Sec 1 Please tell us about yourself

Transcription

1 05/2013

2 Please note that this application form is also available in Arabic á«hô dg á لdÉH ké jcg ôaƒàe Öل dg Gòg êpƒ CÉH á MÓŸG Lôjى upon your request..öل dg Ö ùm In any banking relationship, time and convenience are important qualities that are well appreciated by any customer. We have designed this form so as to make it easier and hassle-free for you when it comes to applying for our comprehensive range of banking services. At Standard Chartered, we look forward to knowing you well, and serving you better. Please complete only the relevant sections in this application form. If you would like to sign up for Online Banking, please visit Sec 1 Please tell us about yourself Residential Address Flat / Villa Salutation / Title Mr Mrs Ms Dr Other First Name P.O. Box Middle Name Duration in Current Residence Last Name Resident in UAE since Identity Document Type Permanent Address (If different from residential address / Home country address for expatriates only) Passport Identity Document Other Expiry Date Date of Birth Your Home Telephone (For expatriates only) Home Telephone Area Code Home Office Mobile Nature of Employment Salaried Self-employed Other Employment Details Real Estate Services Construction Others Occupation/Designation Name of Employer / Name of Business (For self-employed) Name of Sponsor (if different from employer) Nature / Type of Business of Employer or Own Employment Banking / Financial Services Trading Government Address Area Code Date of joining current employer / Business start date (For self-employed) / / Are you an Existing Customer (Please provide your existing Standard Chartered Bank account number, Credit Card or Loan / Finance Account number) Standard Chartered Bank Account / Loan / Finance Standard Chartered Bank Card If your contact details have changed, please choose whether these are Replacement or Additional contact details If your particulars (Address, Nationality, Resident details, employment details etc) have not changed please proceed to Section 1 A (Please complete the fields below) Visa Expiry Date Trade Licence (For Self-employed only) Expiry Date Gender Male Female Nationality Mother s Maiden Name Marital Status Married Single Other Total of Dependents Highest Level of Education Achieved High School Diploma Graduate Postgraduate Degree Other Residence Type Self Owned Company provided Rented Living with Parents Sharing Other 1 Address of Employer (For salaried employees) / Address of Business (For self-employed) Flat / Villa P.O. Box For Self-employed only: Operating Office (For Self-employed only) Flat / Villa P.O. Box. of people employed Other connected business (If any) Proprietor / Director / Partner Name Passport Mail to be sent to Residential Address Address of Employer or Business Monthly Gross Income (AED) Total Work Experience Years Months Permanent Address Others (please specify below) Other income or Additional Income (For salaried individuals only)

3 Sec 1A Do you have a Current Account with Standard Chartered Bank? If, Account If, we will open Account for you For Saadiq Islamic Financial Services (please go to section 6) For Local Currency, please select: Regular Current Account Regular Savings Account Salary Account For Foreign Currency, please select: Regular Current Account Regular Savings Account Sec 1B Salary Account Call Deposit Fusion Account Call Deposit Individual MMDA USD EUR GBP Individual MMDA Would you be interested in opening your Current/Savings Account jointly with someone else? (Please complete this section) (Please go to section 4) If, Please provide us with details of Joint Account holder Mode of Operation for Joint Account Anyone of us All of us Other Relationship to the Main Applicant Salutation / Title Mr Mrs Ms Dr Other First Name Middle Name Last Name Identity Document for Joint Applicant Type Passport Identity Document Others Expiry Date / / Visa Expiry Date / / Date of Birth / / Gender Male Female Nationality Mother s Maiden Name Highest Level of Education Achieved High School Diploma Graduate Postgraduate Degree Others Marital Status Married Single Others Telephone Home Office Mobile Code Area Code Residence Type Self Owned Company provided Rented Living with Parents Sharing Others Residential Address Flat / Villa P.O. Box Duration in Current Residence Resident in UAE since / Permanent Address (If different from residential address) Nature of Employment Salaried Self-employed Others Name of Employer / Name of Business (For self-employed) Nature / Type of Business of Employer or Own Employment Banking / Financial Services Trading Government Real Estate Services Construction Others Occupation / Designation Address of Employer (For salaried employees) / Address of Business (For self-employed) Flat / Villa P.O. Box Monthly Gross Income (AED) Total Work Experience Years Months Sec 2 Your Vehicle Details Type of Car New Used Make Model Year Engine Size Car Mileage (used car only) Valuation From (used car only) Dealer Name Emirate of Dealer/Seller Emirate where car will be registered Sec 3 Your Auto Loan Details 1. Cash Price / Valuation of Vehicle 2. Down Payment 3. Motor Insurance 4. Processing Fee 5. GAP Insurance 6. Others / Accessories Total Loan Amount ( ) Tenor Interest % p.a. (reducing balance) Interest % p.a. (flat rate) Total Interest Amount Total Repayment Amount Monthly Instalment Amount Preferred Repayment Method (Please choose one) Post dated cheques on Standing Instructions (to Standard Chartered Bank) Name of Bank

4 Details of Other Credit Cards & Liabilities Bank Name Bank Name Loan / Finance Type About your Bank Accounts Card Account Monthly Instalment (AED) Credit Limit (AED) Member Since Outstanding Balance Bank Name Account Open Since I agree that a premium of 0.99% (for Credit Secure) of the monthly outstanding balance on my Credit Card shall be payable by me each month. I agree that if I notify you within 14 days from today, of my intention not to participate in Credit Secure Insurance, such premium shall not be charged to me. I note that I still have the option to cancel Credit Secure Insurance after 14 days but, in this case, any premiums paid till the cancellation date will not be refunded. I understand that Credit Secure Insurance would not provide coverage for pre-existing medical conditions, suicide (within 12 months of commencement date), self-inflicted injury, self medication or illegal acts, war, terrorism, strike, riot, civil commotion, sickness or death directly or indirectly attributed to HIV and/or any related illness including AIDS, Military Service in the Armed or Security Forces of any country or any authority; or influence of alcohol or drugs, pregnancy, childbirth or miscarriage, aviation (other than as a fare paying passenger), professional sports, nuclear / radioactive contamination. Please refer to the Credit Secure Insurance Terms & Conditions for detailed information on features, benefits and certain other circumstances where Credit Secure will not provide coverage., I want to apply for Credit Secure Insurance (please select one option) I irrevocably accept fully and without any reservation, the terms and conditions relating to Credit Secure Insurance (as the case may be) as set out in the Credit Secure Insurance Terms and Conditions and Credit Card Terms and Conditions. Primary Applicant s Signature (Do not sign if Payment Protection Insurance is not required), I do not want to apply for Payment Protection Insurance with my Credit Card By signing below, you certify that you have been made aware that the Bank will have the right to recover its outstanding card balance from your End of Service Benefits or claim funds from any other account which you may have with the Bank in the event of your demise. Primary Applicant s Signature Sec 4 Please consider these valuable services (Optional) For Main Applicant Debit Card Name on the Debit Card (Maximum of 19 characters only) Electronic Statements Cheque Book Facsimile Instructions Accepted For Joint Applicant Debit Card Name on the Debit Card (Maximum of 19 characters only) Would you like to have your Credit Card payments deducted from your Current / Savings Account? If yes, please provide Account : If yes, please indicate minimum or full balance: Is your salary transferred to Standard Chartered Bank? Would you like to receive Electronic Statements? Contact details of a friend or relative residing in the UAE Name Telephone Mobile Residence or Office Area Code Sec 5 Credit Card (Optional) Sec 5A Would you like a Supplementary Credit Card? Select your choice of Card (Tick box) VISA MasterCard VISA Infinite Titanium Saadiq Gold Platinum Saadiq Platinum Name on Card (Maximum of 19 characters only) (Please complete this section) (Please go to section 7) Is the Supplementary Credit Card Applicant the Joint Account Holder? (Please proceed to section 7) (Please complete the fields below) Name on Card (Maximum of 19 characters only) Relationship to Main Applicant Salutation / Title Mr Mrs Ms Dr Others First Name Middle Name Payment Protection Insurance (Optional) Take advantage of the benefits of Credit Secure Payment Protection Insurance (t applicable to Saadiq Credit Cards) Credit Secure Insurance (I understand that Credit Secure Insurance provides cover on my Credit Card in case of Death, Permanent Total Disability, Accidental Medical Expenses, Critical Illness and Involuntary Loss of Employment for up to 3 months of my monthly instalments (for salaried clients only) or Temporary Total Disability (for self employed customers only) benefit up to the amount we receive from the Insurance Provider and your liability will be discharged to the extent of such payment. I understand that my enrolment for Credit Secure Insurance is subject to approval by you. Last Name Mother s Maiden Name Identity Document for Supplementary Card Applicant Passport Identity Document Others Expiry Date / / Visa Expiry Date / / Date of Birth / / Gender Male Female Nationality We appreciate your time and patience in providing the information. We seek your help to read and sign the declaration in the next section. Thank you for banking with us.

5 Sec 6 Your Saadiq Auto Finance Details 1) Cost Price 2) Down Payment 3) Insurance Premium (only in case of takaful) 4) Documentation Fee 5) GAP Insurance 6) Others / Accessories Finance Amount Required ( ) Tenor Murabaha Profit Rate % p.a (reducing balance) % p.a (flat rate) Murabaha Sales Price Murabaha Profit Amount Instalment Amount Payment Method (Please choose one) Post dated cheques on (name of bank) Standing Instructions (to Standard Chartered Bank) Local Currency Please select the type of Account: Saadiq Current Account Saadiq Savings Account Saadiq Salary Account Foreign Currency Please select the type of Account: Saadiq Current Account Saadiq Savings Account Saadiq Salary Account Please Specify Currency EUR GBP USD Would you like to consider these value added services: Debit Card Details of Other Credit Cards & Liabilities Bank Name Card Credit Limit (AED) Member Since Bank Name Loan / Finance Type Account Monthly Instalment (AED) Outstanding Balance About your Bank Accounts Bank Name Account Open Since Sec 7A Saadiq Credit Card Would you like a Saadiq Credit Card? If yes, please fill out the card details in section 5. Promissory te (in figures or words) only together with profit at % (reducing balance) effective from date hereof to the date of payment. The bearer of this promissory note has the right of recourse without representation or costs.

6 If you are applying to Credit Secure (not applicable for Saadiq Credit Cards). You declare that you have received, read and understood the insurance terms and conditions. statement for Credit Card will be sent electronically to the address registered on the banks record. Paper statement will be available upon request (if "no" is selected for electronic statements) and charges are applicable as per the latest service and price guide. A paper statement would be sent automatically if electronic statement bounces after sufficient attempts; charges would apply; ا ذا تقدمت بطلب للهص ول على تا مين الا مان الاءتماني (لا ينطبق على البطاقات الاءتمانية من ص ادق). يعني ا نت توءكد با نك اس تملت قرا ت وفهمت الشروط والا حكام الخاص ة للتا مين. س وف يتم ا رس ال كش ف البطاقة الاءتمانية ا لكترونيا ا لى عنوان البريد الا لكتروني المس جل في س جلات البنك ويتم توفير الكش ف الورقي عند الطلب (ا ذا تم اختيار "لا" للكش وفات الا لكترونية) وتطبق الرس وم حس ب ا حدش دليل للخدمات والا س عار. ويتم ا رس ال كش ف ورقي تلقاءيا ا ن ارتد الكش ف الا لكتروني بعد محاولات كافية. وتطبق الرس وم. 5

7 Dealer / Seller Declaration (t applicable for Saadiq Auto Finance) ```````FÉ`````Ñ````dG QGô`````````bEG The information regarding the vehicle is accurate and the prices referred to are the actual prices offered to the Borrower. The Vehicle is not the subject of any other credit transaction. The information relating to the customer has been confirmed by the customer as accurate and is as given to Standard Chartered Bank when approval to finance was given. The Borrower's signature has been witnessed. ا ن المعلومات المتعلقة بالمركبة ص هيهة وا ن الا س عار المش ار ا ليها هي الا س عار المعروض ة للمقترض. المركبة لا تخض ع لا ي معاملة اعتماد ا خرى المعلومات المتعلقة بالمقترض ا كد الزبون ا نها ص هيهة وا عطيت ا لى س تاندرد تش ارترد بنك عندما ا عطيت الموافقة على التمويل. نص ادق على توقيع الزبون. Cash down payment of AED has been paid تم دفع دفعة ا ولى نقدية قدرها درهم Authorised Dealer Stamp and Signature ختم الباءع المفوض وتوقيعه Date التاريخ Vehicle Sale Agreement áñcôe «H á«béøjeg Vehicle Sales Agreement The seller and buyer agreed on the purchase of the vehicle of which specifications are as stated below تم الا تفاق بين الباءع والمش تري على شراء المركبة المدونة ا وص افها ا دناه: Buyer s Signature Î ûÿg «bƒj First party (Seller) الفريق الا ول (الباءع) Address العنوان Second party (Buyer) الفريق الشاني (المش تري) Seller s Signature FÉÑdG «bƒj Address العنوان Vehicle Description áñcôÿg äéø UGƒe Registration. رقم تس جيل المركبة: Chasis. رقم الش اس ي: Witness ógé ûdg Colour لون المركبة: Engine. رقم المهرك: Vehicle Type نوع المركبة: Model موديل المركبة: Date ïjqéàdg For Bank use only Relationship Inter Group ARM Code Master ISIC 1 Service Indicator Branch Code Institution Classification Choice of gift made by Customer Segment PvB PrB OCC Retail SME Residency Classification Sourcing ID Employer Code Sub Segment / Customer Segment Referral ID Closing ID Signature of staff opening account Signature of staff reviewing account Name of staff opening account Name of staff reviewing account Account 6

8 Dubai Bur Dubai Al Mankhool Rd, Bur Dubai P.O. Box 999 Deira Maktoum Road, Baniyas Square P.O. Box 1125 Al Ras Souq Hasher Bin Maktoum Bin Juma Al Maktoum Bldg. P.O. Box Jebel Ali The Galleries, Tower 4 Downtown, Jebel Ali P.O. Box Emaar Business Park Building 3 P.O. Box Dragon Mart Mall Al-Awir Road (Hatta Rd) P.O. Box 4166 Dubai Mall Branch Lower Ground Level, Unit 156 P.O. Box Sharjah Al Boorj Ave (Banks St) P.O. Box 5 Sharjah, U.A.E Abu Dhabi Khalidiya Street Standard Chartered Financial Centre Crystal Tower, Khalidiya, P.O. Box 240 Abu Dhabi, U.A.E Al Nadja Street and, Zayed the First (Electra) Street Intersection, Dhafir Building, next to Seasons, Al Hamra Hotel, P.O. Box 241 Abu Dhabi, U.A.E Al Ain Al Dhaheri Group Building Main Street, P.O. Box 1240 Al Ain, U.A.E العين مبنى مجموعة الظاهري الشارع الري يسي ص.ب: ١٢٤٠ العين ا.ع.م