|)

(L) cÖwZôv‡bi wbU m¤ú‡`i (Net Worth) cwigvY t

Avj-Iqvw`qvn& PjwZ wnmv‡e †jb‡`‡bi cwigvY gy`vivev mÂqx wnmv‡e †jb‡`‡bi wi¯‹ †¯‹vi wUK (√) wPý w`b (j¶ UvKvq) cwigvY (j¶ UvKvq) 0-10 0-5 0 >10-50 >5-20 1 >50 >20 3

(N) MÖvn‡Ki AbywgZ gvwmK †jb‡`‡bi cwigvY t

aiY wi¯‹ †¯‹vi wUK (√) wPý w`b wi‡jkbwkc g¨v‡bRvi/kvLv KZ…©K 0 WvB‡i± †mjm& G‡R›U KZ©„K 3 B›Uvi‡bU/Non Face to Face 3 ¯^cÖ‡Yvw`Zfv‡e/Walk-In 3

(M) wnmve †Lvjvi aiY t

Avj-Iqvw`qvn& PjwZ wnmv‡e †jb‡`‡bi msL¨v gy`vivev mÂqx wnmv‡e †jb‡`‡bi msL¨v wi¯‹ †¯‹vi wUK (√) wPý w`b 0-100 0-20 0 101-250 21-50 1 >250 >50 3

(O) MÖvn‡Ki AbywgZ gvwmK †jb‡`‡bi msL¨v t

Page 9: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

Avj-Iqvw`qvn& PjwZ wnmv‡e †jb‡`b gy`vivev mÂqx wnmv‡e †jb‡`b wi¯‹ †¯‹vi wUK (√) wPý w`b (j¶ UvKvq) (j¶ UvKvq) 0-10 0-2 0 >10-25 >2-7 1 >25 >7 3

(P) MÖvn‡Ki AbywgZ gvwmK bM` †jb‡`‡bi cwigvY t

Avj-Iqvw`qvn& PjwZ wnmv‡e †jb‡`‡bi msL¨v gy`vivev mÂqx wnmv‡e †jb‡`‡bi msL¨v wi¯‹ †¯‹vi wUK (√) wPý w`b 0-15 0-5 0 16-30 6-10 1 >30 >10 3

(Q) MÖvn‡Ki AbywgZ gvwmK bM` †jb‡`‡bi msL¨v t

wi¯‹ †¯‹v‡ii †hvMdj mvgwMÖK wi¯‹ †iwUs wUK (√) wPý w`b>=14 D”P <14 wb¤œ

17. mvgwMÖK SuywK/wi¯‹ †iwUs wbiƒcb (Dc‡ii K n‡Z Q µwgK ch©šÍ wi¯‹ †¯‹v‡ii †hvMdj) t

gšÍe¨ t

†gvU wi¯‹ †¯‹v‡ii †hvMdj t

(*wi¯‹ †iwUs 14 Gi Kg n‡jI Beneficial owner Gi D”P SuywK we‡ePbvq wb‡q KviY D‡j øLc~e©K Subjective we‡ePbvq MÖvnK‡K D”P SuywK m¤úbœ wn‡m‡e wbiƒcY Kiv †h‡Z cv‡i|)

wnmve †Lvjvi Kg©KZ©v(bvghy³ mxjmn ¯^v¶i I ZvwiL)

wi‡jkbwkc g¨v‡bRvi(bvghy³ mxjmn ¯^v¶i I ZvwiL)

ch©v‡jvPbv I wbwðZKvix Kg©KZ©vkvLv gvwbjÛvwis cÖwZ‡iva cwicvjb Kg©KZ©v

(BAMLCO)(bvghy³ mxjmn ¯^v¶i I ZvwiL)

18. wnmve I MÖvnK msµvšÍ Z_¨vw` me©‡kl ch©v‡jvPbv Ges nvjbvMv` (Review & Update) Kivi ZvwiL t

ch©v‡jvPbv Ges nvjbvMv`Kvix Kg©KZ©v t¯^vÿi tbvg tZvwiL t

Aby‡gv`bKvix EaŸ©Zb Kg©KZ©v(bvghy³ wmjmn ¯^vÿi I ZvwiL)

D D M M Y Y Y Y

PEP/IP/AvšÍR©vwZK ms¯’vi EaŸ©Zb Kg©KZ©vi wnmv‡ei †ÿ‡Î-

Page 10: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

G·‡cvU© Bg‡cvU© e¨vsK Ae evsjv‡`k wjwg‡UWkixqvn& wfwËK Bmjvgx e¨vsK

..........................................................................kvLv

Export Import Bank of Bangladesh Limited

Z‡_¨i e¨envi tAvwg/Avgiv ¯^Áv‡b †NvlYv KiwQ †h, e¨vsK wb‡Ri Ges Dnvi wbqš¿YKvix ms¯’vi cÖ‡qvRb/wb‡`©kbv †gvZv‡eK Avgvi/Avgv‡`i cwiwPwZ mbv³Ki‡Yi j‡ÿ¨ wnmve mswk øó mKj Z_¨/`wjjvw` h_vh_ KZ©„cÿ KZ©„K hvPvB/mbv³KiY Ges cÖ‡qvR‡b e¨envi Ki‡Z cvi‡e|

gvwb jÛvwis cÖwZ‡iva, mš¿v‡m A_©vqb cÖwZ‡iva, AvšÍR©vwZK wb‡lavÁv Ges eva¨evaKZv mg~n cwicvjb

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i

†`‡k A‰ea m¤ú` AvniY eÜKiY, m¤ú‡`i A‰ea cvPvi Ges mš¿v‡m A_©vqb cÖwZ‡iv‡a we`¨gvb gvwbjÛvwis cªwZ‡iva AvBb, 2012 (ms‡kvabx 2015) Ges mš¿vm we‡ivax AvBb, 2009 (ms‡kvabx 2012 I 2013) †g‡b Pje|

m¤ú„³ Aciv‡ai (Predicate offence) gva¨‡g AvnwiZ ev AwR©Z m¤ú‡`i A‰ea cš’vq n¯ÍvšÍi, iƒcvšÍi, Ae¯’v‡bi †MvcbKiY ev D³ Kv‡R mnvqZv Kiv RvZxq ¯^v‡_©i cwicwš’|

ûwÛ Kvh©µg †`‡ki A_©bxwZi Rb¨ ¶wZKi| ûwÛi gva¨‡g A_© †cÖiY, A_© MÖnY Ges ûwÛi Kv‡R mnvqZvKiY gvwb jÛvwis cÖwZ‡iva AvB‡b kvw¯Í‡hvM¨ Aciva|

e¨vs‡K wnmve †Lvjv, UvKv DVv‡bv I MÖvnK cwiwPwZ m¤úwK©Z mwVK Ges c~Y©v½ Z_¨ mieivn I msi¶‡Y AwaKZi m‡PZb I Zrci n‡q e¨vsK KZ…©c¶‡K mn‡hvwMZv Kie|

A¯^vfvweK †jb‡`bRwbZ Kvi‡Y m‡›`n ¯’vwcZ n‡j †K›`ªxq e¨vsK †h †Kvb wnmv‡ei †jb‡`b cix¶v-wbix¶v Ki‡Z cv‡i| A‰ea †jb‡`b cÖgvwYZ n‡j cÖ‡qvR‡b Av`vj‡Z gvgjv `v‡qi Kiv ‡h‡Z cv‡i Ges GB AvB‡bi Aaxb mKj Aciva A-Rvwgb‡hvM¨|

Av`vjZ GB AvB‡bi Aaxb Aciv‡ai Rb¨ wba©vwiZ `Û Av‡ivc Ges Dchy³ †¶‡Î Z`šÍv‡`k, Aeiæ×KiYv‡`k, †µvKv‡`k, A_©`Û Ges ¶wZc~iY Av‡`kmn Ab¨vb¨ Av‡`k cÖ`vb Ki‡Z cv‡i| G‡¶‡Î Acivax Ab~¨b 04 (Pvi) ermi Ges AbwaK 12 (evi) ermi ch©šÍ Kviv`‡Û `wÛZ n‡eb Ges Gi AwZwi³ Aciv‡ai mv‡_ mswk øó m¤úwËi wظY g~‡j¨i mgcwigvY ev 10 (j¶) UvKv ch©šÍ, hv AwaK, A_©`‡Û `wÛZ n‡eb|

mswk øó AvBb, wewagvjv I mvKz©jv‡ii Av‡jv‡K MÖvn‡Ki bvg RvwZms‡Ni wbivcËv cwil‡`i wewfbœ †iRy‡jk‡bi AvIZvq mš¿vmx Kv‡h©, mš¿vmx Kv‡h© A_©vqb I e¨vcK aŸsmvZ¥K A¯¿ we¯Ív‡i A_©vq‡b RwoZ m‡›`‡n ZvwjKvfy³ †Kvb e¨w³ ev mËv Ges evsjv‡`k miKvi KZ©„K ZvwjKvfy³ ‡Kvb e¨w³ ev wbwl× †NvwlZ mËvi bv‡gi ZvwjKvi mv‡_ hvPvB evQvBc~e©K †Kvbiƒc wgj cvIqv ‡M‡j mv‡_ mv‡_ AvBbvbyM e¨e¯’v MÖnY Kiv hv‡e| hw` †Kvb e¨w³ mš¿vmx Kv‡h© A_©vq‡bi Aciv‡a †`vlx mve¨¯Í nb, Zvn‡j wZwb Ab~aŸ© 20 (wek) ermi I Ab~¨b 4 (Pvi) erm‡ii mkªg Kviv`‡Û `wÛZ n‡eb Ges Gi AwZwi³ D³ Aciv‡ai mv‡_ mswk øó m¤úwËi g~‡j¨i wظY cwigvY A_© ev 10 (`k) j¶ UvKv, hv AwaK, A_©`Û Av‡ivc Kiv hv‡e|

Page 11: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com

Account No.

01. Citizenship (Please put cross mark in the box) Single Citizenship Dual Citizenship (bvMwiKZ¡) Permanent Resident (PR) in US

02. In case of Dual Citizenship please name the country

03. In case of US Citizen/US Permanent Resident (PR), Please furnish following informationt US Address BD Gm wVKvbv

Occupation with full details

Telephone Number Tax Identification Number (TIN USA) †Uwj‡dvb b¤^i U¨v· mbv³KiY b¤^i

E-mail (B-†gBj)

Passport Number PR Card Number cvm‡cvU© b¤^i wc Avi KvW© b¤^i

Visa Status Visa Expiry Date wfmv ÷¨vUvm wfmvi †gqv‡`vËx‡Y©i ZvwiL

Social Security Number Driving License No.

04. Client's Information regarding FATCA** compliance (please put cross mark in the box); FATCA msµvšÍ MÖvn‡Ki Z_¨

05. Declaration of the Client

Declaration Form for Compliance ofForeign Account Tax Compliance Act (FATCA)

(TO BE FILLED IN BLOCK LETTERS)

** Foreign Account Tax Compliance Act (FATCA), a new tax law of the USA to be compiled by all scheduled banks of Bangladesh inevitably aiming at combating tax evasion by U.S. taxpayers who hide assets in offshore accounts. It requires reports to the U.S. Internal Revenue Service (IRS) information about certain accounts held by U.S. taxpayers or by foreign entities in which U.S taxpayers hold a substantial ownership interest.

As per stipulations of Money Laundering Prevention Act-2012, Anti Terrorism Act-2009/(revised 2013) & BFIU Circulars/guidelines of Bangladesh Bank or any other instruction/guidelines from any local/global regulatory authority, notwhithstanding anything contained in Banker's Book Evidence Act-1891, I/We shall be responsible for providing any desired information to the Bank for forwarding/providing/submitting/disclosing the same to Bangladesh Bank/any local/global regulatory authority including Internal Revenue Services (IRS) of USA regarding FATCA.

I/We do hereby declare that all the information provided by me/us are authentic and I/we be held responsible for the authenticity of the information.

I/We also do hereby declare that upon receipt US citizenship/permanent US residentship by me/us or my/our parents/sibling(s)/spouse in future, I/we shall furnish all related information, at my/our own responsibility, to the Bank for ready references.

Sl No.1. Whether the client is a US citizen/ permanent resident/ Green Card Holder/ temporary resident/associated with any entity owned by US citizen?

2. Whether the client holds a substantial U.S ownership interest @ 10% or above (in case of entity)?

3. Whether any power of attorney granted by the client to a person with a US address?

Information sought Yes No If yes, please furnish the details

Signature(s) of the client(s) with date

Prepared by

Account Opening Officer (Seal & Signature with Date)

Reviewed by

Operation Manager (Seal & Signature with Date)

Approved by

Relationship Manager (Seal & Signature with Date)

1. 2.

Signature(s) of the client(s) with date

D D M M Y Y Y Y

Page 12: Export Import Bank of Bangladesh Limited G·‡cvU© Bg‡cvU© e ... · Export Import Bank of Bangladesh Limited (wnmve †Lvjvi Av‡e`bKvix GKvwaK e¨w³ n‡j cÖ‡Z¨K‡K di‡gi

mvaviY kZ©vejx/wbqgvejx 1. ïaygvÎ Avj-Iqvw`qvn&& PjwZ wnmve Qvov mKj gy`vivev Rgv wnmve, Bmjvgx kixqvn&& Gi gy`vivev bxwZ Abyhvqx cwiPvwjZ n‡e| cÖ‡Z¨K wnmv‡ei Rb¨

e¨vsK KZ©„K wba©vwiZ I‡q‡UR Abyhvqx wewb‡qvM Av‡qi Kgc‡ÿ 65% gy`vivev wewb‡qvMKvix‡`i gv‡S e›Ub Kiv n‡e|2. e¨vsK Zvi bxwZgvjv Abyhvqx gybvdv weZi‡Yi bxwZmg~n Ges I‡q‡UR cwieZ©‡bi AwaKvi msi¶Y K‡i| 3. evsjv‡`‡ki wmwWDjW e¨vsK mg~‡n evsjv‡`‡ki †hme AvBb, wbqg-bxwZ cÖPwjZ i‡q‡Q GB wnmve cwiPvjbvi †¶‡ÎI †m me wbqgbxwZ cÖ‡hvR¨ n‡e| 4. e¨vs‡Ki bxwZgvjv Abyhvqx wnmv‡ei mvwf©m PvR© A_ev †gBb‡Ub¨vÝ wd mgq mgq KZ©b Kiv n‡e | e¨vsK AveMvix ïé (Excise Duty) Ges Ab¨vb¨

PvR©mg~n ev‡`I wnmv‡ei mv‡_ †h †Kv‡bv fv‡e m¤ú&„³ mKj e¨q I LiP (Kv‡jKkb wdm Ges ˆea LiPmg~n) KZ©‡bi AwaKvi msi¶Y K‡i|5. hw`I e¨vsK GB wnmv‡ei †¶‡Î me ai‡Yi †MvcbxqZv i¶v Ki‡e, wKš‘ wbgœwjwLZ cÖwZôvbmg~‡ni †¶‡Î e¨vsK Z_¨ cÖKv‡k eva¨ _vK‡e t (K) e¨vs‡Ki Dci cÖfvewe¯ÍviKvix †h †Kv‡bv †i¸‡jUix, mycvifvBmwi, miKvix, Avav-miKvix cÖwZôvb; (L) AvBb A_ev †KvU© AW©vi Gi gva¨‡g ¶gZvcÖvß †Kvb e¨w³|6. MÖvnK KZ…©K †h †Kv‡bv Z‡_¨i cwieZ©b AwZ mZ¡i e¨vsK‡K Rvbv‡Z n‡e, Ab¨_vq †Kvb AbvKvw•LZ NUbvi Rb¨ e¨vsK `vqx _vK‡e bv|7. WvK, Kzwiqvi, B‡jKwUªK¨vj, †gKvwbK¨vj, †UwjKwgDwb‡Kkb A_ev Ab¨ †Kvb ai‡Yi cÖvK…wZK `y‡h©vM, hy×, hvwš¿K †Mvj‡hvM, Kw¤úDUvi mgm¨v A_ev

e¨vs‡Ki AvIZv ewnf©~Z †Kvb NUbvi Rb¨ wnmv‡ei †Kvbiƒc ¶wZ n‡j e¨vsK `vqx _vK‡e bv|8. e¨vs‡Ki `„wó‡Z wnmve cwiPvjbvq Am‡šÍvlRbK †jb‡`b n‡j A_ev Ab¨ †h †Kv‡bv Kvi‡Y †Kvb cÖKvi c~e© †bvwUk e¨wZ‡i‡KB e¨vsK †h †Kv‡bv wnmve

eÜ K‡i †`qvi AwaKvi msi¶Y K‡i|9. †Kvbiƒc c~e© †bvwUk QvovB e¨vsK †h †Kvb mgq wnmve msµvšÍ †h †Kvb wbqgvejx cwieZ©b, cwiea©b, ms‡kvab ev evwZj Ki‡Z cv‡i Ges MÖvnK Zv

†g‡b Pj‡Z eva¨ _vK‡eb|10. AvgvbZKvix (MY) Gi g„Zy¨ n‡j mswk øó wnmv‡ei †jb‡`b eÜ n‡q hv‡e Ges gybvdvmn (cÖ‡hvR¨ †¶‡Î) mgy`q A_© wnmve †Lvjvi di‡g Dwj øwLZ

bwgwb‡K cÖ`vb Kiv n‡e| bwgbx bvevjK n‡j AvBbMZ AwffveK‡K mgy`q A_© cÖ`vb Kiv n‡e| Ab¨vb¨ †¶‡Î cÖPwjZ AvBb †gvZv‡eK A_© Aegy³ Kiv n‡e|

11. P~ovšÍ gybvdvi nvi †NvlYvi c~‡e©B wnmve fv½v‡bv n‡j/eÜ Kiv n‡j AvgvbZKvix cÖwfkbvj nv‡i gybvdv MÖn‡Yi `vex`vi Ges P~ovšÍ gybvdvi nvi I cÖwfkbvj gybvdvi nvi Avjv`v n‡j e¨vsK A_ev AvgvbZKvix (MY) AwZwi³ gybvdv `vex Ki‡Z cvi‡e bv| wKš‘ P~ovšÍ gybvdvi nvi hw` cÖwfkbvj gybvdvi nv‡ii †P‡q †ewk nq Zvn‡j AvgvbZKvixi wjwLZ Av‡e`‡bi †cÖw¶‡Z AwZwi³ gybvdv AvgvbZKvix(MY)†K cÖ`vb Kiv ‡h‡Z cv‡i|

12. cÖ‡Z¨K wnmv‡ei AwZwi³ kZ©vejx/wbqgvejx Dc‡i Dwj øwLZ kZ©vejx/wbqgvejxi Awe‡”Q`¨ Ask wn‡m‡e we‡ewPZ n‡e|

Avj-Iqvw`qvn& PjwZ/GgGmwW/GgGmGbwW wnmv‡ei AwZwi³ kZ©vejx/wbqgvejx 1. Avj-Iqvw`qvn& PjwZ/GgGmwW/GgGmGbwW wnmvemg~‡ni †¶‡Î wb‡gœv³ I‡q‡UR AbymiY Kiv n‡e t

(K) Avj-Iqvw`qvn& bxwZmg~n AbymiY K‡i Avj-Iqvw`qvn& PjwZ AvgvbZ wnmv‡ei AvgvbZ MÖnY Kiv n‡e hvi I†q‡UR k~b¨ Ges †Kvb gybvdv cÖ`vb Kiv n‡e bv | e¨vsK Avj-Iqvw`qvn& PjwZ AvgvbZ wnmv‡ei AvgvbZ e¨env‡ii AwaKvi msi¶Y K‡i|

(L) gy`vivev mÂqx Avgvb‡Zi I‡q‡UR 0.63|(M) gy`vivev we‡kl †bvwUk Avgvb‡Zi I‡q‡UR 0.62|

2. †PK cwi‡kva eÜ ivLvi wb‡`©k (Stop payment Instruction), †PK eB Bmy¨, e¨vsK m”QjZvi mvwU©wd‡KU, wnmve weeiYx, Ab-jvBb †jb‡`b, w¯’wZ AbymÜvb (Balance Enquiry) m¤úwK©Z mKj wb‡`©kbv e¨vsK †K wjwLZ AvKv‡i w`‡Z n‡e| e¨vsK MÖvn‡Ki Aby‡iv‡a Zvi Aby‡gvw`Z †Kvb e¨w³‡K †PK eB, m”QjZvi mvwU©wd‡KU (Solvency Certificate), wnmve weeiYx BZ¨vw` eÜ Lv‡g mieivn Ki‡Z cvi‡e| †Kvb †PK/BÝUªy‡g›U cwi‡kv‡ai ci †Kvb †PK cwi‡kva eÜ ivLvi wb‡`©k (Stop payment Instruction) Avm‡j Zv evwZj e‡j MY¨ n‡e|

3. †Kvbiƒc Awbqg A_ev cÖZviYv cwijw¶Z n‡j e¨vsK MÖvn‡Ki †h †Kv‡bv wnmv‡ei †h †Kv‡bv †jb‡`b cÖwµqvKi‡Y Am¤§wZ Ávcb Ki‡Z cvi‡e|4. e¨vs‡K wnmve †Lvjvi c~‡e©B MªvnK‡K me `wjjvw` msµvšÍ wbqgvejx AbymiY Ki‡Z n‡e| mKj wbqgvejxi c~Y©v½ AbymiY bv nIqv ch©šÍ †Kvb †PK eB

Bmy¨ Kiv n‡e bv|5. 1 (GK) eQi †Kvbiƒc †jb‡`b bv n‡j Avj-Iqvw`qvn& PjwZ AvgvbZ wnmve myß (Dormant) wnmv‡e iƒcvšÍwiZ n‡e| 6. 2 (`yB) eQi †Kvbiƒc †jb‡`b bv n‡j gy`vivev mÂqx Ges gy`vivev we‡kl †bvwUk AvgvbZ wnmve myß (Dormant) wnmv‡e iƒcvšÍwiZ n‡e| 7. hw` †Kvb wnmv‡ei †jb‡`b GK eQi ev Zvi AwaK Kvj eÜ _v‡K Zvn‡j e¨vsK k~b¨ w¯’wZ m¤^wjZ †h †Kv‡bv wnmve eÜ K‡i †`Iqvi AwaKvi msi¶Y K‡i| 8. 1991 mv‡ji e¨vsK †Kv¤úvbx AvBbvbyhvqx 10 (`k) eQi I Z`~aŸ© †gqv` ch©šÍ †Kvb wnmv‡e †jb‡`b bv n‡j mswk øó wnmvewU A`vexK…Z (Unclaimed)

wn‡m‡e MY¨ K‡i D³ wnmv‡ei w¯’wZ evsjv‡`k e¨vs‡K ¯’vbvšÍi K‡i †`qv n‡e|Avwg/Avgiv GB g‡g© wbðqZv cÖ`vb KiwQ †h, Avwg/Avgiv wnmve msµvšÍ hveZxq wbqgvejx/kZ©vejx c‡owQ Ges D³ wbqgvejx/kZ©vejx †g‡b Pj‡Z eva¨ _vKe|

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i

MÖvnK/wnmve cwiPvjbvKvixi ¯^v¶i

Export Import Bank of Bangladesh Limitedwww.eximbankbd.com