ACCOUNT OPENING FORM - (Individual)

Date d d m m y y y y Customer ID For Bank use Only

Account No.
Manager
IFIC Bank Limited
__________________________ Branch
PLEASE FILL UP THE FORM IN CAPITAL LETTER IN ENGLISH. (`qv K‡i digwU eo nv‡Zi Aÿ‡i c~iY Kiæb)
Please fill up all fields carefully & strike-out the ones which are not applicable. AbyMÖnc~e©K mZK©Zvi mv‡_ dig c~iY Kiæb Ges AcÖ‡hvR¨ NiMy‡jv †K‡U w`b|
Dear Sir/Madam,
I/We am/are applying to open an ___________________________________________________ account in your branch. My/our detailed information
is given below: (Product Name)

1. Account Title evsjv

wnmv‡ei bvg English

2. Account Short Name

3. Type of Account Savings Current SND FC RFCD NFCD AMAR Account FDR

MIS PSS Flexi DPS Others____________________________________

4. Nature of Account Individual Joint Non-Resident Minor

5. Currency BDT USD GBP URO Others _______________________

6. COMMUNICATION DETAILS
a) Communication Address Selection Present Address (Residence) Professional Address Permanent Address
(Please select only 1 type of Address)
b) E-mail ID
(In Block Letters)
c) Mobile Number
For Joint Account all Communication will be made with the 1st Applicant

7. INTRODUCER’S INFORMATION
Introducer’s Name Relationship
with Applicant(s)
Account Number Branch Name

Contact Number : Phone No. Mobile No.

Signature of Introducer Signature

(with Date) Verified by
Bank (Seal & Date)

8. SOURCES OF FUND/INCOME
Salary Own Business Commission Foreign Remittance Inheritance/Gift/Return on Investment

Others (Please Specify)

9. PURPOSE OF ACCOUNT OPENING

10. INITIAL DEPOSIT

Nature of Initial Deposit : Cash/Instrument or Account Transfer: _________________________________________________________________
Amount: ____________________ (In words ______________________________________________) Currency: ____________________________
PO/Cheque No.: _____________________________ Date: ________________________ Bank & Branch: _________________________________
11. OTHER FACILITIES
a) Cheque Book Yes [No. of Leaves____________ Delivery Branch ________________________________ ] No
b) Debit Card Yes [Please fill up the “Card Details” section] No
c) SMS Alert Yes [Please provide Mobile No. in “Communication Details” section] No
d) Internet Banking Yes [Please provide E-mail ID in “Communication Details” section] No
e) Call Centre Yes [Please provide Mobile No. in “Communication Details” section] No
f) Statement Facility Yes [Please select any one option from below: No
Printed Statement e-Statement [Please provide E-mail ID in “Communication Details” section]
12. MINOR APPLICANT(S) DETAILS
I/we, being the legal guardian (parents or legal entity declared by laws) of the following applicant, hereby declare that the applicant is/are
minor(s). His/Her necessary information has been furnished in the enclosed Personal Information Form. The account will be operated under
my/our signature(s) being the lawful guardian until the account holder(s) becomes majority (Adult) or any other declaration is given by me/us.
a) Name of the Minor Applicant(s) : i) ________________________________________ ii)__________________________________________
b) Name of the Guardian(s) : i)________________________________________ ii)__________________________________________
c) Relationship with the Minor : i)________________________________________ ii)__________________________________________
(“Personal Information Form” must be filled in for both Minor and the Guardian. Both the forms must be signed by the Guardian at the place of “Account Holders Signature”)

Signature 1st Applicant Signature 2nd Applicant Signature 3rd Applicant

13. OTHER BANK ACCOUNTS OF THE APPLICANT (IF ANY)

Name of the Bank Branch Nature of Account (Please tick)
a. Deposit Accounts Loan Accounts Others
b. Deposit Accounts Loan Accounts Others
c. Deposit Accounts Loan Accounts Others

14. CUSTOMER’S ACCOUNT (CONCERN) WITH IFIC BRANCHES (IF ANY)

Name of the Account (Concern) Account Number Name of Branch
a.

b.

15. NOMINEE INFORMATION

No. of Nominee : _________________________________________
Name of Nominee Percentage % Relationship with the Applicant
a.
b.
c.
“Nominee Information Form” must be filled in for each nominee [cÖ‡Z¨K bwgwbi Rb¨ bwgwb msµvšÍ Z_¨vewj dig c~iY Ki‡Z n‡e|]
16. CARD DETAILS

Card Application 1st Applicant 2nd Applicant Others

Customer Category Individual Staff Corporate – Name of the Organization

Name on Card (As you see on the Card-Maximum 19 Character)

(Please write in Block Letters and leave a blank space between two parts of your name)

Operating on: Specify Account(s) Account No. Account No.

17. FIXED DEPOSIT INFORMATION

Currency: Amount: Period/Tenor: Days: Months: Years

Date of Maturity/Renewal d d m m y y y y FDR No.: Rate of Interest:

Debit Instruction:
Please Debit my/our Account
Note: Signature of the A/C holder(s) mandatory only when the amount to be transferred from other account holder(s) account, which is not owned by the FD holder(s).

Signature of the A/C Holder(s)

Renewal Instruction:
Yes Renew Both Principal and Interest
(if Yes, Please select
any 1 Option)
Renew Principal only and Credit interest to the account
Auto Renewal Not applicable
No

Maturity Disposal Instruction:

Encash at Maturity and credit to my/our A/C No.
Note: In case of Auto Renewal, if prior written notice is not served to the Bank, the Bank will automatically renew the principal plus interest for the period as per Banks rule on the
maturity date at the prevailing rate of interest.
18. RECURRING DEPOSIT (SCHEME) INFORMATION

Name of the Scheme: Period of Scheme: No. of Installments (per Year):

Installment size (amount) Initial Deposit: One time Deposit:

Installment Start Date: d d m m y y y y Date of Maturity: d d m m y y y y Scheme No.

Rate of Interest: Monthly Payable: Payable at Maturity:

Debit Instruction:
Please debit my/our Account No.:
Note: Signature of the A/C Holder(s) mandatory 0nly if, when the amount will be transferred from other account holder(s)’ account, which is not owned by the scheme holder(s).

Signature of the Account Holder(s)

19. SIGNING AUTHORITY and ACCEPTANCE OF TERMS & CONDITIONS

I/we hereby declare that I/we have read, understood and shall be bound to comply with all the terms and conditions relating to the accounts of
IFIC Bank Limited as attached herewith. I/we declare with full conscience that the information provided here is true, complete and accurate.
I/we shall provide any kind of relevant necessary information/documents in addition relating to the account that you may require in future.

Mode of Operation of A/C: Singly Jointly Anyone (Either/Survivor) Others/Special Instruction__________________

wnmve cwiPvjbv msµvšÍ †NvlYv
Signature of 1st Applicant Signature of 2nd Applicant Signature of 3rd Applicant

Date : Date : Date :

Name : Name : Name :
Mobile No. : Mobile No. : Mobile No. :

20. FOR BANK USE ONLY

Mandatory Fields for Regulatory Reporting: Sector Code:
Account Opening Checklist Completed Account Opening Form
Introduction
Copy of Valid NID/Passport/Driving
License/Photo ID (of Applicant & Nominee)
Copy of E-TIN certificate (if any)
Others
Type of Deposit Code:
Photograph – Applicant (Passport size duly attested by Introducer)
Photograph – Nominee (Passport size duly attested by Applicant)
FATCA
Student ID Card for Student Account

Identity Verified by Passport Driving License National ID Card Others

Address verified by Utility Bill Rent Agreement BTCL Telephone Bill Visit by RM/BOM Others

How was the A/C opened By RM/Branch Employee By DSA By Internet Walk-in/Unsolicited

Name of the Branch Employee/DSA: RM/Employee/DSA Code:

Marketed By: Code:

Comments: Risk Grade:

Branch Back Office

A/C Opening Officer: _______________________________________ Data Input in CBS Yes/ No

(Full Signature with Seal)

Approved by (Manager) _____________________________________ Systems / Input verified by: __________________________________

(Full Signature with Seal) Name with Designation:

Date ______________________________________ Date ______________________________________

 CHECK LIST OF DOCUMENTS REQUIRED TO OPEN ACCOUNT

Date d d m m y y y y Customer ID

Account No.

 Account Opening Form: to be filled in and signed by each applicant

 Recent Passport size photograph for each account holder attested by the introducer
 Copy of National ID Card/ Valid Passport/ Driving License (for Resident Bangladeshi Customers only)
 Nominee details & one copy of nominee photograph attested by the applicant
 Copy of passport along with valid visa/ work permit (in case of foreign passport customer needs to provide the copy of “No Visa Required
for Bangladesh” page - only for Non-Resident Bangladeshi Customer)
 Proof of employment/income – (Employment Certificate/ Pay Slip/ Employment Contract mentioning annual income/ Bank Statement
mentioning monthly salary or last tax return paper.) [for Resident Bangladeshi Customers only]
 Minor Account (addition requirement)–copy of birth certificate, and recent passport size photograph to be attested by the guardian.
 Student ID Card for Student Account
 Copy of recent utility bill (Gas, Electricity, Water, Telephone) as proof of mailing address.
 Foreign Citizen in Bangladesh (additional requirement) – photocopy of passport with valid visa and work permit
 Copy of E-TIN (if available)

Note:
 For verification please present the original document for each photocopy submitted.
 Please confirm any overwriting by full signature
 All the above documents must be in English (if the documents are in other language it has to be translated into English) [For NRB
customers only]
 Above mentioned documents sent from abroad by the customer must be verified and attested by any reputed International
Bank/Notary Public/Bangladesh High Commission or Consulate General’s Office. [For NRB customers only]