BUSINESS CONNECT AMENDMENT REQUEST FORM

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1 Please ( ) to select HSBC Bank Malaysia Berhad HSBC Amanah Malaysia Berhad BUSINESS CONNECT AMENDMENT REQUEST FO Please submit this completed form to your nearest HSBC branch I/We wish to request the following changes to my/our subscription of the following service(s): Please tick ( ) the applicable service(s): CUSTOMER INFOATION (please complete ALL sections) Registered Name BSA BTB Registration No: BIB Details of Contact Person: BCR Name: Please state the applicable main account: BSA Handphone No: BTB BIB Business Address: BCR FOR BSA AMENDMENT Section A : Amendment to accounts accessible through BSA Please indicate the account to which you require receipt of SMS Alerts. To add the services to: To remove the services from: Transactions of 5,000 and above will be advised to you via SMS. If you wish to set a different limit, please indicate the minimum threshold amount : - Do you wish to receive up-to-date broadcast on HSBC s products and services via this BSA? Yes No Section B : Amendment to BSA Nominated Users Please note that only one (1) Nominated User is allowed for access to BSA Mobile phones must support Short Message Service (SMS) by the following mobile telecommunication providers - Maxis, Celcom or DiGi network only. Name Please insert particulars of new Nominated User Other/Former Name New IC No Mobile Phone No 0 1 Existing User will be automatically removed and replaced by new User FOR BTB AMENDMENT Please tick ( ) and complete the details where applicable Section A : Accounts Matters Please add/remove the following account(s) for access/to be operated through the HSBC BTB service Business Connect Amendment Request Form Page 1 of 5

2 FOR BTB AMENDMENT (CONT D) Section B : Relating to Delegate s Service Access Delegate s access to BTB service has been blocked, please set BTB service to normal Please reset Delegate s password and send a new PIN Remove Delegate Personal Banking No. (PBN) Name of Business/Company/Club/Society/Association/Embassy Delegate s access to BTB service has been blocked, please set BTB service to normal Please reset Delegate s password and send a new PIN Remove Delegate Personal Banking No. (PBN) Name of Business/Company/Club/Society/Association/Embassy Section C : Addition and Amendment on BTB Delegate Add new Delegate Change Delegate s details Add new Delegate Change Delegate s details Date of Birth d d m m y y y y Date of Birth d d m m y y y y Nationality Position in Company Personal Banking No. (PBN) (if applicable) Funds Transfer Service Required (complete Sections D, E and F when this is marked) Not Required (restricted to Enquiry only) Nationality Position in Company Personal Banking No. (PBN) (if applicable) Funds Transfer Service Required (complete Sections D, E and F when this is marked) Not Required (restricted to Enquiry only) Section D : Funds Transfer to Own Account(s) Maximum combined limit of 500,000 for all Delegates per day Note: only complete this section if you wish to link your other accounts for the Funds Transfer Service Account Name Account Name Section E : Funds Transfer to Non-Designated 3rd Party Payees Maximum combined limit of 100,000 for all Delegates per day Note: Telebanker(s) will provide assistance on this type of payment Add service Cancel service Change amount Add service Cancel service Change amount Section F : Details of Designated 3rd Party Payees Intra-bank Funds Transfer to designated payees (within HSBC) Maximum combined limit of 500,000 for all Delegates per day (inclusive of Fund Transfer to Own Account) Cashier s Order/Demand Draft IC/Passport No. IC/Passport No. Payee s Address Payee s Address Payee s Account No./Bank (if any) ( equivalent) Payee s Account No./Bank (if any) ( equivalent) Business Connect Amendment Request Form Page 2 of 5

3 FOR BTB AMENDMENT (CONT D) Outward Telegraphic Transfer (TT) Payee s bank and address Payee s bank and address Payee s Payee s Payment details/ Sort code (if any) ( equivalent) Payment details/ Sort code (if any) ( equivalent) Overseas charges for: Beneficiary s account Remitter s account Overseas charges for: Beneficiary s account Remitter s account (Please attach copies of relevant bills showing the names of the payee company, merchant or utility board and your account or bill reference number for our verification.) Name of Company/ Merchant Name of Company/ Merchant Account/Bill reference No. Account/Bill reference No. FOR BIB AMENDMENT Please tick ( ) and complete the details where applicable Section A : Company/Business Set Up [for BIB] Subscribe to e-statement? Yes No (E-statement is available for download upto 12 prior months) Note: If you have requested for e-statement, hardcopy statement will be discontinued. Please automatically link all accounts to BIB Yes No Do you wish to subscribe for the following services: AutoPay/Bulk Payment Yes No Internet Trade Service Yes No e-share Payment (by Brokers) Yes No Note: By default these services are not included. Account/BIB User to be set up by One Primary User Two Primary Users Note: By default, all future company accounts will be automatically linked unless stated otherwise. Set by HSBC () 500, ,000 Requested Daily Transaction Limit () Transactions to be approved by One to approve One or two within a signature group to approve One or two within two signature groups to approve AutoPay/Bulk Payment All Transactions 1,000, ,000 1,000,000 Please refer to the note in Page 4 Section B : Password Matters The request under Section A must be signed by the User/Delegate Please reset my password My access to BIB service has been blocked (Please reset my access to BIB service) of User/Delegate Section C : Security Device Matters Please send a replacement Security Device for the following reason: The Device has been misplaced/lost The battery is low The Device is broken On/Off button stuck The Device displays row of zeroes Other reason (please indicate): Please send a replacement Security Device for the following reason: The Device has been misplaced/lost The battery is low The Device is broken On/Off button stuck The Device displays row of zeroes Other reason (please indicate): Business Connect Amendment Request Form Page 3 of 5

4 Section D : Accounts Matters Please add/remove the following account(s) for access/to be operated through the HSBC BIB service PLEASE INDICATE THE FOLLOWING CHANGES Authorised Signatory(ies) is/are reminded that a minimum of 2 Primary Users and up to a total of 20 Users are allowed. If all Users have already been nominated, at least One User must be removed before any addition can be effected. 1. Please ( ) where applicable: Add Primary User Change Primary User to Secondary User Remove Primary User Change Secondary User to Primary User Change Primary User Transaction Limit 2. Please ( ) where applicable: Add Primary User Change Primary User to Secondary User Remove Primary User Change Secondary User to Primary User Change Primary User Transaction Limit Name: Name: Position in Company: New IC No/Passport No: Date of Birth: Nationality: d d m m y y y y Position in Company: New IC No/Passport No: Date of Birth: Nationality: d d m m y y y y address: Mandatory field I wish to receive marketing information to the address provided above: Yes No address: Mandatory field I wish to receive marketing information to the address provided above: Yes No Types of Transaction Types of Transaction Enquiry/Payment Preparation only AutoPay/Bulk Payment 0.00 Enquiry/Payment Preparation only 0.00 AutoPay/Bulk Payment Specimen Specimen CANCELLATION OF SERVICES As I/we do not require the following service/s, please cancel the service/s with immediate effect : Business Internet Banking Business Telephone Banking Business SMS Alert Reason being: Please note that the for your Company/Business will be defaulted to the highest limit accorded to any of your Users, unless otherwise stated in the Company / Business Setup. Please also note that if no amount is stated, the default limit will be set at Zero (0). This refers to the maximum amount allowable to be performed by your company/business as a whole for all types of transactions. The limit is recommended to be set as the total of your entire daily transaction limit for the various types of transfers. Please note that if no amount is stated, the default limit will be set at Zero (0). Users with Zero limit assigned to all types of transaction above can perform enquiry services, view and prepare payment only. Please also note that the maximum daily limit for each transaction should not exceed the corresponding limit set by you under the Company/Business Set Up (For BIB) section. Business Connect Amendment Request Form Page 4 of 5

5 FOR BCR AMENDMENT User 1 Details Add New User Change User s details Request new PGP password User 2 Details Add New User Change User s details Request new PGP password User 3 Details Add New User Change User s details Request new PGP password PGP is an encrypted service for the user to receive the BCR. IMPORTANT NOTE 1. Please cancel all unused portion(s) in this Form to prevent tampering/alteration. 2. Please note that transfers/payments made from an external account is subjected to the permitted purpose under the Exchange Control Regulations. 3. Please note that transfer of funds made via BIB or BTB for any purpose, between (i) an external account and a resident account or (ii) an external account and another external account belonging to a different account holder, is subject to a maximum daily limit of 5, per bank in aggregate. DECLARATION 1. I/We wish to request for changes to the services indicated in this amendment request form ( Services ) and hereby acknowledge that the use of the Services is subject to HSBC s Generic Terms & Conditions and Specific Terms & Conditions for Commercial Banking (available at I/We have read and agree to be bound by the same (including all amendments thereto from time to time). 2. I/We confirm that the information given in this amendment request form is true, complete and not misleading, and authorise HSBC to confirm this from any source HSBC may choose. I/We will furnish such identification and/or supporting documents as may be required by HSBC. 3. I/We acknowledge that I/we remain bound by all transactions effected through the Services whether or not the named users of the Services are the account signatories. 4. I/We acknowledge that if HSBC s Specific Terms & Conditions for Commercial Banking allows for the named users of the Services to instruct HSBC on matters pertaining to their personal identifiers and/or password, then HSBC authorised to act on such instructions notwithstanding the named user is not an account signatory. 5. Reference to "HSBC" in this Form will be to the bank that the applicant selects at the beginning of this Form. To be signed by: For Sole Proprietorship - the Sole Proprietor For Partnership - the Partner(s) authorised by the partnership resolution For Limited Company - the person(s) authorised by a Board resolution For Registered Club/Society/Association - the Office-Bearer(s) authorised by the governing body resolution For Embassy/Diplomatic Office - H.E. Ambassador/High Commissioner SIGNED FOR AND ON BEHALF OF THE CUSTOMER 1. Full name in BLOCK LETTERS 2. Full name in BLOCK LETTERS 3. Full name in BLOCK LETTERS Date Received: FOR BANK USE ONLY Input By: Date Input: Approved By: Date Approved : May 2012 Issued by HSBC Bank Malaysia Berhad (Company No: V) Issued by HSBC Amanah Malaysia Berhad (Company No: X) Business Connect Amendment Request Form Page 5 of 5

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