ACCOUNT APPLICATION FORM INDIVIDUAL (Please read the terms and conditions attached to this application form before completing the form)

Transcription

1 Appendix 1 ACCOUNT APPLICATION FO INDIVIDUAL (Please read the terms and conditions attached to this application form before completing the form) A. TYPE OF ACCOUNT/FACILITY Please tick ( ) where applicable 1 Account/Facility Securities Trading FOR OFFICE USE ONLY Client A/c : CDS A/c : Online Trading: Local Global Capital Markets Services Representative s Licence Holder ( CMSRL ) Code : 3 Margin Trading Margin (T+10) Name of CMSRL : 4 Global/Bursa Multi-Currency Equities Trading 7 E-Trade Trading Settlement Currency in Foreign Securities Trading: Ringgit Malaysia n-ringgit Malaysia Cash Deposit: Shares Pledged: As per list attached Contra in Foreign Securities: Yes 8 E-Statement Dividend Payment in Foreign Securities: Ringgit Malaysia n-ringgit Malaysia Contract tes Margin Statements Monthly Statements Trust Account Statements 5 Trade in US securities? If yes, please execute the W-8Ben Form. Securitised Trading Account 9 Intra-Day Trading: Intra-Day Option (FIFO) (T+3) Shares Deposited: As per list attached. 10 Custodial 6 Cash Upfront Trading 11 3rd Party Pledge Trading Initial Deposit: Payment Mode Cash Cheque Others, please specify Trust Others, please specify B. PERSONAL DATA Name (as per NRIC/Passport/Authority Card) New NRIC Old NRIC /Passport/Authority Card of Birth (DD/MM/YYYY) U.S. Taxpayer Identification Number (For U.S. Resident only) Nationality Malaysian n-malaysian (please specify) Race (for Malaysian only) Bumiputra Chinese Indian Others (please specify) Gender Male Female Marital Status Single Married Others (please specify) Residency Resident n-resident Registered Address (as per NRIC/Passport/Authority Card) Correspondence Address (if different from above) Tel.: Home Office Handphone Facsimile

2 C. EMPLOYMENT INFOATION Employment Status Employed Self Employed Others (please specify) Name of Employer Employer Nature of Business Occupation/Designation Office Address Years in Employment/Business D. FINANCIAL INFOATION Gross Annual Income Below 50,000 50, , , , , , , ,000 Above 500,000 Estimated Net Worth Bank/Branch Type of Account Account. E. DETAILS OF SPOUSE (if married) Name (as per NRIC/Passport/Authority Card) New NRIC. Old NRIC/Passport. Employment Status Employed Self-Employed Others (please specify) Name of Employer/Nature of Business Occupation/Designation Contact Office Handphone F. INVESTMENT OBJECTIVE AND EXPERIENCE Investment Objective Capital Growth Dividend Income Speculation Others (please specify) Investment Horizon Short Term (<1 year) Long Term (>1year) Both Investment Experience Shares Years Derivatives Years Others (please specify) Source of Funds Own Cash Business Investment Returns Others (please specify) 2

3 G. OTHER INFOATION 1 Existing account with Kenanga Investment Bank Berhad Yes, Account 2 Is the Applicant an employee or dealer s representative of a participating organization of Bursa Malaysia Securities Berhad? (If yes, please state the name of the participating organization) Yes (Name Of PO) 3 Any trading account maintained with other participation organization of Bursa Malaysia Securities Berhad? (If yes, please specify name of the participating organization) 4 Is the Applicant related to any staff/director/capital markets services representative s licence holder of Kenanga Investment Bank Berhad or K&N Kenanga Holdings Berhad Group? (If yes, please provide name and relationship) 5 Do any of the Applicant s related persons have Trading Account(s) maintained with Kenanga Investment Bank Berhad? Related persons include the applicant s spouse and child (If yes, please provide name, account number and relationship) Name of Related Person Trading Account Relationship a b c 6 Is the Applicant a Director or a substantial shareholder of a company which has a Trading Account with Kenanga Investment Bank Berhad? (If yes, please provide name and account number) Name of Related Person Trading Account a b c (Please attach details in separate sheet if the space provided is insufficient) 7 Political Exposed Persons Does the Applicant hold, or has previously held or is actively seeking a position or is being considered for a prominent public position? (If yes, please provide details) Position Held of Years Does any of the Applicant s immediate family member(s) hold, or has previously held or is actively seeking a position or is being considered for a prominent public position? (If yes, please provide details) Name of immediate family member(s) Relationship Position Held NRIC/Passport of Years 8 Is the Applicant a guarantor for any account holder in Kenanga Investment Bank Berhad or K&N Kenanga Holdings Berhad Group? (If yes, please provide details) Name of Guaranteed Person Account Number H. PAYMENT INSTRUCTION I hereby agree to receive the share sales proceeds only via direct credit into my following bank account subject to the terms and conditions attached to this application form. Bank/Branch Type of Account Joint Account Yes Account (Please submit a photocopy of passbook/latest bank statement for verification purpose) 3

4 I. DECLARATION BY APPLICANT I hereby declare as follows:- 1 I wish to open an account with Kenanga Investment Bank Berhad ( the Bank ) and understand that the Bank may at its absolute discretion approve the opening of my account at any of the bank s branches on such terms and conditions the Bank deems fit (which shall be communicated to me) or reject my application without assigning any reason whatsoever. 2 I am at least eighteen (18) years old and am neither insolvent nor an undischarged bankrupt. I do not have any criminal record nor any litigation case pending against me for any debt due and I have not been declared a defaulter by Bursa Malaysia Securities Berhad at any time to date. 3 The particulars and information given in this application form are true and correct and I have not withheld any material facts or information from the Bank. I undertake to furnish the Bank with such additional particulars as the Bank may require from time to time. I further authorize the Bank to verify the information given by me from any source (including third parties) and in such manner as the Bank shall deem fit. I undertake to inform the Bank in writing should there be any change(s) to my particulars declared in this Account Application Form. 4 I have been advised to seek independent legal advice on the effects and consequences of the terms and conditions of this Account Application Form and the Client Account Common Terms & Conditions ( Terms ) and any failure to do so shall be at my risk. 5 I have read and understood the risks in investing in structured warrants. 6 The dealings in securities in respect of my trading account shall be carried out in accordance with Rule 404.3(7)(a) of the Rules of Bursa Malaysia Securities Berhad: for me as principal for and on behalf of the party(ies) set out below, from who, through whom or on whose behalf the securities are to be dealt with. Particulars Name of party(ies) concerned NRIC /Passport. Address/Registered Address 7 * Declaration of Domestic Ringgit Credit Facilities as at to-date I do not have Domestic Ringgit Credit Facilities as defined under the Exchange Control tices of BNM. I have Domestic Ringgit Credit Facilities as defined under the Exchange Control tices of BNM. I hereby acknowledge that I have read and understood the Exchange Control Act 1953 and/or BNM s FEA policy and shall abide by the provisions at all material time. 8 * Declaration of Exposure in Foreign Securities for the current calendar year-to-date: Currently invested Remaining balance for investment * To be completed by applicants who wish to trade in Global/Bursa Multi-Currency Equities (For Malaysia Residents Only) 9 I declare that I have read and fully understood the contents and terms and conditions of this Account Opening Form and the Client Account Common Terms & Conditions ( Terms ) and acknowledge that I have received a copy of the Client Account Common Terms & Conditions. I fully accept and agree to be bound by the said Terms and agree that the said Terms may be varied and/or supplemented by the Bank and/or any regulatory bodies from time to time. Witnessed by Capital Markets Services Representative s License holder or Authorised Officer of Kenanga Investment Bank Berhad or tary Public Signature of Applicant : NRIC.: : 4

5 J. TO BE COMPLETED BY CAPITAL MARKETS SERVICES REPRESENTATIVE S LICENCE HOLDER Recommended limit: Trading/Margin _ Brokerage Rate 1 of years I have known the Applicant 2 How do I know the Applicant/relationship 3 Other background information I hereby declare that the information given by me is true and correct and I have not withheld any information which might prejudice this application. I further declare that the Applicant/Applicant s authorized personnel has met me in person and that all information given by the Applicant on this form has been verified and is a correct record and reflection of the Applicant. I also confirm that the signature on page 4 is that of the Applicant and am aware that the Applicant is required to comply with all the terms and conditions accompanying this application form which the Bank may vary from time to time at its absolute discretion. I undertake to indemnify the Bank against any losses, damages, debts, charges and all other costs and expenses whatsoever incurred or suffered or which the Bank may incur or suffer in relation to the Bank opening an account for this Applicant and the subsequent operation thereof. Signature of Capital Markets Services Representative s Licence Holder New NRIC.: : DOCUMENTS TO BE SUBMITTED * Photocopy of NRIC or passport (foreigner) * Copy of latest Payslip/EA Form/Tax Return (Form BE) * Any other documents required by the Bank K. FOR OFFICE USE ONLY 1 Operations Department Bursa Defaulter Yes, Defaulted Defaulter Uplifted, Uplifted Received Checked By Approved By Data Entry By Account Opened 2 Credit Department Equity Broking Credit Check Yes Recommendation Yes If yes, limit recommended If no, please state reason Recommended By Approval Yes If yes, limit approved Remarks Approved By limit sent By Brokerage Code Connected Party Yes Multiple Trading Account Yes 5