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Guide on How to Fill-in:
ACCOUNT OPENING & e-AmBiz
APPLICATION FORM
For any new customers who wish to open account and sign-up for e-AmBiz facility
with Inquiry access only.
For any new customers who wish to open account and sign-up for e-AmBiz facility with both Inquiry & Payment access, please
go to Page 9 in this e-guide.
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 1 of 7 Version 21 (Last updated 23 Jan 2017)
Section A: Type of Accounts
A.1 Ringgit Malaysia (MYR) Accounts *
Conventional Current Account Savings Account Business Entity
Sole Proprietor Private Limited
Partnership Public Listed Others, please indicate: __________________________
Islamic Current Account – i Savings Account - i
A.2 Foreign Currency Current Accounts (FCA): Please tick (√)
Purpose & type of currency AUD CAD CNY EUR GBP HKD JPY NZD SGD USD OTHERS**
IFCA
Non-Export / Individual
Employment
Education
Services Export Proceeds
TFCA Goods Export Proceeds
**Subject to Transaction Banking Approval
Charges, if any, to be debited from Ringgit savings/current account
A.3 Fixed Deposit/Term Deposit-i Terms and Instructions (for multiple FD/TD-i placements, please attach FD/TD-i addendum)
Fixed Deposit Term Deposit-i Foreign Currency Fixed Deposit Currency:_________________________
Maturity Instructions
Withdrawal Upon Maturity Placement Instructions:
Cash
Cheque : ______________________
Debit Account : _________________
Amount/Tenure:
RM ______________
Months___________ Withdrawal Upon Maturity (Interest/Profit Only)
Auto Renew (Principle & Interest/Profit)
A.4 Business Banking Services - eChannels
For sole proprietors only Please complete Section E
ATM AmOnline AmMobile AmOnline Virtual Pin For accounts without ATM Card
e-AmBiz Inquiry
e-AmBiz Payment
A.5 Cheque Book Application (for MYR Current Account/Account-i only)
Number of cheque books
Collection Method
By accountholder
By authorized 3rd party: Name: _________________________________________ NRIC/Passport No.
Courier to account correspondence address
012345
Eligible for protection by PIDM
* Denotes mandatory fields – are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations
100,000.00
12
Ali Bin Abu
8 8 8 8 0 0 0 0 0 1 2 3 4
x x x x x x - x x - x x x x
1
Indicate your collection Method
Indicate the number of cheque books you require (if any)
Fill in name and identification number of the 3rd party who will be collecting on your behalf.
Select account type Select business entity type
Please tick the relevant boxes ONLY if u were to open a FD/TD Account
Please tick any of the relevant square boxes ONLY if you were to open a Foreign Currency Account
Please indicate the amount and tenure you would like to place
Indicate e-AmBiz Inquiry
Note: The information filled below acts as a sample and is for illustration purposes only. Please tick and fill in whichever is required.
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 2 of 7 Version 21 (Last updated 23 Jan 2017)
Section B: Business Details*
B.1 Registered Business Details
Registered Name of Business:
Registered Address:
Account Correspondence Address: (if different from above)
Business Status:
Resident Non- Resident Business Registration No: _________________________
Nature of Business:
Business Office No.:
Business Fax No:
Business Email Address:
B.2 Small Medium Enterprises (SMEs)
Business Category: SME Non-SME
Business Type: Manufacturing/Manufacturing-Related Services/Agro-based Industries
Services and Others
Annual sales turnover (Ringgit Malaysia):
as at financial year:
No. of Staff:
as at financial year:
B.3 Contact Person Details: Appointment of authorized personnel to perform non-monetary transactions and to receive/disclose your company’s information to/ from AmBank (M) Berhad and/or AmBank Islamic Berhad
1. Full Name (as per NRIC/Passport):
Mobile No.: NRIC/Passport No.:
Email Address:
Account balance inquiry Confirmation of remittance instrument application/collection
Confirmation of encashment Confirmation of debiting/crediting transaction of the said account
2. Full Name (as per NRIC/Passport):
Mobile No: NRIC/Passport No.:
Email Address:
Account balance inquiry Confirmation of remittance instrument application/collection
Confirmation of encashment Confirmation of debiting/crediting transaction of the said account
3. Full Name (as per NRIC/Passport):
Mobile No:
NRIC/Passport No.:
Email Address:
Account balance inquiry Confirmation of remittance instrument application/collection
Confirmation of encashment Confirmation of debiting/crediting transaction of the said account
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* Denotes mandatory fields – are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations
Fill in your company name and address
Select your business residency type and indicate your Business Registration number
Fill in your company’s nature of business and company’s contact details.
Please indicate your business details.
Fill in FIRST contact person details
Fill in SECOND contact person details
.
Fill in THIRD contact person details (if any)
ABC SDN BHD
LEVEL 2, MENARA XYZ, JALAN SULTAN ISMAIL, 50250 KUALA LUMPUR
ELECTRONIC
03-2026XXX 03-2026XXX
123456-X
ABC.COM.MY
XX,XXX.XX YYYY
25 YYYY
JANE DOE
012-388XXXX XXXXXX-XX-XXXX
012-388XXXX XXXXXX-XX-XXXX
JOHN SMITH
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 3 of 7 Version 21 (Last updated 23 Jan 2017)
Section C: Declaration*
C.1 Perbadanan Insurans Deposit Malaysia (PIDM)
I/We have received a copy of the PIDM brochure and acknowledge that this product is insured by PIDM.
C.2a Foreign Account Tax Compliance Act (FATCA) for Sole Proprietor/Partnership
C.2b Foreign Account Tax Compliance Act (FATCA) for Associations, Limited Liability Partnerships, Clubs, Society, Trusts of Entity and Companies.
Identifying Specified/Potential U.S. Person (To be completed by the customer - please tick (“✓”) in the “Yes” / “No” column respectively for each of the following questions)
Identifying U.S. Reportable Accounts for company (To be completed by all types of entities – please (√) where applicable)
No. U.S. Indicia Status Account Holder
a) A Specified U.S. Person1 Yes No
1. Are you a U.S. citizen or resident (including
green card holder)?
2. Is U.S. your country of birth?
b) A Passive Non-Financial Foreign Entity (NFFE) with one or
more Controlling Persons who are Substantial U.S. Owners23.
Do you hold a current U.S. residence address
or mailing address (including a U.S. post office
box)?
4. Do you have a current U.S. telephone number?
5. Do you currently maintain any standing instructions to the U.S.?
c) A Non-Participating Foreign Financial Institution (NPFFI)3 6. Do you currently assign power of attorney or signatory authority to a person within the U.S.?
7. Do you currently have a ‘hold mail’ or ‘in care of’ address as your sole address?
Definition: The term U.S person means a person described in section 7701(a)(30) of the Internal Revenue Code: (A) a citizen or resident of the U.S.
Definition: 1 • An individual who is a U.S. citizen or U.S. resident,
• A partnership, corporation, company, or association created or organized in the U.S. orunder the laws of the U.S.,
• An estate (other than a foreign estate), or• A domestic trust (as defined in Regulations section 301.7701-7 of the Internal Revenue
Code).
2 • Owns, directly or indirectly, more than 10% (by vote or value) of the stock of any foreign corporation;
• Owns, directly or indirectly, more than 10% of the profits or capital interests in aforeign partnership;
• Is treated as an owner of any portion of a foreign trust under sections 671 through679; or
• Holds, directly or indirectly, more than a 10% beneficial interest in a trust.
3 • A Foreign Financial Institution that does not enter into an agreement with the U.S. IRS.
C.3 Choice of language for Terms and Conditions
English Bahasa Malaysia
C.4 Personal Data Protection Act (PDPA)
AmBank Group’s Business Partners may from time to time offer products, promotions and services that maybe of interest to you. Say ‘YES’ to great offers and promotions from AmBank Group’s Business Partners.
Yes, we would like to receive marketing promotions from AmBank Group’s business partners
No, not at this point of time.
I/We hereby declare that I/we have read and understood the Privacy Notice of AmBank Group which is made available at AmBank branches or website and give my/our consent(s) for the bank to process my/our personal data and sensitive data for the intended usage as stated under the Privacy Notice.
*Denotes mandatory fields – are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations
Please tick the checkbox
Please tick ONLY if you are a Sole Proprietor/Partnership type of business
Select the choices of language for your T&C
Please tick “Yes” if you would like to receive future marketing promotions
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 4 of 7 Version 21 (Last updated 23 Jan 2017)
I/We agree that our application from time to time for products and services provided by AmBank (M) Berhad/AmBank Islamic Berhad herein shall be governed by
the General Terms and Conditions for Accounts and Services, the Specific Terms and Conditions for Foreign Currency Account, the Master Services Terms and
Conditions and/or Master Services Agreement (as the case maybe) and the terms and conditions intended to apply to one or more types of products and services
provided by you which is available at the Ambank Group website (http:www.ambankgroup.com) and I/We agree to adhere to the same. For the avoidance of doubt,
references to ‘you’ shall mean AmBank (M) Berhad and/or AmBank Islamic Berhad, as the case maybe.
I/We confirm that all information and documents provided to you by us pursuant to this application are true, correct, complete and untampered. In addition, you
shall be entitled to rely on the information and particulars provided by us under this account opening application form for any additional products and services made
available by you to us from time to time. In case of any change of particulars, I/We shall immediately notify you in writing of the changes, failing which you are
entitled to deem all particulars as provided under this account opening application form as true and accurate.
I/We also confirm that I/We are not subjected to any cessation of business/winding up liquidation at the time of this application.
I/We hereby declare, certify and confirm that the person(s) whose signature(s) appear below (‘Authorized Persons’) is/are acting in accordance with the mandate
given by us and have authority to effect all transactions/declaration/confirmation/agreements on our behalf in connection with the products and services applied
for - and all such transaction are binding and legally enforceable against us. I/We shall not hold the bank liable for processing the services/accounts that we have
applied for as per my/our instruction even though the Authorized Persons named in the board resolution which is obtained at a later date may differ.
I/We hereby confirm, acknowledge and understand that we as follows:
1. Open and close account
The Authorized Persons are authorized to open and close account with AmBank and AmBank Islamic for any types of account and currency as specified in the
account opening forms and sign and deliver other relevant documents, notices or instructions in accordance with the bank’s terms and conditions governing
such accounts.
2. Subscribe, utilize and terminate the services
The Authorized Person are authorized to subscribe for any electronic facilities, transaction banking services, and any other services which may be offered by the
bank from time to time subject to the terms and conditions of such services.
3. Authorization to appoint authorized signatories
The Authorized Person is authorized to appoint signatories and appoint users for the services subscribed.
The authorized signatories are authorized to operate the accounts in accordance with the signing mandate and/or authority given.
Authorized Person:
Authorized Person:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No. :
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Read and understand the Terms and Conditions
CHEONG YI AHMAD DIN CHEONG YI AHMAD DIN
X X X X X X - X X - X X X X X X X X X X - X X - X X X X
MALAYSIAN MALAYSIAN
03021980 13081970
FIRST Authorised Person to sign and fill in personal details
SECOND Authorised Person to sign and fill in personal details
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 5 of 7 Version 21 (Last updated 23 Jan 2017)
Condition of Authorization Please tick (√) one. [To only complete Section D if the Board Resolution does not indicate specimen signature(s)]
Any One to Sign Any Two to sign All to sign Others : ________________________________
Section D: Authorised Signatories/ Signature Specimen Card Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Note: Please photocopy this page if additional authorized signatories are required.
CHEONG YI AHMAD DIN CHEONG YI
X X X X X X - X X - X X X X X X X X X X - X X - X X X X
AHMAD DIN
MALAYSIAN MALAYSIAN
03021980 13081970
You may strikethrough Section D if you provide us your own BR
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 6 of 7 Version 21 (Last updated 23 Jan 2017)
Note: Please photocopy this page if additional inquiry users are required
B. INQUIRY AND PAYMENT
Primary Security Administrator (Token Custodian)
Name as per NRIC/Passport
NRIC/Passport No Mobile No.
Email address
Designation Specimen
Preferred User ID Signature (Maximum 10 Characters, no special characters allowed, eg: .,!?;)
Secondary Security Administrator (Pin Mailer Custodian)
Name as per NRIC/Passport
NRIC/Passport No Mobile No.
Email address
Designation Specimen
Preferred User ID Signature
(Maximum 10 Characters, no special characters allowed, eg: .,!?;)
¹Basic Payment Package (Internal Fund Transfer, GIRO, RENTAS, SWIFT-FCY TT) ² FS/FP-Floor Stock / Floor Plan
A. INQUIRY ONLY
Inquiry User 1
Name as per NRIC/Passport
NRIC/Passport No. Mobile No.
Preferred User ID Email
(Maximum of 10 Characters, no special characters are allowed, eg: .,!?;) address
Inquiry User 2 (If applicable)
Name as per NRIC/Passport
NRIC/Passport No. Mobile No.
Preferred User ID Email
(Maximum of 10 Characters, no special characters are allowed, eg: .,!?;) address
Payment Services* Please tick (√)
Charging Account
Services Offered
Basic Package̴¹
Banker’s Cheque
Internal Fund
Transfer
GIRO RENTAS SWIFT (FCY TT)
Payroll-IFT Payroll-GIRO
EIPP/ProColl (Direct
debit)
EIPP/ProColl (FS/FP²)
Debit Method Individual Debit
Consolidated Debit
*Denotes mandatory fields - are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations.
All charges debited from new account
Others, please indicate
CHEONG YI
X X X X X X X X X X X X
C H E O
0 1 3 X X X X X X X X
Select “Inquiry Only” for e-Ambiz Access with Inquiry facility
Fill-in details for Inquiry User 1
Fill-in details for Inquiry User 2 (if any)
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 7 of 7 Version 21 (Last updated 23 Jan 2017)
FOR BANK’S USE ONLY:
Date: CIF:
Attended by: Verified by: Approved by: SVS Captured: SVS Validated:
Account No: Currency: e-Ambiz:
1.
2.
3.
4.
5.
6.
1.
2.
3.
4.
5.
6.
Yes
Yes
Yes
Yes
Yes
Yes
X X X X X X X X X X X X X XXX
RM’s name or the person
who attended the customer
DDMMYYYY XXXXXXX
Customer do not need to fill this in. Reserved for Bank Use
Guide on How to Fill-in:
ACCOUNT OPENING & e-AmBiz
APPLICATION FORM
For any new customers who wish to open account and sign-up for e-AmBiz facility
with Inquiry and Payment access
For any new customers who wish to open account and sign-up for e-AmBiz facility with Inquiry access only, please go to Page 1
in this e-guide.
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 1 of 7 Version 21 (Last updated 23 Jan 2017)
Section A: Type of Accounts
A.1 Ringgit Malaysia (MYR) Accounts *
Conventional Current Account Savings Account Business Entity
Sole Proprietor Private Limited
Partnership Public Listed Others, please indicate: __________________________
Islamic Current Account – i Savings Account - i
A.2 Foreign Currency Current Accounts (FCA): Please tick (√)
Purpose & type of currency AUD CAD CNY EUR GBP HKD JPY NZD SGD USD OTHERS**
IFCA
Non-Export / Individual
Employment
Education
Services Export Proceeds
TFCA Goods Export Proceeds
**Subject to Transaction Banking Approval
Charges, if any, to be debited from Ringgit savings/current account
A.3 Fixed Deposit/Term Deposit-i Terms and Instructions (for multiple FD/TD-i placements, please attach FD/TD-i addendum)
Fixed Deposit Term Deposit-i Foreign Currency Fixed Deposit Currency:_________________________
Maturity Instructions
Withdrawal Upon Maturity Placement Instructions:
Cash
Cheque : ______________________
Debit Account : _________________
Amount/Tenure:
RM ______________
Months___________ Withdrawal Upon Maturity (Interest/Profit Only)
Auto Renew (Principle & Interest/Profit)
A.4 Business Banking Services - eChannels
For sole proprietors only Please complete Section E
ATM AmOnline AmMobile AmOnline Virtual Pin For accounts without ATM Card
e-AmBiz Inquiry
e-AmBiz Payment
A.5 Cheque Book Application (for MYR Current Account/Account-i only)
Number of cheque books
Collection Method
By accountholder
By authorized 3rd party: Name: _________________________________________ NRIC/Passport No.
Courier to account correspondence address
012345
Eligible for protection by PIDM
* Denotes mandatory fields – are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations
100,000.00
12
Ali Bin Abu
8 8 8 8 0 0 0 0 0 1 2 3 4
x x x x x x - x x - x x x x
1
Indicate your collection Method
Indicate the number of cheque books you require (if any)
Fill in name and identification number of the 3rd party who will be collecting on your behalf.
Select account type Select business entity type
Please tick the relevant boxes ONLY if u were to open a FD/TD Account
Please tick any of the relevant square boxes ONLY if you were to open a Foreign Currency Account
Please indicate the amount and tenure you would like to place
Indicate e-AmBiz payment
Note: The information filled below acts as a sample and is for illustration purposes only. Please tick and fill in whichever is required.
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 2 of 7 Version 21 (Last updated 23 Jan 2017)
Section B: Business Details*
B.1 Registered Business Details
Registered Name of Business:
Registered Address:
Account Correspondence Address: (if different from above)
Business Status:Resident Non- Resident Business Registration No: _________________________
Nature of Business:
Business Office No.: Business Fax No:
Business Email Address:
B.2 Small Medium Enterprises (SMEs)
Business Category: SME Non-SME
Business Type: Manufacturing/Manufacturing-Related Services/Agro-based Industries
Services and Others
Annual sales turnover (Ringgit Malaysia): as at financial year:
No. of Staff: as at financial year:
B.3 Contact Person Details: Appointment of authorized personnel to perform non-monetary transactions and to receive/disclose your company’s information to/ from AmBank (M) Berhad and/or AmBank Islamic Berhad
1. Full Name (as per NRIC/Passport):
Mobile No.: NRIC/Passport No.:
Email Address:
Account balance inquiry Confirmation of remittance instrument application/collection
Confirmation of encashment Confirmation of debiting/crediting transaction of the said account
2. Full Name (as per NRIC/Passport):
Mobile No: NRIC/Passport No.:
Email Address:
Account balance inquiry Confirmation of remittance instrument application/collection
Confirmation of encashment Confirmation of debiting/crediting transaction of the said account
3. Full Name (as per NRIC/Passport):
Mobile No: NRIC/Passport No.:
Email Address:
Account balance inquiry Confirmation of remittance instrument application/collection
Confirmation of encashment Confirmation of debiting/crediting transaction of the said account
F
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C
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F
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* Denotes mandatory fields – are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations
Fill in your company name and address
Select your business residency type and indicate your Business Registration number
Fill in your company’s nature of business and company’s contact details.
Please indicate your business details.
Fill in FIRST contact person details
Fill in SECOND contact person details
.
Fill in THIRD contact person details (if any)
ABC SDN BHD
LEVEL 2, MENARA XYZ, JALAN SULTAN ISMAIL, 50250 KUALA LUMPUR
ELECTRONIC
03-2026XXX 03-2026XXX
123456-X
ABC.COM.MY
XX,XXX.XX YYYY
25 YYYY
JANE DOE
012-388XXXX XXXXXX-XX-XXXX
012-388XXXX XXXXXX-XX-XXXX
JOHN SMITH
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 3 of 7 Version 21 (Last updated 23 Jan 2017)
Section C: Declaration*
C.1 Perbadanan Insurans Deposit Malaysia (PIDM)
I/We have received a copy of the PIDM brochure and acknowledge that this product is insured by PIDM.
C.2a Foreign Account Tax Compliance Act (FATCA) for Sole Proprietor/Partnership
C.2b Foreign Account Tax Compliance Act (FATCA) for Associations, Limited Liability Partnerships, Clubs, Society, Trusts of Entity and Companies.
Identifying Specified/Potential U.S. Person (To be completed by the customer - please tick (“✓”) in the “Yes” / “No” column respectively for each of the following questions)
Identifying U.S. Reportable Accounts for company (To be completed by all types of entities – please (√) where applicable)
No. U.S. Indicia Status Account Holder
a) A Specified U.S. Person1 Yes No
1. Are you a U.S. citizen or resident (including
green card holder)?
2. Is U.S. your country of birth?
b) A Passive Non-Financial Foreign Entity (NFFE) with one or
more Controlling Persons who are Substantial U.S. Owners23.
Do you hold a current U.S. residence address
or mailing address (including a U.S. post office
box)?
4. Do you have a current U.S. telephone number?
5. Do you currently maintain any standing instructions to the U.S.?
c) A Non-Participating Foreign Financial Institution (NPFFI)3 6. Do you currently assign power of attorney or signatory authority to a person within the U.S.?
7. Do you currently have a ‘hold mail’ or ‘in care of’ address as your sole address?
Definition: The term U.S person means a person described in section 7701(a)(30) of the Internal Revenue Code: (A) a citizen or resident of the U.S.
Definition: 1 • An individual who is a U.S. citizen or U.S. resident,
• A partnership, corporation, company, or association created or organized in the U.S. orunder the laws of the U.S.,
• An estate (other than a foreign estate), or• A domestic trust (as defined in Regulations section 301.7701-7 of the Internal Revenue
Code).
2 • Owns, directly or indirectly, more than 10% (by vote or value) of the stock of any foreign corporation;
• Owns, directly or indirectly, more than 10% of the profits or capital interests in aforeign partnership;
• Is treated as an owner of any portion of a foreign trust under sections 671 through679; or
• Holds, directly or indirectly, more than a 10% beneficial interest in a trust.
3 • A Foreign Financial Institution that does not enter into an agreement with the U.S. IRS.
C.3 Choice of language for Terms and Conditions
English Bahasa Malaysia
C.4 Personal Data Protection Act (PDPA)
AmBank Group’s Business Partners may from time to time offer products, promotions and services that maybe of interest to you. Say ‘YES’ to great offers and promotions from AmBank Group’s Business Partners.
Yes, we would like to receive marketing promotions from AmBank Group’s business partners
No, not at this point of time.
I/We hereby declare that I/we have read and understood the Privacy Notice of AmBank Group which is made available at AmBank branches or website and give my/our consent(s) for the bank to process my/our personal data and sensitive data for the intended usage as stated under the Privacy Notice.
*Denotes mandatory fields – are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations
Please tick the checkbox
Please tick ONLY if you are a Sole Proprietor/Partnership type of business
Select the choices of language for your T&C
Please tick “Yes” if you would like to receive future marketing promotions
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 4 of 7 Version 21 (Last updated 23 Jan 2017)
I/We agree that our application from time to time for products and services provided by AmBank (M) Berhad/AmBank Islamic Berhad herein shall be governed by
the General Terms and Conditions for Accounts and Services, the Specific Terms and Conditions for Foreign Currency Account, the Master Services Terms and
Conditions and/or Master Services Agreement (as the case maybe) and the terms and conditions intended to apply to one or more types of products and services
provided by you which is available at the Ambank Group website (http:www.ambankgroup.com) and I/We agree to adhere to the same. For the avoidance of doubt,
references to ‘you’ shall mean AmBank (M) Berhad and/or AmBank Islamic Berhad, as the case maybe.
I/We confirm that all information and documents provided to you by us pursuant to this application are true, correct, complete and untampered. In addition, you
shall be entitled to rely on the information and particulars provided by us under this account opening application form for any additional products and services made
available by you to us from time to time. In case of any change of particulars, I/We shall immediately notify you in writing of the changes, failing which you are
entitled to deem all particulars as provided under this account opening application form as true and accurate.
I/We also confirm that I/We are not subjected to any cessation of business/winding up liquidation at the time of this application.
I/We hereby declare, certify and confirm that the person(s) whose signature(s) appear below (‘Authorized Persons’) is/are acting in accordance with the mandate
given by us and have authority to effect all transactions/declaration/confirmation/agreements on our behalf in connection with the products and services applied
for - and all such transaction are binding and legally enforceable against us. I/We shall not hold the bank liable for processing the services/accounts that we have
applied for as per my/our instruction even though the Authorized Persons named in the board resolution which is obtained at a later date may differ.
I/We hereby confirm, acknowledge and understand that we as follows:
1. Open and close account
The Authorized Persons are authorized to open and close account with AmBank and AmBank Islamic for any types of account and currency as specified in the
account opening forms and sign and deliver other relevant documents, notices or instructions in accordance with the bank’s terms and conditions governing
such accounts.
2. Subscribe, utilize and terminate the services
The Authorized Person are authorized to subscribe for any electronic facilities, transaction banking services, and any other services which may be offered by the
bank from time to time subject to the terms and conditions of such services.
3. Authorization to appoint authorized signatories
The Authorized Person is authorized to appoint signatories and appoint users for the services subscribed.
The authorized signatories are authorized to operate the accounts in accordance with the signing mandate and/or authority given.
Authorized Person:
Authorized Person:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No. :
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Read and understand the Terms and Conditions
CHEONG YI AHMAD DIN CHEONG YI AHMAD DIN
X X X X X X - X X - X X X X X X X X X X - X X - X X X X
MALAYSIAN MALAYSIAN
03021980 13081970
FIRST Authorised Person to sign and fill in personal details
SECOND Authorised Person to sign and fill in personal details
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 5 of 7 Version 21 (Last updated 23 Jan 2017)
Condition of Authorization Please tick (√) one. [To only complete Section D if the Board Resolution does not indicate specimen signature(s)]
Any One to Sign Any Two to sign All to sign Others : ________________________________
Section D: Authorised Signatories/ Signature Specimen Card Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Authorized Signature:
Authorized Signature:
Full Name as per NRIC/Passport:
Full Name as per NRIC/Passport:
NRIC/Passport No.:
NRIC/Passport No.:
Nationality
Nationality
Date of Birth DDMMYYYY Date of Birth DDMMYYYY
Contact No.
Contact No.
Note: Please photocopy this page if additional authorized signatories are required.
CHEONG YI AHMAD DIN CHEONG YI
X X X X X X - X X - X X X X X X X X X X - X X - X X X X
AHMAD DIN
MALAYSIAN MALAYSIAN
03021980 13081970
Select condition of Authorisation
Fill-in FIRST authorized person details
Fill-in SECOND authorised person details (if any)
Fill-in THIRD authorized person details (if any)
Fill-in FOURTH authorized person details (if any)
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 6 of 7 Version 21 (Last updated 23 Jan 2017)
Note: Please photocopy this page if additional inquiry users are required
B. INQUIRY AND PAYMENT
Primary Security Administrator (Token Custodian)
Name as per NRIC/Passport
NRIC/Passport No Mobile No.
Email address
Designation Specimen
Preferred User ID Signature (Maximum 10 Characters, no special characters allowed, eg: .,!?;)
Secondary Security Administrator (Pin Mailer Custodian)
Name as per NRIC/Passport
NRIC/Passport No Mobile No.
Email address
Designation Specimen
Preferred User ID Signature
(Maximum 10 Characters, no special characters allowed, eg: .,!?;)
¹Basic Payment Package (Internal Fund Transfer, GIRO, RENTAS, SWIFT-FCY TT) ² FS/FP-Floor Stock / Floor Plan
A. INQUIRY ONLY
Inquiry User 1
Name as per NRIC/Passport
NRIC/Passport No. Mobile No.
Preferred User ID Email
(Maximum of 10 Characters, no special characters are allowed, eg: .,!?;) address
Inquiry User 2 (If applicable)
Name as per NRIC/Passport
NRIC/Passport No. Mobile No.
Preferred User ID Email
(Maximum of 10 Characters, no special characters are allowed, eg: .,!?;) address
Payment Services* Please tick (√)
Charging Account
Services Offered
Basic Package̴¹
Banker’s Cheque
Internal Fund
Transfer
GIRO RENTAS SWIFT (FCY TT)
Payroll-IFT Payroll-GIRO
EIPP/ProColl (Direct
debit)
EIPP/ProColl (FS/FP²)
Debit Method Individual Debit
Consolidated Debit
*Denotes mandatory fields - are obligatory fields which are required for the processing of Personal Data to fulfill contractual obligations.
All charges debited from new account
Others, please indicate
X X X X X X X X X X X X
Select “Inquiry and Payment’ for e-AmBiz access with both Inquiry and Payment Facility
Fill-in details of the appointed Token Custodian
CHEONG YI
C H E O
0 1 3 X X X X X X X X
ACCOUNT MANAGER
CHEONG YI
AHMAD DIN
Fill-in details of the appointed PIN Mailer Custodian
AHMAD DIN
X X X X X X X X X X X X
MANAGER
D I N
0 1 3 X X X X X X X X
Select or fill-in the Charging Account
Select type of services (payment mode) you require
Indicate debiting method of your account for that particular payment mode Consolidated Debit – Transactions will be debited from your account in one total amount (reflected on your account statement) Individual debit – Tramsactions will be debited from your account individually. (reflected on your account statement)
ACCOUNT OPENING FORM (NON – INDIVIDUAL)
Page 7 of 7 Version 21 (Last updated 23 Jan 2017)
FOR BANK’S USE ONLY:
Date: CIF:
Attended by:
Verified by:
Approved by:
SVS Captured:
SVS Validated:
Account No: Currency: e-Ambiz:
1.
2.
3.
4.
5.
6.
1. 2. 3. 4. 5. 6.
Yes Yes Yes Yes Yes Yes
X X X X X X X X X X X X X XXX
DDMMYYYY XXXXXXX
RM’s name or the person
who attended the customer
Customer do not need to fill this in. Reserved for Bank Use