MyMoney Application form

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1 Under 18s MyMoney For Branch use only Branch sort code 4 0 MyMoney Application form Please use black ink and BLOCK CAPITALS to fill in your details below. It is important that you complete this application form in full and sign as required to enable us to consider your application. Age 7 10? We ll open you a MySavings account now and a MyAccount when you turn 11. Age 11 17? We ll now open you a MySavings account for you to save money in and a MyAccount for your everyday banking. You can open a MyMoney account at any HSBC branch or by giving us a call. However, if you d prefer, just complete this form and take it to your local branch, we ll then write to you within five to seven days with details of your new account(s). To open a MyMoney account you ll need to provide proof of who you are (eg your Passport or Birth Certificate) and if you don t live with your parent/ guardian, or if they re not an existing HSBC customer, proof of your address (such as a recent utility bill). If you are opening this account on behalf of another individual please tick this box Your answers should apply to the account holder. Parents/ legal guardians are advised to assist younger account holders while answering some of these questions. 1. What is the purpose of the account? Personal expenses Regular mandated credits Savings Student fees Foreign transactions Standing order to an individual Cash exchanges (in and out) Household expenses Other (please specify) If you are 11 or over, we will send you a debit card, if you don t want this please tick this box. If you re 15 or under and your Parent/Legal Guardian would prefer you not to have a debit card, they will need to sign below. Signature 2. Personal details Gender Male Female Title Mr Miss Mrs Other (Please specify) Surname First name(s) Date of birth Country of birth Town or City of Birth (only required if your account is held within the Channel Islands or Isle of Man) Nationality/Citizenship (If you hold more than one include these below you may include up to three) Nationality/Citizenship 1 Nationality/Citizenship 2 Nationality/Citizenship 3

2 Country of Residence for Tax Purposes and related Taxpayer Identification Number or functional equivalent ( TIN ). Please complete the following table indicating: (i) where the Account Holder is tax resident; (ii) the Account Holder s TIN for each country indicated.* * Please only complete if you are resident for tax purposes outside of the United Kingdom (UK), (including if you are dual resident in the UK and another jurisdiction)/or you are a United States citizen. If the Account Holder is tax resident in more than three countries please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C. Reason A The country where the Account Holder is liable to pay tax does not issue TINs to its residents. Reason B The Account Holder is otherwise unable to obtain a TIN or equivalent number. (Please explain why you are unable to obtain a TIN in the below table if you have selected this reason). Reason C No TIN is required. (Note: Only select this reason if the authorities of the country of tax residence entered below do not require the TIN to be disclosed). Country of tax residence TIN* If no, TIN available enter Reason A, B* or C *Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above Contact details Permanent home address Date moved to Postcode previous address Previous address (if you have lived at the current address for less than three years). Previous address Date moved to Postcode previous address Home Tel. No. Ex-directory Yes No Mobile Tel. No Ex-directory Yes No address 4. Employment and Education A student/pupil at (school, college, or university) Other full-time education Unemployed Employed full-time Employed part-time Self-employed A Homemaker If you are a pupil/student please state the name of the school, college or university you are attending

3 If you are in employment/self-employed please complete Employer s name Business address (in full) Postcode Nature of business Date commenced present employment Occupation If self-employed, at which bank is your business account held? 5. Your Home Details Are you: Living with family A homeowner A tenant Halls of residence Other If you are a homeowner please also give: Estimated Value of your home 6. Financial Information As part of our on going commitment to managing financial crime risk, we need to ask you the following questions about how you intend to use your account. Are you in full time or part time employment? Yes (go to 6.1) No (go to 6.2) 6.1 What is you total annual income (Before tax and deductions)? Net Monthly income Monthly expenditure When are you paid? (eg, every Thursday, Monthly, etc,) How are you paid? Cash Cheque Direct to Bank/BACS Will your income be paid directly into this Account? Yes No 6.2 All applicants should complete the questions below. Will there be any other regular monthly payments paid into the account (this will include any income you receive while in full time or part time education as well as any income you receive in addition to the income detailed above) Yes No If you answered yes to the question above, where will this money come from? (Tick one) Transfer/Standing Order from personal account (non-hsbc) Benefit/Welfare Transfer/Standing Order from Other personal account (HSBC) Any other paid work (Please tell us about it) How much cash (coins or notes) do you expect to pay into the account each month? Where will this cash come from? Other paid work Gift Other (please tell us about it) What other payments may be coming into your account? (tick all that apply) Savings from other paid work Inheritance Investments Family Other (please tell us about it) Not expecting anything else How much will your first payment into the account be? Roughly how much money do you expect to pay into the account over the next three months?

4 Do you expect to send money to/or receive money from overseas? Yes No If you have answered Yes to the previous question, please tell us which countries and currencies below. If you have answered Yes to the previous question, what do you think the value of these payments will be over the next year? ,000 1,001-5,000 5,000-10,000 10,001+ How many of these payments to/from countries outside the UK do you think you ll make over the next year? Do you have an account with another bank outside the UK? No Yes within EU Yes outside EU Yes Both; within and outside EU Do you have another current account already? Yes No If you answered yes to the above question please fill in your Sort Code and Account Number below. Sort Code Account number Will you keep this account open? Yes No Do you hold other debit cards? Yes No 7. Parent/legal guardian s details (Parents/legal guardians, you must fill out this section if your child is under 16). If you have an existing account with HSBC, please provide your sort code and account number 4 0 Sort code HSBC account number Gender Male Female Title Mr Mrs Miss Ms Other (Please specify) Surname First name(s) Nationality/Citizenship (If you hold more than one include these below you may include up to three) Nationality/Citizenship 1 Nationality/Citizenship 2 Nationality/Citizenship 3 Date of birth Please confirm your permanent home address is the same as that given in section 3 If not please provide your address below Postcode Country (if not UK) How long have you been at the permanent home address you have provided above? If you have been at your address for less than three years, please provide your previous address Country (if not UK) Postcode

5 In which country are you a resident for tax purposes? (If you hold more than one, include these below you may include up to three). Country 1 Country 2 Country 3 What is your employment status? Employed full-time Employed part-time Self-employed A Homemaker Unemployed) A Student Receiving a pension 8. Your information In this form, we, us and our refer to HSBC Bank plc and HSBC Group means collectively and individually, HSBC Holdings plc, its affiliates, subsidiaries, associated entities and any of their branches and offices, and any member of the HSBC Group has the same meaning. HSBC Bank plc will collect and use your personal information to process your application, in accordance with the MyMoney and HSBC Premier Family Terms and Conditions, copies of which you have received. If you appear to be tax resident outside of the UK, then regulations on international tax transparency require us to report certain information about you [and certain connected persons] to the tax authority where your account is held (such as HM Revenue & Customs for UK accounts). Under international agreements to exchange account information, that tax authority may transfer this information to the tax authorities of other jurisdictions in which you [or a connected person] may be tax resident. A connected person is somebody who holds an account for the benefit of somebody else as an agent, a custodian, a nominee, a signatory, an investment advisor, an intermediary, or as a legal guardian. Information about Products, Services and Promotions If you agree, the HSBC Group may use and share relevant information about you, your transactions and your relationships with the HSBC Group, to give you information about products, services and promotions available from members of the HSBC Group and selected third parties which may interest you by post, telephone, electronic and other means. By completing this application you will be consenting to the use of your information for this unless you tick the appropriate box(es) below to indicate that you do not wish to receive such information; Applicant I request that you open a MyAccount and/or MySavings Account. By signing below, I agree that my account(s) will be subject to the terms and conditions that apply to MyMoney and HSBC Premier Family, copies of which I have received. I confirm I have also received a copy of the Financial Services Compensation Scheme (FSCS) Information Sheet and Exclusions List (this does not apply to accounts opened in the Channel Islands or the Isle of Man, who have their own compensation schemes). By signing below, I confirm that the information given is accurate and true to the best of my knowledge. By signing this application, I agree that my Parents will be able to enquire about my account if I am under the age of 18. Your signature Parent/legal guardian (Required for Applicants Under 16) By signing below you the parent/legal guardian agree that we can open the account (s) for your child and that we may share information with credit reference agencies (CRAs) to verify your identity. This will include the use of information from the electoral register and other public sources. CRAs record details of the search even if we do not proceed but the search will not be seen or used by lenders to assess your ability to obtain credit. If your child is under 11 we will require your consent for withdrawals or transfers of 50 or more from a MySavings account. Parent/legal guardian s signature No post No No telephone No mobile messaging (eg, SMS) No secure e-messaging ( through internet banking) By signing this application, you agree that we can use your information in the way set out above and in the MyMoney and HSBC Premier Family Terms and Conditions.

6 9. For parents/legal guardians wishing to make a regular payment: If you are an existing HSBC customer and would like to set up a standing order into your child s account, please fill in the details below. If you are not an HSBC customer and would like to set up a standing order into your child s account, please ask for a form from your bank. Standing Order request Please create a new standing order from: Sort code 4 0 Please indicate the account you would like to credit: HSBC Account Number MySavings MyAccount (If you don t specify an account, we will set up the standing order to credit MySavings). Amount Date of first Payment Frequency Weekly / Monthly / Quarterly (Delete as appropriate) Signature For branch use only: Mandatory details must complete 4 0 LCS01 Branch sort code Branch signature Name of Date of Is this a branch signatory signature SchoolBank? Yes No Parent CIN number MyAccount account no. MySavings account no. NAB marker This document has been printed on paper made from responsibly-managed forests. hsbc.co.uk Issued by HSBC Bank plc HSBC Bank plc, Customer Information, PO Box 6201, Coventry CV3 9HW Printed by St Ives Management Services Ltd. MSCOMP2 MCP /15 HSBC Bank plc All Rights Reserved.

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