ACCOUNT OPENING FORM - INDIVIDUAL ACCOUNT - PRIORITY BANKING
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1 ACCOUNT OPENING FORM - INDIVIDUAL ACCOUNT - PRIORITY BANKING Account No. Branch Date D D M M Y Y Y Y ACCOUNT HOLDERS Applicant 1 Applicant 2 Applicant 3 Applicant 4 ACCOUNT TYPE (Please tick all that apply) Sole Account Joint Account Student Account Current Account Call Deposit Fixed Deposit Other ACCOUNT CURRENCY (Please tick all that apply) GBP USD EUR AED Other ACCOUNT ACTIVITY INFORMATION Purpose of Account (Must be Specific) Amount of Initial Deposit Source of Initial Deposit Cash Banker Transfer Cheque Deposit Other (Please specify) ANTICIPATED ACCOUNT ACTIVITY PLAN Cash Deposits/Withdrawals Inward Payments Outward Payments s of major/regular remitters s of major/regular beneficiaries Destination/Origin of Remittances (Countries) Number per Quarter Source/Method Purpose Avg Value per Transaction Total Value per Quarter ACCOUNT ADMINISTRATION CHEQUE BOOK FACILITY (for Current Accounts only) Please issue a cheque book and: Deliver it by courier to my Correspondence/Residence Address I will collect it from the London office PLEASE PROVIDE ME/US WITH THE FOLLOWING SERVICE(S) Debit Card for Applicant Debit Card for Joint Applicant(s) I/we want my/our name to appear in Visa Electron Personalised Card(s) as (not to be filled in for jointly operated account): Applicant 1 Applicant 2 Applicant 3 Applicant 4 Page 1 of 7
2 APPLICANT 1 OF - PERSONAL INFORMATION APPLICANT 1 OF - EMPLOYMENT/BUSINESS INFORMATION APPLICANT 1 OF - FINANCIAL INFORMATION Page 2 of 7
3 APPLICANT 2 OF - PERSONAL INFORMATION APPLICANT 2 OF - EMPLOYMENT/BUSINESS INFORMATION APPLICANT 2 OF - FINANCIAL INFORMATION Page 3 of 7
4 APPLICANT 3 OF - PERSONAL INFORMATION APPLICANT 3 OF - EMPLOYMENT/BUSINESS INFORMATION APPLICANT 3 OF - FINANCIAL INFORMATION Page 4 of 7
5 APPLICANT 4 OF - PERSONAL INFORMATION APPLICANT 4 OF - EMPLOYMENT/BUSINESS INFORMATION APPLICANT 4 OF - FINANCIAL INFORMATION Page 5 of 7
6 FORM OF AUTHORITY FOR ACCEPTANCE OF INSTRUCTIONS BY WAY OF FACSIMILE TRANSMISSIONS, ELECTRONIC MAIL AND TELEPHONE Branch Date D D M M Y Y Y Y 1. I/We hereby authorise Emirates NBD Public Joint Stock Company (the Bank ) to accept this document as my/our authority and to so act upon any facsimile transmission ( fax ) purported to be sent by myself/ourselves to the Bank containing any instructions or information ( Instruction ) whatsoever relating to my/our account(s), whether or not the Bank at its sole discretion obtains from myself/ourselves telephonic confirmation to so act and the fax shall be purported to be sent by myself/ourselves where it contains the name and signature of the person(s) whose name(s) and specimen signature(s) appear below, even though the said fax may actually be compiled or transmitted in error or by negligence or by fraud or by someone other than myself/ ourselves or without my/our actual instruction or knowledge. The Bank may in good faith believe that instructions are genuine and authorised, act upon these instructions. The Bank may wait for confirmation from me/us provided for in Clause 4 of this authority or may, at its sole discretion, act upon my/our Instructions whether a confirmation as per Clause 4, has been received by the Bank or not. The Bank may, at its sole discretion, act upon my/our instructions whether a confirmation, as per Clause 4 has been received by the Bank or not. 2. I/We hereby authorise the Bank to accept this document as my/our authority and to so act upon any electronic mail ( ) instruction purported to be made by myself/ourselves to the Bank relating to my/ our account(s), and such communication shall be purported to be made by myself/ourselves where the Bank assumes that the account from which it originates is in the control of myself/ourselves and have been made by the name and signature of the person(s) whose name(s) and specimen signature(s) appear below, even though the may actually have been made in error or by negligence or by fraud or by someone other than myself/ourselves or without my/our actual instruction or knowledge or may have been tampered with after it was sent by me/us below. The Bank may, at its sole discretion, act upon my/our instructions whether a confirmation, as per Clause 4 has been received by the Bank or not. 3. I/We hereby authorise the Bank to accept this document as my/our authority and to so act upon any telephonic instruction purported to be made by myself/ourselves to the Bank relating to my/our account(s), and such telephone calls shall be purported to be made by myself/ourselves where the Bank assumes that the calls have been made by the name and signature of the person(s) whose name(s) and specimen signature(s) appear below, even though the telephone calls may actually have been made in error or by negligence or by fraud or by someone other than myself/ourselves or without my/our actual instruction or knowledge. The Bank may, at its sole discretion, act upon my/our telephonic instructions whether a confirmation, as per Clause 4 below, has been received by the Bank or not. 4. Without prejudice to Clause 1, 2 and 3 of this Authority, I/we agree to clearly mark my/our Letter in confirmation ( Letter ) of the communication whether by telephone call and/or by fax and/ or made by me/ourselves, with the words For information only in confirmation of my/our telephone call and/or by fax and/or (date) and to deliver the same to the Bank on the same day as the telephone call and/or by fax and/or and should these words not clearly appear on the Letter, I/we will not hold the Bank, its directors, officers, or employees responsible for any loss or other consequence arising from the duplication of the transaction. I/We further understand that all instructions; telephonic, facsimile or mail may be recorded and retained by the Bank. Pursuant to the clauses above I/we elect to communicate instructions to the bank in the following manner(s), please select your preferred means of communicating instructions: Telephone Facsimile By electing one or more of the options above and affixing my/our signature to the signature boxes provided below in the section Terms and Conditions I/we agree to be bound by the terms of this Authority. Page 6 of 7
7 TERMS & CONDITIONS I/We agree that the information given above is true and complete and that I/We have received, read, understood and accepted (please select one of the options below): The General Terms & Conditions for Current Accounts, Call Deposit Accounts, Fixed Deposit Accounts with Emirates NBD PJSC, London Branch The General Terms & Conditions for Current Accounts, Call Deposit Accounts, Fixed Deposit Accounts with Emirates NBD PJSC, Jersey Branch and those applicable specifically to the type of account chosen by me/us which I/We understand and expressly agree and accept to be bound by them. Joint Account Only: We agree with the provisions for Joint Account mandates as set out in the General Terms and Conditions and we understand that we are jointly and severally liable for any overdrawn balances on the account. We also request you to accept the signing authority instructions as set out below by us. Note: Maximum of four named parties allowed on a Joint Account Emirates NBD PJSC, London Branch, is authorised and regulated by the Financial Services Authority in the UK Emirates NBD PJSC, Jersey Branch, is regulated by the Jersey Financial Services Commission to take deposits SIGNING INSTRUCTIONS (for Joint Accounts only) Singly (Any one to sign) Jointly (All to sign) Other (see Special Instructions below) ACCOUNT HOLDER(S) SIGNATURE(S) SPECIAL INSTRUCTIONS Page 7 of 7
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