F-559(Revised 01-05-2009)

Account Opening Form

Individual Account (Single/Joint)
SINGLE RESIDENT
Branch Name: MAIN BRANCH WAZIRABAD Account/TDR Number: 019823-6 Title of Account: MUHAMMAD AZAM KHOKHAR Branch Code : 0418 A/C Open Date: 12-12-2011

Nature of Account & Currency

Nature of Account: Currency of Account: Initial / Term Deposit:

PLS SAVING ACCOUNT - CUSTOMERS

PKR

200.00

Individual Account (Address / Contact Information)

Current Mailing Address: SAYADAN WALI BALOCHI GALA # 1, B1/67 WAZIRABAD Tehsil / Distict: Telephone Office: Fax: City: GURJANWALA Residence: 556607378 Postal Code: Mobile:

EMAIL(s) Attached with Account:

S.NO. EMAIL ID E-Statement Required

Personal Information - Applicant No. 1

CIF No. 15892 (PRIMARY)
Name as Per CNIC: MR. MUHAMMAD AZAM KHOKHAR Father/Husband Name: ANAYAT ULLAH KHOKHAR Mother Name: SARDAR BEGUM Date of Birth: 01-01-1971 CNIC No.: 3410417448735 Date of Issue: 17-11-2011 Expiry Date: Marital Status: MARRIED Nationality: Pakistan Any Other Photo Identity: 17-11-2021 NTN: 0

Permanent Address: SAYADAN WALI BALOCHI GALA # 1, B1/67 WAZIRABAD GURJANWALA Email: Telephone (Office): Employment Detail: SELF EMPLOYED Name & Address of Employer: Residence: 556607378 Mobile: 3424296411 FAX:

Account Operating Instructions

Authority to Operate: Zakat Deduction: Account Statement Frequency:

SINGLY

YES

HALF YEARLY
Page 1 of 5

Printed On : Monday, December 12, 2011 11:40:33 am

A/C Nature : PLS SAVING ACCOUNT - CUSTOMERS

Account/TDR Number : 019823-6

A/C Title : MUHAMMAD AZAM KHOKHAR

Next of Kin (Mandatory in Case of Single Individual Account )

CIF No. 15895
Name as Per CNIC: MRS. NASEEM AKHTAR CNIC: 3410495133100 Relationship: SISTER

Address: H# BY67 GALI MOHALLAH SAYADAN WALI GALA BALOCHI WAZIRABAD City: WAZIRABAD Phone No. Office: Mobile: Tehsil / District: GURJANWALA Residence: 556607378 FAX:

Customer Profile (Know Your Customer)

(To be filled in by the account opening officer after interviewing the applicant) Type of Customer: REFERED BY Personal Information: If Referred By: TANVEER ASGHAR OG-III Social Status: If Other: If Other:

Education: BELOW MATRICULATION

Purpose of Account: PERSONAL SAVING Source of Fund: BUSINESS A/C Exempt from Service Charges: Exempt Reason (If Other): Expected Monthly Income: 10,000.00 Usual Mode of Transaction: Cash Deposit, Cash Withdrawal Usual Mode of Transaction (If Other): Max. Expected Transaction Amount: Debit: 10,000.00

YES

No (Not-Exempted)

Credit: 10,000.00 Beneficiary Name: CNIC:

Real Beneficiary of Account: SELF Relationship with A/C Holder

Printed On : Monday, December 12, 2011 11:40:33 am

Page 2 of 5

A/C Nature : PLS SAVING ACCOUNT - CUSTOMERS

Account/TDR Number : 019823-6

A/C Title : MUHAMMAD AZAM KHOKHAR

Documents Required
Individual Account:
1.(A) Photocopy of valid Computerized National Identity Card (CNIC) or passport attested by gazetted/bank officer. Note: If CNIC is without photo, then obtain another photo ID i.e. driving licence etc. along with CNIC without photo or in absence of any other photo ID, obtain; I) Photograph attested by gazetted officer / Nazim. II) CNIC without photo, attested by the same person as (i) above. III) written confirmation that individual has no photo ID. (B) The Following ID Documents are also acceptable in restpective circumstances in lieu of CNIC. I) Copy of valid Alien Registration Card (ARC) issued from National Alien Registeration Authority(NARA) in case of Registered Aliens. II) Copy of National Identity Card for overseas Pakistanis (NICOP) or Pakistan Origin Card (POC) issued by NADRA, to overseas Pakistanis. (C) In case applicant has not yet obtained CNIC, the bank may obtain attested copies of old NIC & receipt & receipt of NADRA (evidence that the applicant has applied for CNIC) alongwith an undertaking in writing that a copy of CNIC will be sumitted immediately on receipt of the same. The above terms & conditions/requirement are applicable in all type of A/cs for obtaining CNICs. 2. NADRA verification of CNIC to be obtain by the bank within 5 days of opening of A/c through verisys, or in writing from NADRA. In case of discrepancy in NADRA verification of CNIC the account operation will be suspended till rectification of discrepency 3. Attested copy of service card or any other proof of service i.e. employers certificate etc. 4. In case of illiterate person, with shaky signatures, obtain a photograpg alongwith right and left thumb impressions on SS Card. 5. Copy of valid CNIC of Next of Kin
Yes No NA

Printed On : Monday, December 12, 2011 11:40:33 am

Page 3 of 5

A/C Nature : PLS SAVING ACCOUNT - CUSTOMERS 6. Zakat Exempt Decalartion/Affidavit on Stamp Paper of appropriate value 7. For Claiming exemption from levy of service charges on PLS Deposit A/c following documentary evidences are required in respective cases. a) Proof of being a student/Widow b) Proof of being a Govt./Semi Govt./Retd. Employee and that the Salary/Pension will be credited to the account being opened. c) Proof of recipient of Zakat from bait-ul-mal or Earth Quake d) Proof of being Ex-employee of NBP or his/her (spouse). 8. In the case of Account of a Minor proof of age of Minor (Form-B) issued by NADRA) alongwith copy of valid CNIC of gaurdian. 9. In case of Blind and visually impaired person, a declaration on prescribed format. (only joint account of the blind person with a normal literate person to be opened) Ref: Instructions Cicular No. 12/2006 dated: February 20, 2006

Account/TDR Number : 019823-6

A/C Title : MUHAMMAD AZAM KHOKHAR

Customer Signature
I/We request you to open an account with National Bank of Pakistan (NBP) as per above given details. I/we confirm having read, understood and accepted the terms and conditions as printed over leaf for opening and operating a bank account with NBP and have also received a copy of account opening form/Terms & Conditions for opening an account with NBP. I/we shall abide by all rules and regulations that have been enforced upon me/us. I/we shall not use this account to support /finance any unlawful activity like money laundering terrorist financing and I /we shall update the bank about any changes in my/ our mailing address / contact information and /or any change in any of the information furnished in this Account Opening Form viz; nature of business, change of authorised person (s) for account operations in compliance with State Bank of Pakistan (SBP) regulations and Bank's own Internal Control requirements from time to time. I/we also agree to abide by any such changes , supplements or modifications etc. made by the bank in terms & conditions. Further I/we agree to maintain at all times the minimum balance in the account as informed to me/us by the Bank from time to time and in case of any violation thereof the Bank is authorised to recover the amount of service charges to the debit of my /our account. I/we hereby declare that I/we have not been refused banking facilities by any other bank before approaching NBP for opening of my /our this account.

MUHAMMAD AZAM KHOKHAR Applicant No. 1 Name as Per CNIC Signature Date & Stamp

Applicant's thumb impressions and Photograph in case the applicant is unable to sign or having shaky signature. Left Thumb Right Thumb
Photograph
of Person unsable to sign or with shaky signature

Printed On : Monday, December 12, 2011 11:40:33 am

Page 4 of 5

A/C Nature : PLS SAVING ACCOUNT - CUSTOMERS

Account/TDR Number : 019823-6

A/C Title : MUHAMMAD AZAM KHOKHAR

For Bank's use Only:

I here confirm that i have obtained all the relevent documents as tick filled by the applicant(s) in the Document required checklist of this account opening form and also have satisfied myself about identity and customer profile of the applicant(s) as per bank's KYC policy and other regulatory requirements.

Account Entered By Name: Name:

Account Opening Officer Name:

Branch Operations Manager / Manager

Signature:

Signature:

Signature:

Stamp:

Stamp:

Stamp:

(Account Opening Terms & Conditions are Printed overleaf.)

Printed On : Monday, December 12, 2011 11:40:33 am

Page 5 of 5