NON-INDIVIDUAL APPLICATION FORM

Maybank (Cambodia) Plc. Date (dd/mm/yyyy)

Security Code

Branch: ______________________ Savings Current Fixed Deposit Others _____________________

Type of Customer New Existing Resident Non-Resident

Currency of Account US Dollar Khmer Riel Others _________________________

Account Operating Condition All to Sign Anyone to Sign As per Resolution Others ___________________________

Section 1 - A: Particulars of Business, Company, Society etc. (Please delete whichever is inapplicable and tick “” the relevant box)

Business Types Sole Proprietor Partnership Limited Company Society Others __________________________________

Name
(Registered Name)
Date of Registration
Postcode
(dd/mm/yyyy)

Place of Registration Registration No.

Correspondence
Address

Mobile No. Office No.

Contact Detail
Email Address Others

Name No. PP/ ID, Place of Issue Citizenship/ Race

Particular of Proprietor, 1.
Partners, Directors, 2.
Committee Members
etc. 3.
(Applicable for account
opening only) 4.
5.

Section 1 - B: Beneficial Owners and Principal Controllers (For individuals or entities who ultimately beneficially own 25% or more of the company)

Number of Beneficial Owners and Principal Controllers : 1 2 3 4 Other________________________

Name: Name:

Address: Address:

Contact No: Contact No:

Citizenship/ Citizenship/
Country of Incorp: Country of Incorp:
Passport No/Co. Passport No/Co.
Registration No: Registration No:

Position: Position:

% Ownership: % Ownership:

Section 1 - C: Additional Information

Purpose of Opening
Nature of Business
the Account
Name of
Source of Fund
Existing Bank

Are you expected to To/ From Which Countries

Yes
send funds overseas or Purpose of Funds/ Payment
receive funds from No
overseas? Expected Amount Involved

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 Section 2 - Internet Banking Service Yes No

Add IB Facility Add/ Change Account No. Activate/ Deactivate IB Service

Type of Application Cancel Account No. Update/ Cancel Mobile No. M2U TAC (HP) ________________________________
Cancel IB Facility Others _____________________

Account Linkage Savings / Current Account 1. __ __ __ __ __ - __ __ - __ __ __ __ __ __ - __ __

Section 3 - Acknowledgment
Internet Banking (IB) Access Number and FTAC Number are issued to the above-mentioned customer.
I acknowledge receipt of the following items:

1. IB Access Number and FTAC Number Yes No

Signature of Access Number Holder

_____________________________________ Date: _____________________________

Section 4: Declaration
By Signing Below:

1. I/We request the Bank to open the above deposit account.

2. I/We agree to apply for the service(s) and/or card(s) that I/we have opted for herein and link the deposit account to it/them, and it is subject to the Bank’s approval.
3. I/We confirm all information given is true, correct and complete.
4. I/We authorize the Bank to verify the information given here with any party (including without limitation, with any credit bureau or any other competent authorities
where necessarily required by the Bank) or corporation set up for the purpose of collecting and providing information relating to the credit standing of a person
without reference to me/us.
5. I/We have been given a copy of related Terms and Conditions at the time of this application; I/we will be bound to the related Terms and Conditions and acknowledge
that I/we have been given an opportunity to read, understand and accept the said Terms and Conditions.
6. I/We am/are required to resubmit the request and contact the Bank to update my/our telephone number, address, and other info if these have been changed.
7. I/We hereby agree that the Bank shall be entitled to charge for any of its services provided to me/us at the rates as notified by the Bank to me/us from time to time
or, in the absence of such notification, at a reasonable rate. All banking charges when due shall be debited from my/our Banking Accounts.
8. I/We declare that I/we have not committed any act of bankruptcy at the time the account(s) is/are opened.
9. I/We agree to examine and notify you of any errors, irregularities or discrepancies in the statement of account sent to me/us and to notify you if I/we fail to receive
such monthly statement.
10. I/We agree to pay the fees that the Bank may prescribe from time to time in relation to Internet Banking Service. (For Internet Banking Service only)
11. I/We agree that once we sign up for Internet Banking Service, all my/our accounts will be linked. (For Internet Banking Service only)
12. I/We authorize the bank to close my/our dormant Savings account (account showing no transaction activity other than posting of interest and/or service
charges for the past 12 months) with “ZERO” balance, if no deposit is made within 14 days from the date the account balance turns to ZERO without prior notice.

Signature (1) ______________________________________________________________ Signature (4) ______________________________________________________________

Signature (2) ______________________________________________________________ Signature (5) ______________________________________________________________

Signature (3) ______________________________________________________________ Signature (6) ______________________________________________________________

_____________________________________________________________________________ Date: ___________________________________

Chop/ Stamp of Business/ Company/ Society

FOR BRANCH USE ONLY

Attended by: _______________________________________________________________ Date: ___________________________________

Verified by & Approved by: __________________________________________________ Date: ___________________________________

For account opening, please complete section 1 A, B & C and section 4

For Internet Banking service, please complete section 1A, section 2, 3 and 4.

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