sc.com/npb) Authorized a person who has a U.S. address to operate the banking account (either physically or electronically). 2. I have set up Payment Standing Instruction (s) for the

sc.com/np

For Bank Use Only

CDD Checklist Reference No. _________________________

Branch: _____________ Currency Code: _______________

Account Number

Date: D D M M Y Y Y Y

PERSONAL ACCOUNT OPENING FORMPlease complete all details in CAPITAL letter

Permanent Address: ___________________ District: __________

Municipility/V.D.C_________________________ Ward No.: ____

Tole/Street/Road ______________________House No.: ________

Phone No.: (Land Line) _____________ (Mobile) ________________

Email Address: ________________________________________

Current Address

District: _____________ Municipility/V.D.C ___________________

Ward No.: ______ Tole/Street/Road ___________House No.: ___


Type of Identification Card: Citizenship/Passport

Identification Number: _________________________________

Issued by: _____________________ Issued Date: ____________

PAN No.: ____________________________________________

Family Details

Spouse: _____________________________________________

Father: ______________________________________________

Mother: ______________________________________________

Grand Father: ________________________________________

Son: ________________________________________________

Daughter : ___________________________________________

Daughter in Law (Wife of Account Holder's Son): ___________________

Father in Law (For married women): ___________________________

Associated Profession / Business

Nationality: ___________________________________________

Would you like a Joint Account?Yes (For Joint Applicant/s, please complete the fields below )

No (Please go to Section 5)

Relationship No. (for Bank use only)

Salutation / Title Mr. Mrs. Ms. Other______

Full Name in block letter:

Gender: Male Female Other

Secondary Applicant (B)3.

S.N.

Name of Organization Address Designation Estimated AnnualIncome / Remuneration

Annual Estimated Transaction:

1.

2.

3.

Please tell us about yourself

Do you have any associated accounts with Standard Chartered

Bank Nepal Limited? Yes No

If Yes, Name of Account ____________________________

Account Number

Sole Applicant/ Primary Applicant (A)1.

Please complete others details as per NRB KYC Form (Directive 19.1)2.

D D M M Y Y Y YDate of Birth:

Name of Organization: __________________________________

Tel: (Res.): __________________ (Off.) ____________________

Mobile: ______________________________________________

email: ________________________________________________

Fax: ________________________________________________

Residence Address: (in full with House No & Ward No) __________________

_____________________________________________________

Nearest Landmark: ____________________________________

No. of years at current add.: _____________________________

Mailing Address: _______________________________________

____________________________________________________

Permanent Address: (If different from Residence Address) _________________

____________________________________________________




Nationality: ___________________________________________

Marital Status Single Married Other

Occupation / Nature of Employment:

Salaried Employed with: Pvt Ltd. Pub Ltd. Others

Self Employed You are a: CA Doctor Engineer

Retired Businessman Others ________________



Tel: (Res.): __________________ (Off.) ____________________

Mobile: ______________________________________________

email: ________________________________________________

Fax: ________________________________________________


_____________________________________________________



Mailing Address: _______________________________________

____________________________________________________


____________________________________________________










Email Address: ________________________________________

Current Address







PAN No.: ____________________________________________

Family Details

Spouse: _____________________________________________

Father: ______________________________________________

Mother: ______________________________________________

Grand Father: ________________________________________

Son: ________________________________________________

Daughter : ___________________________________________




Please complete others details as per NRB KYC Form (Directive 19.1)3.1


Secondary Applicant (C)4.




Nationality: ___________________________________________


Tel: (Res.): __________________ (Off.) ____________________

Mobile: ______________________________________________

email: ________________________________________________

Fax: ________________________________________________


_____________________________________________________



Mailing Address: _______________________________________

____________________________________________________


____________________________________________________







Please complete others details as per NRB KYC Form (Directive 19.1)4.1





Email Address: ________________________________________

Current Address





S.N.



1.

2.

3.

Transaction Profile5.

Source of Funds: Business Income Salary Income

Returns on Investments

Other please specity __________________

Average Monthly Income ________________________________

Expected Transaction Amount and No. of Transactions per Month:

Currency ______________ Amount ________________________

No. of Transactions ____________________________________

Type / Nature of Transaction: Cash Cheque

Remmitance

Please consider these valuable services7.

A. Statement:Frequency: Monthly QuarterlyMode of Delivery: e-statement Post Print on DemandFor e-statement please provide your email address:__________________________________________________

C. Online Banking: (For joint A/c this is issued only if the A/c is operated singly)

Yes NoPlease link my/our following Credit Cards to my/our Online Banking:

Purpose of Account:

Saving Payroll Investment Business Transactions Remittance

Others ______________________________________________ (Please specity)

Type and Purpose of Accounts6.

Current Account ____________________________________

Savings Account: Normal Savings _________________

(Specify currency of Account)

(Specify currency of Account)

Amulya Bachat Khata Diva

Access Plus Kiddy Bank

Payroll Others __________________(Specify type & currency of Account)

In case of Joint Account:Name of Applicant to whom Online Banking ID and PIN are to be delivered:__________________________________________________________

Preferred delivery branch for Cheque book and Debit Card._______________________________

Nomination Form (Applicable for Sole Accounts Only)8.

I _________________________________________________________

son/daughter of _____________________________________________

hereby nominate ____________________________________ to receive

any sum of monies which may be due to me from this account held by your

Bank in the event of my death.

Nominee's Father's/Mother's Name _____________________________

Nominee's Age ______________________________________________

Nominee's Citizenship No. _____________________________________

Nominee's Relationship to me __________________________________

Nominee's Telephone No. ______________________________________

Nominee's Mailing Address _____________________________________

___________________________________________________________

If the Nominee is a minor at the time of my death, I appoint Mr./Mrs./Ms.

___________________________________________________________

Address ____________________________________________________

____________________Telephone No.___________________________

to receive all monies due to me on behalf of the Nominee.

YOUR NAME

Would you be interested in the following products?

Home Loan Yes No ____________ ________

Auto Loan Yes No ____________ ________

Bancassurance Yes No ____________ ________

Personal Loan Yes No ____________ ________

SME Business Loan Yes No ____________ ________

Month Year

Month Year

Month Year

Month Year

Month Year

(If Yes, Please mention tentative Month & Year)

(Note: Loans are subject to approval)

Would you like the Bank to inform you about new products & services?Yes No

If Yes, please tick the preferred channel for communication:SMS Telephone Email Letters Any one/All of the above




PAN No.: ____________________________________________

Family Details

Spouse: _____________________________________________

Father: ______________________________________________

Mother: ______________________________________________

Grand Father: ________________________________________

Son: ________________________________________________

Daughter : ___________________________________________




B. Debit Card: (For joint A/c this is issued only if the A/c is operated singly)

For Sole/Primary Applicant (A) Yes NoKindly write your name as you would like it to appear on your card(s).

For Secondary Applicant (B) Yes NoKindly write your name as you would like it to appear on your card(s).

For Secondary Applicant (C) Yes NoKindly write your name as you would like it to appear on your card(s).

S.N.



1.

2.

3.

Please complete in BLOCK LETTERS

Name: ___________________________________________________________________________________________________________________________

Country of Residence: ______________________________________________

Country of Birth: ___________________________________________________

Please check Yes or No for each of the following questions:Yes / No

1. Are you a U.S. Resident?

2. Are you a U.S. Citizen?

3. Are you holding a U.S. Permanent Resident Card (Green Card)?

Mandate9.

I/We hereby acknowledge that I/We have read and understood the Terms and Conditions pertaining to the opening and operation of this account and agree to be boundby the same. I/We further agree to abide by any amendments to the said Terms and Conditions made by the Bank from time to time, with or without notice to me/us.

Signing authority for Joint Accounts:Any one or Survivor Jointly Other _______________

1. Is the residential address mentioned in account opening form a care of address? Yes No

Please put a if any statement below applies to you.

1. I have

a) Granted a power of Attorney to a person who has a U.S address, or

b) Authorized a person who has a U.S. address to operate the banking account (either physically or electronically).

2. I have set up Payment Standing Instruction (s) for the banking account and the beneficiary accounts(s) is in U.S.

I hereby confirm the information provided above is true, accurate and complete.Subject to applicable local laws, I hereby consent for Standard Chartered PLC or any of its affiliates (including branches) to share my information with domestic and overseas tax authoritieswhere necessary to establish my tax liability in any jurisdiction.Where required by domestic or overseas regulators or tax authorities, I consent and agree that the Bank may withhold from my account(s) such amounts as may be required according toapplicable laws, regulations and directives

This form must be completed by any individual who wishes to open a banking account.

Account Opening Form (AOF) Supplement11.

Specimen Signature(s) (Please sign with black ink) & Photograph10.

PHOTO

Name: ______________________________________________ Name: ____________________________________________Sole/Primary Applicant (A) Secondary Applicant (B)

Signature Signature

PHOTO

PHOTO

Name: ______________________________________________Secondary Applicant (C)

Signature

_______________________Signature of Sole Applicant/

Primary Applicant (A)

__________________Signature of

Secondary Applicant (B)

__________________Signature of

Secondary Applicant (C)

Declaration12.

By signing on this appliation you:

represent and warrant that all information (including any documents) you have given to us in connection with the application is correct, complete and not misleading. (ifthis is not the case you may be personally liable):

authorise us to verify any of the information you have given us or your credit standing from anyone we may consider appropriate:

acknowledge that we may decline your application. If this happens, no contractual relationship will arise between us, and we reserve the right to retain the documents yousubmitted to us with your application;

confirm that you have read, received a copy and understood the Terms and Conditions as outlined in the Terms and Conditions Booklet that you have signed

BANK USE ONLY13.

Checked/Approved(Branch)Name:Designation:

Input & Checked(Account Operations)

SIGCAP Confirmed(Account Operations)

Cheque Book Ordered

BranchActivity Fee ARM Code Segment Code

Risk Grade Assigned Product Type Employer Code Resident

Non-Resident Profession Code Tax on interestYes

Waived (Please attach relevant daocument)

Minimum Balance _______________

Account Operations

Relationship opened Master opened Subsidiary opened Call Deposit

Sigcap updated Debit Card Issued eStatement (Account) Issued Online Banking ID Issued

Online Banking PIN Issued Fixed Deposit

Documents

sc.com/npb) Authorized a person who has a U.S. address to operate the banking account (either physically or electronically). 2. I have set up Payment Standing Instruction (s) for the