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    Individual Information Form

    Uploaded by

    Tanzir Hasan
    This document is an individual information form for opening a bank account. It requests personal details such as name, date of birth, address, nationality, occupation, income, emergency contacts, and credit card information. The applicant consents to sharing their information with regulators as required by law. Signatures are required from the applicant and bank officers to verify and approve the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Individual Information Form

    Uploaded by

    Tanzir Hasan
    55 views2 pages
    This document is an individual information form for opening a bank account. It requests personal details such as name, date of birth, address, nationality, occupation, income, emergency contacts, and credit card information. The applicant consents to sharing their information with regulators as required by law. Signatures are required from the applicant and bank officers to verify and approve the application.

    Original Title

    INDIVIDUAL INFORMATION FORM

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    © © All Rights Reserved

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    This document is an individual information form for opening a bank account. It requests personal details such as name, date of birth, address, nationality, occupation, income, emergency contacts, and credit card information. The applicant consents to sharing their information with regulators as required by law. Signatures are required from the applicant and bank officers to verify and approve the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    55 views2 pages

    Individual Information Form

    Uploaded by

    Tanzir Hasan
    This document is an individual information form for opening a bank account. It requests personal details such as name, date of birth, address, nationality, occupation, income, emergency contacts, and credit card information. The applicant consents to sharing their information with regulators as required by law. Signatures are required from the applicant and bank officers to verify and approve the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    INDIVIDUAL INFORMATION FORM

    THIS IS A MACHINE READABLE FORM. It should be completed in "ENGLISH CAPITAL" letters. Date D D MM Y Y Y Y

    FOR BANK USE ONLY


    Unique Customer ID

    A/C No.

    Relation with the Account 1st Applicant 2nd Applicant 3rd Applicant

    Director A/C Operator Partner


    Please affix here a recent
    Beneficial Owner Minor Guardian Passport size photograph
    duly attested by A/C holder
    Trustee Attorney Holder Proprietor

    Others Please Specify

    Account Name

    Customer’s Name

    Father’s Name

    Mother’s Name

    Spouse Name

    Date of Birth D D MM Y Y Y Y Gender


    Religion Male Female Third Gender

    National ID Card No.* Resident Status


    Birth Certificate No.* Resident Non-Resident

    Passport No.* Issue Date D D MM Y Y Y Y

    Place of Issue Exp. Date D D MM Y Y Y Y

    Driving License No. Exp. Date D D MM Y Y Y Y

    Other Photo ID E-TIN

    Nationality Bangladeshi Others Please Specify *Foreigners will provide VISA and Passport copy.

    Place of Birth (Dist/City) Country of Birth

    Profession Monthly Income


    (For Individual A/C Only)

    Name of the Employer/ Designation


    Organization

    Nature of Business

    Page 01 of 02
    Present Address (Residence)

    Postcode Country Landmark

    Professional Address

    Postcode Country Landmark

    Parmanent Address

    Postcode Country Landmark

    Phone No.(Residence) Office

    Mobile 0 1 Fax No

    E-mail ID

    Emergency Name
    Contact

    Address

    Email

    Mobile 0 1

    Relationship with A/C


    Operator or A/C Holder

    Credit Card Information of A\C Holder (If any)

    Issued By (Local)

    Issued By (International)

    1. Are you a U.S. Resident Yes No 2. Are you a Yes No 3. Do You hold a U.S. Permanent Yes No
    U.S. Citizen Resident Card (Green Card)?
    I/We hereby consent for The City bank Limited or any of its affiliates (include branches) (here in after collectively referred to as “Bank”) to share my/our information with domestic or overseas
    regulators or tax authorities or other concerned authorities where necessary and/or required by applicable laws, agreement with regulators or authorities and/or directives.

    Where required by domestic or overseas regulators or tax authorities or other concerned authorities, I/we consent and agree that the Bank may with hold, and pay out, from my/our account
    (s) such amounts as may by required according to applicable laws, regulations, or authorities and directives and Bank shall not be held liable for any consequences thereof. In the event of any
    loss suffered by bank due to my/our failure or inaction or misrepresentation, I/we shall hold the Bank fully indemnified and harmless against all such losses arising thereof. Proof of address
    required (of any one).

    Signature with Date Signature with Name Seal Signature with Name Seal

    Applicant’s Name Account Opened By Approved by BM/Designated Officer

    *Any one photo ID must be Submitted. *In case of Birth Certificate, provide additional Photo ID as per Bangladesh Bank guideline.

    Page 02 of 02

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