Kindly complete, print, sign and submit all

the 3 copies of this form to your ADA

BURSA MALAYSIA DEPOSITORY SDN BHD (165570 W)

Clear Form

APPLICATION FOR OPENING OF ACCOUNT

Please read the instructions on the reverse before completing the Form.
To be completed by ADA / ADM / Bursa Depository
(where applicable)
OLD NRIC / PASSPORT / AUTHORITY CARD / REG. NO.: NEW NRIC NO.:
PARTICIPANT TYPE:

NAME OF APPLICANT (AS PER NRIC/PASSPORT / AUTHORITY CARD/REGISTRATION DOCUMENT):

ADA / ADM CODE:

ACCOUNT QUALIFIER (FOR TRUSTEES / CORPORATE BODY, IF ANY):

INVESTOR TYPE:

REGISTERED ADDRESS OF APPLICANT (AS PER NRIC / PASSPORT / AUTHORITY CARD / REGISTRATION DOCUMENT) (SEE NOTE 5): ACCOUNT TYPE (FOR ADA ONLY):

RY
BENEFICIARY:
POST CODE: TOWN:

STATE: COUNTRY:
STATE: COUNTRY:

CORRESPONDENCE ADDRESS:

TO
POST CODE:

STATE:
TOWN:

COUNTRY: TELEPHONE NO.:

STATE: COUNTRY:

NATL / PLACE OF INCORP.:

CROSS (X) WHERE APPLICABLE NATIONALITY / PLACE OF INCORPORATION: RACE / OWNERSHIP:

SI
(SEE NOTE 13) RACE / OWNERSHIP:
( ) MALAYSIAN
( ) FOREIGNER

DECLARATION BY DEALERS REPRESENTATIVE / ADAS AUTHORISED OFFICER(S) /

DECLARATION BY APPLICANT / AUTHORISED SIGNATORY(IES) / ATTORNEY(S) NOTARY PUBLIC / OTHERS AS APPROVED BY BURSA DEPOSITORY
(To be completed when applicant is not present in person)

*I / We hereby:- I hereby affirm and attest that the particulars of the applicant have been verified to be
PO

i. declare that I have attained 18 years of age (for individuals true and the *signature(s) / thumbprint(s) of the *applicant / authorised
only) signatory(ies) / attorney(s) belong(s) to the *applicant / authorised
ii. declare that I am not an undischarged bankrupt (for individuals signatory(ies) / attorney(s) who *has / have appeared in person before me.
only)
iii. agree to be bound by the Rules of Bursa Malaysia Depository NAME :
Sdn. Bhd. (Bursa Depository) and any amendments thereto
iv. agree to be bound by any procedures and / or directives issued NRIC NO. :
by Bursa Depository
v. affirm that I have no other individual securities account LICENSE NO. :
maintained with this Authorised Depository Agent (ADA) (for (IF APPLICABLE)
individuals only)
vi. affirm that this account *is / is not for pledged securities DESIGNATION :
DE

vii. affirm that all the information stated in this Application Form
and Specimen Signature Cards is correct SIGNATURE :
viii. undertake to notify the ADA / Bursa Depository of any change of
particulars or information provided by *me / us in this Application DATE :
Form
FOR OFFICE USE ONLY
ix. declare that *I / We *am / are the *beneficial owner(s) /
authorised nominee of all securities credited into this To be completed by ADA / Bursa Depository
account. (Sign and affix company rubber-stamp)

VERIFIED BY : DATE :

APPROVED BY : DATE :

DATA ENTRY BY : DATE :

CDS ACCOUNT NUMBER ALLOTTED:

CROSS (X) WHERE APPLICABLE (FOR INDIVIDUALS ONLY)

Applicant appeared in person and the original *NRIC / Passport / Authority Card was
SIGNATURE OF APPLICANT / AUTHORISED SIGNATORY(IES)** DATE
verified by us.
* Delete whichever inapplicable Application received from *Dealers Representative / ADAs Authorised Officer(s)/
** Affixation of common seal or company rubber-stamp (where applicable) Notary Public / Others as approved by Bursa Depository.

FMN010 NF/11 Page 1 of 3

 BURSA MALAYSIA DEPOSITORY SDN BHD (165570 W)

APPLICATION FOR OPENING OF ACCOUNT

Please read the instructions on the reverse before completing the Form.
To be completed by ADA / ADM / Bursa Depository
(where applicable)
OLD NRIC / PASSPORT / AUTHORITY CARD / REG. NO.: NEW NRIC NO.:
PARTICIPANT TYPE:

NAME OF APPLICANT (AS PER NRIC/PASSPORT / AUTHORITY CARD/REGISTRATION DOCUMENT):

ADA / ADM CODE:

ACCOUNT QUALIFIER (FOR TRUSTEES / CORPORATE BODY, IF ANY):

INVESTOR TYPE:

REGISTERED ADDRESS OF APPLICANT (AS PER NRIC / PASSPORT / AUTHORITY CARD / REGISTRATION DOCUMENT) (SEE NOTE 5): ACCOUNT TYPE (FOR ADA ONLY):

BENEFICIARY:
POST CODE: TOWN:

STATE: COUNTRY:

M
STATE: COUNTRY:

CORRESPONDENCE ADDRESS:
AD
POST CODE: TOWN:
STATE: COUNTRY:
STATE: COUNTRY: TELEPHONE NO.:
NATL / PLACE OF INCORP.:

CROSS (X) WHERE APPLICABLE NATIONALITY / PLACE OF INCORPORATION: RACE / OWNERSHIP:

(SEE NOTE 13) RACE / OWNERSHIP:
( ) MALAYSIAN
( ) FOREIGNER
A/

DECLARATION BY DEALERS REPRESENTATIVE / ADAS AUTHORISED OFFICER(S) /

DECLARATION BY APPLICANT / AUTHORISED SIGNATORY(IES) / ATTORNEY(S) NOTARY PUBLIC / OTHERS AS APPROVED BY BURSA DEPOSITORY
(To be completed when applicant is not present in person)

*I / We hereby:- I hereby affirm and attest that the particulars of the applicant have been verified to be
i. declare that I have attained 18 years of age (for individuals true and the *signature(s) / thumbprint(s) of the *applicant / authorised
only) signatory(ies) / attorney(s) belong(s) to the *applicant / authorised
ii. declare that I am not an undischarged bankrupt (for individuals signatory(ies) / attorney(s) who *has / have appeared in person before me.
only)
iii. agree to be bound by the Rules of Bursa Malaysia Depository NAME :
AD

Sdn. Bhd. (Bursa Depository) and any amendments thereto

iv. agree to be bound by any procedures and / or directives issued NRIC NO. :
by Bursa Depository
v. affirm that I have no other individual securities account LICENSE NO. :
maintained with this Authorised Depository Agent (ADA) (for (IF APPLICABLE)
individuals only)
vi. affirm that this account *is / is not for pledged securities DESIGNATION :
vii. affirm that all the information stated in this Application Form
and Specimen Signature Cards is correct SIGNATURE :
viii. undertake to notify the ADA / Bursa Depository of any change of
particulars or information provided by *me / us in this Application DATE :
Form
FOR OFFICE USE ONLY
ix. declare that *I / We *am / are the *beneficial owner(s) /
authorised nominee of all securities credited into this To be completed by ADA / Bursa Depository
account. (Sign and affix company rubber-stamp)

VERIFIED BY : DATE :

APPROVED BY : DATE :

DATA ENTRY BY : DATE :

CDS ACCOUNT NUMBER ALLOTTED:

CROSS (X) WHERE APPLICABLE (FOR INDIVIDUALS ONLY)

Applicant appeared in person and the original *NRIC / Passport / Authority Card was
SIGNATURE OF APPLICANT / AUTHORISED SIGNATORY(IES)** DATE
verified by us.
* Delete whichever inapplicable Application received from *Dealers Representative / ADAs Authorised Officer(s)/
** Affixation of common seal or company rubber-stamp (where applicable) Notary Public / Others as approved by Bursa Depository.

FMN010 NF/11 Page 2 of 3

 BURSA MALAYSIA DEPOSITORY SDN BHD (165570 W)

APPLICATION FOR OPENING OF ACCOUNT

Please read the instructions on the reverse before completing the Form.
To be completed by ADA / ADM / Bursa Depository
(where applicable)
OLD NRIC / PASSPORT / AUTHORITY CARD / REG. NO.: NEW NRIC NO.:
PARTICIPANT TYPE:

NAME OF APPLICANT (AS PER NRIC/PASSPORT / AUTHORITY CARD/REGISTRATION DOCUMENT):

ADA / ADM CODE:

ACCOUNT QUALIFIER (FOR TRUSTEES / CORPORATE BODY, IF ANY):

INVESTOR TYPE:

REGISTERED ADDRESS OF APPLICANT (AS PER NRIC / PASSPORT / AUTHORITY CARD / REGISTRATION DOCUMENT) (SEE NOTE 5): ACCOUNT TYPE (FOR ADA ONLY):

R
BENEFICIARY:
POST CODE: TOWN:

STATE: COUNTRY:
STATE: COUNTRY:

TO
CORRESPONDENCE ADDRESS:

POST CODE:

STATE:
TOWN:

COUNTRY: TELEPHONE NO.:

STATE: COUNTRY:

NATL / PLACE OF INCORP.:

SI
CROSS (X) WHERE APPLICABLE NATIONALITY / PLACE OF INCORPORATION: RACE / OWNERSHIP:
(SEE NOTE 13) RACE / OWNERSHIP:
( ) MALAYSIAN
( ) FOREIGNER

DECLARATION BY DEALERS REPRESENTATIVE / ADAS AUTHORISED OFFICER(S) /

DECLARATION BY APPLICANT / AUTHORISED SIGNATORY(IES) / ATTORNEY(S) NOTARY PUBLIC / OTHERS AS APPROVED BY BURSA DEPOSITORY
PO

(To be completed when applicant is not present in person)

*I / We hereby:- I hereby affirm and attest that the particulars of the applicant have been verified to be
i. declare that I have attained 18 years of age (for individuals true and the *signature(s) / thumbprint(s) of the *applicant / authorised
only) signatory(ies) / attorney(s) belong(s) to the *applicant / authorised
ii. declare that I am not an undischarged bankrupt (for individuals signatory(ies) / attorney(s) who *has / have appeared in person before me.
only)
iii. agree to be bound by the Rules of Bursa Malaysia Depository NAME :
Sdn. Bhd. (Bursa Depository) and any amendments thereto
iv. agree to be bound by any procedures and / or directives issued NRIC NO. :
by Bursa Depository
v. affirm that I have no other individual securities account LICENSE NO. :
(IF APPLICABLE)
DE

maintained with this Authorised Depository Agent (ADA) (for

individuals only)
vi. affirm that this account *is / is not for pledged securities DESIGNATION :
vii. affirm that all the information stated in this Application Form
and Specimen Signature Cards is correct SIGNATURE :
viii. undertake to notify the ADA / Bursa Depository of any change of
particulars or information provided by *me / us in this Application DATE :
Form
FOR OFFICE USE ONLY
ix. declare that *I / We *am / are the *beneficial owner(s) /
authorised nominee of all securities credited into this To be completed by ADA / Bursa Depository
account. (Sign and affix company rubber-stamp)

VERIFIED BY : DATE :

APPROVED BY : DATE :

DATA ENTRY BY : DATE :

CDS ACCOUNT NUMBER ALLOTTED:

CROSS (X) WHERE APPLICABLE (FOR INDIVIDUALS ONLY)

Applicant appeared in person and the original *NRIC / Passport / Authority Card was
SIGNATURE OF APPLICANT / AUTHORISED SIGNATORY(IES)** DATE
verified by us.
* Delete whichever inapplicable Application received from *Dealers Representative / ADAs Authorised Officer(s)/
** Affixation of common seal or company rubber-stamp (where applicable) Notary Public / Others as approved by Bursa Depository.

FMN010 NF/11 Page 3 of 3

INSTRUCTIONS FOR COMPLETION OF APPLICATION FOR OPENING OF ACCOUNT FORM
1. This form must be completed in triplicate.

2. Please type or write using BLOCK LETTERS.

3. Each box should contain only one letter. Leave one box between words.

4. The following completed application must be accompanied by the required documents as stated below:-

TYPE OF APPLICANT DOCUMENTS TO BE SUBMITTED

INDIVIDUAL Two copies of:-
i. NRIC / Passport / Armed Forces or Police Personnel Authority Card
Two certified true copies of:-
ii. Power of Attorney (if applicable)
COMPANY INCORPORATED UNDER THE Two certified true copies of:-
COMPANIES ACT 1965 i. Board Resolution
ii. Memorandum and Articles of Association
iii. Form 8 or 9, 24, 44 and 49 (Form 13 and 20 only if applicable)
iv. Power of Attorney (if applicable)
SOCIETY REGISTERED UNDER THE Two certified true copies of:-
SOCIETIES ACT 1966 OR CO-OPERATIVE i. Constitution / By-Laws of the Society
SOCIETIES ACT 1948 ii. Certificate of Registration
iii. Resolution of Governing Body (ie. Committee / Board)
CORPORATIONS INCORPORATED BY AN Two certified true copies of:-
ACT OF PARLIAMENT OR STATE i. Board Resolution
ENACTMENT ii. Power of Attorney (if applicable)
iii. In respect of statutory body other than EPF, LUTH, SOCSO, LTAT,
copy of the act / enactment incorporating the said body

5. a) For individual applicants apart from armed forces / police personnel, use the address as stated in national identity card or a
valid and unexpired JPN 1/9, JPN 1/11 or JPN 1/22.
b) For armed forces / police personnel, use the address of their respective camp / base / station.
c) For foreign applicants, use the address as stated in the passport (if any).

6. An individual is required to be present in person to apply for a CDS account, unless waived by the Authorised Depository
Agent (ADA).

7. The witness to the account opening application must certify on the photocopies of the NRIC / Passport / Armed Forces or Police
Personnel Authority Card / supporting documents.

8. Form defaced by erasure or any kind of correcting fluid may result in the application being rejected.

9. Any amendment made on the form must be legible and signed by the applicant / authorised signatory(ies) of the corporate
applicant.

10. Where affixation of common seal is not required, corporate investors must ensure that they affix the company rubber-stamp.

11. Bursa Malaysia Depository Sdn Bhd (Bursa Depository) reserves the right to reject applications, which do not conform to the
Rules of Bursa Depository (including amendments thereto), and / or guidelines or instructions issued by Bursa Depository from
time to time.

12. Please contact your ADA if you do not receive the Account Opening Notice within 14 days after opening your account.
13. A foreigner is defined as:-
a) an individual who is not a citizen of Malaysia;
b) a body, corporate or unincorporate, which is incorporated or constituted, as the case may be, outside Malaysia;
c) a trustee administering a trust which is constituted under any foreign law;
d) a trust corporation which is incorporated under any foreign law:
e) a society, including a co-operative society or any other institution, which is constituted, registered or incorporated under
any foreign law;
f) a nominee company incorporated in Malaysia which-
(i) is identified with the word (Asing) in its name; and
(ii) performs the services of a nominee, agent or trustee solely for or on behalf of legal or beneficial owners of securities
who are foreigners; or
g) a company, other than a company described under paragraph (f), which is incorporated in Malaysia and where any one of
the persons or a combination of the persons referred to in paragraph (a), (b), (c), (d) or (e) is entitled to exercise or control
the exercise of more than fifty per centum of the voting rights of the company.