CITIZEN SECURITIES AND INVESTMENT LIMITED (A Full-Fledged Merchant Bank) Head office : Al-Razi Complex, Suite # G-802, 8 th Floor, 166-167, Saheed Syed Nazrul Islam Sarani, Purana Paltan, Dhaka-1000 Tel: 9574542, Fax: 9570546 Application for Opening Investment Account (To fill in the block letters) A/C No. Date : BO A/C No. D D M M Y Y Y Y (Please tick the appropriate box) Investor s Discretionary Account (IDA) Individual Account Standard Portfolio Managers Discretionary Account (PDA) Joint Account Premium Corporate Account Supreme Dear Sir / Madam, I/we the undersigned, request you to open an IDA/PDA account with you in the name as stated below. I/We have read and fully understood the instructions enclosed. I/We am/are also aware of the BSEC rules, regulations and procedure regarding operation of an investment account with you and agree to abide by the rules and regulations governing the investment account. All relevant particulars about myself/ourselves are furnished below for necessary record: PRINCIPAL APPLICANT Name : Father s Name : Mother s Name : Spouse Name : Mailing Address : Nationality : B A N G L A D E S H I National ID Permanent Address : Tell: Cell: E-mail :... TIN No (If any) :... JOINT APPLICANT Name : Father s Name : Mother s Name : Spouse Name : Mailing Address : Nationality : B A N G L A D E S H I National ID Permanent Address : Tell: Cell: E-mail :... TIN No (If any) :... 01
PASSPORT DETAILS : Passport No. Date of Issue Valid up to Date of Birth Passport No. Date of Issue Valid up to Date of Birth PROFESSIONAL / SERVICE DETAILS : Designation & Department : Name of Organization : Address : Designation & Department : Name of Organization : Address : PARTICULARS OF BANK ACCOUNT : Bank Name :... Branch Name :... Account No. :... Bank Name :... Branch Name :... Account No. :... In Case of Corporate Account Name of Organization... Place of Incorporation... Address... Name of CEO/MD... Contact Name... Contact Designation... Bank Name... Branch Name... Nature of Business... Account No... TIN 02
PARTICULARS OF INTRODUCER: NAME... I/A No. BO ID. Mailing Address :...... of Introducer : Telephone : Mobile : PARTICULARS OF NOMINEE: Attested Photograph (One copy each person) Name Address Age Relation Share% SPECIAL INSTRUCTION The account will be operated as per instruction in the box below (Please insert in the appropriate box) Single Join Any one PARTICULARS OF OPERATOR (IN ANY) Attested Photograph NAME... I/A No. BO ID. Telephone : Mobile : verified 03 Account Holder
FOR OFFICE USE ONLY Date I/A No.: Inlialed by : Admitted by : Approved by: of Dealing Officer Authorized of Approving Authority PHOTOGRAPH & DOCUMENTS REQUIRED Single/Joint Applicant: 1. 2 Copies Photographs of the Applicant 2. Bank Statement (Last 3 Months) 3. Passport / National ID / Driving License (Photocopy) 4. Photograph of each nominee attested by the applicant(s) 5. Photograph of the operator attested by the application(s) Corporate Account : 1. Valid Trade License 2. Board Resolutions, Article/Memorandum of Association 3. Photograph of Authorized person (s)/ operator(s) 4. Any other paper / documents as deem necessary RULES, TERMS AND PROCEDURES FOR OPENING ACCOUNT UNDER PORTFOLIO MANAGEMENT SERVICE 1. Any Bangladeshi over 18 years of age is eligible to open an account under Portfolio Management Services. Each person can open maximum three accounts-two in his/her individual name and the other in joint name. 2. The client has to sign an agreement with the Portfolio Manager. The Porfolio Manager shall carryout operations as per the Agreement. 3. Under lda the client shall have absolute discretionary power to make investment decision and may from time to time instruct Portfolio Manager to execute such investment decision(s) for and on his/her behalf. 4. The client shall be eligible to purchase only the securities from the " list of securities" approved by the Portfolio Manager. 5. An individual client shall be allowed to authorise one person by mandate to act on his/her behalf. 6. An individual client shall be allowed to appoint authorized signatory maximum three persons to act jointly or individually on his/her behalf. 7. The client shall have the option to avail of "value added services" and "assisted services" from the Portfolio manager on/without payment of service charge. 8. The client would be allowed to withdraw fund from the account up to 40% of purchasing power excluding all dues and charges subject to having positive purchasing power. 9. Under PDA the company shall have absolute discretionary power to make investment decision. 10. Portfolio Manager does not ensure return/equal return for all clients. 11. The Portfolio Manager is entitled to recover various charges and fees from the investor as agreed by both the parties including brokerage on buy and sale value of securities, necessary stamp duty and other expenses of transfer of securities, portfolio fees and other relevent charges as shown in the financial account of the investor. 12. The Portfolio Manager reserves the right to change/amend any terms and conditions including fees and charges as deemed necessary. of Principal Account Holder of Joint Account Holder 04
DECLARATION REGARDING RELATIONSHIP WITH PRIVATE/PUBLIC LIMITED COMPANY [Pursuant to the Regulation 35(2) (Jha) of Bangladesh Securities and Exchange Commission (Merchant Banker and Portfolio Manager) Regulation, 1996 I/ We the undersigned declare that l/we have relationship with the following Private/Public Limited Companies as stated below: Principal / Joint Applicant Name of the Company Private / Public Nature of Relationship Number of Shares Percentage of Share Holding l/we also declare to the best of my/ our knowledge that information furnished above are true and correct and I/we agree to notify in writing of any change in particulars given as above. Principal Applicant Joint Applicant 05