HSBC Advance Account Opening Application

HSBC Advance Account Opening Application To The Manager,... Office The Hongkong and Shanghai Banking Corporation Limited Sri Lanka FOR BANK USE ONLY D D M M Y Y Y Y Note : 1. Please complete in Block Letters and tick where applicable. All accounts opened will be subject to prevailing Exchange Control Regulations. All information requested on this form is mandatory in order to open an account with HSBC. Customer Number :... Account Number :... RM ID :... Bank Authorised Signature/Stamp Branch Entry Criteria For HSBC Advance In order to qualify for an HSBC Advance account, the applicant must satisfy any one of the following conditions, I/We confirm that I/We will maintain deposits amounting to Rs.1,000,000/- or above in my/our time deposit accounts with HSBC I/We confirm that I/We will maintain Rs.250,000/- or above in my/our Advance accounts with HSBC I/We confirm having obtained a loan (Personal/ Car loan ) for over Rs 1,000,000/- from HSBC I/We confirm that I/We will remit a monthly salary amount not less than Rs.125,000/- to my/our Advance account with HSBC Note: A monthly service fee of Rs 1,250/- will be levied if the above criteria is not maintained. Signature of the Sole Applicant Signature of the Joint Applicant Type of Account (To be completed by the Primary Applicant) Local Currency Account Current Account Statement Savings Account Time Deposit Account Foreign Currency Account Statement Savings Account Time Deposit Account If foreign currency ; GBP USD currency The reason for choosing to open the account in a foreign jurisdiction : (Applicable only for applicants for NRFC or NRRA accounts) Foreign (Applicable only for applicants for RNNFC or RGFC accounts) Assets Products Personal Exclusive Revolving Credit Secured Overdraft Facility Lifestyle Loan Personal Information Primary Applicant Joint Applicant Title Mr Mrs Miss Ms Dr Mr Mrs Miss Ms Dr Full Name Former Name Names (as appearing in the identity document) Date of Birth d m m y y y y Place : d d m m y y y y Place : Gender Nationality Country of Residence NIC : NIC No : (Mandatory to be completed by Sri Lankan nationals) VISA (Applicable for non nationals) VISA Number : VISA Type : NIC No : Date of Issue d d m m y y y y Date of Issue d d m m y y y y VISA Number : VISA Type : Expiry Date : d d m m y y y y Expiry Date : d d m m y y y y

Personal Information Contd. Passport No: Expiry d d m m y y y y Expiry d m m y y y y Marital Status Single (1) Married (2) Widowed (3) Single (1) Married (2) Widowed (3) Education Level Divorced/ Separated (4) Primary (2) Secondary (3) Tertiary (4) Graduate (6) Post Graduate (5) Divorced/ Separated (4) Primary (2) Secondary (3) Tertiary (4) Graduate (6) Post Graduate (5) Relationship to the primary applicant : The following is a mandatory declaration which is required to be completed by all applicants under the Inland Revenue Act No 10 of 2006 STATUTORY TAX DECLARATION PLEASE COMPLETE THE WITHHOLDING TAX DECLARATION FORM IN TERMS OF SECTION 133 OF THE INLAND REVENUE ACT. IF A DECLARATION IS NOT SUBMITTED, WITHHOLDING TAX @ 10% ON INTEREST EARNED WILL BE APPLIED ON RUPEE INTEREST BEARING ACCOUNTS. Residence Contact Information Residence Address Previous address if less than 3 years at current address Contact No. Residence : Mobile : Residence : Mobile : Fax Number E-mail Residence Ownership Status Rent (1) Mortgaged (3) Own Home (4) Rent (1) Mortgaged (3) Own Home (4) Living in Parents Dwelling (5) Company Residence (6) Living in Parents Dwelling (5) Company Residence (6) Permanent Address (if differs from residence address) Employment Information Occupation Professional/Administrative (1) Administrative/Executive (2) Professional/Administrative (1) Administrative/Executive (2) Self Employed (11) s (16) Self Employed (11) s (16) Name of Address of (Include department) Contact No. Ext : Ext : Fax Number Nature of Business With this since Years : Months : Years : Months : Designation Your Income Previous Connected Businesses/ Professional Activities Basic Salary : Fixed Allowance : Income : Length of Service : : Basic Salary : Fixed Allowance : Income : Length of Service : :

Family Information Spouse Name Spouse s Annual Income Household Income Children Number of Children : Number of Children : Number of Dependants : Number of Dependants : Assets and Liabilities Bank Account Branch Account No. Account Type Branch Account No. Account Type Credit Card Credit Card Number (if HSBC) Credit Card Number (if HSBC) Bank & Branch Balance Bank & Branch Balance Facilities Overdraft Loans Overdraft Loans s (specify) s (specify) of Assets Motor Vehicle(s) Property Market Value Motor Vehicle(s) Property Market Value Shares Shares Information (To be completed by the Primary Applicant) Purpose of Opening the Account Salary Remittance Inward Remittance Loan Repayment Savings Investment Purpose Crediting of Interest Repayment of Credit Card Education Purpose Source of Funds Salary/Profit Income Family Remittance Interest in Time Deposits Rent Income Sales of Property/Vehicle Anticipated Volumes Expected / average volume of deposits / withdrawals in to / from the account in LKR / FCY equivalent to LKR per month Initial and ongoing sources of wealth or income Source and origins of funds to be used with regards to the banking relationship Types of services which will be used (i.e. nature of activity) Deposits Less than 100,000/- 100,000 to 500,000/- 500,000 to 1,000,000/- 1,000,000 to 2,000,000/- 2,000,000 to 3,000,000/- 3,000,000 to 4,000,000/- 4,000,000 to 5,000,000/- Over 5,000,000/- Withdrawals Less than 100,000/- 100,000 to 500,000/- 500,000 to 1,000,000/- 1,000,000 to 2,000,000/- 2,000,000 to 3,000,000/- 3,000,000 to 4,000,000/- 4,000,000 to 5,000,000/- Over 5,000,000/- Earning from work Sale of an asset (e.g. car) Earning from business interest Inheritance Winning lottery/prize money Personal savings Return on investment/investment matured (please specify) Cash deposit Cheque deposit Transfer from other accounts Wire transfers from other Banks (please specify) General banking services Investment (e.g. Cash, Cheques, Personal Internet Banking, etc) Remittance services (e.g. Wire Transfer, Demand Draft) Credit services (e.g. Loans, Credit Cards, etc) (please specify)

Time Deposit Account Information Deposit Amount Interest (if payable monthly) Please credit account no:... Deposit Period Fixed for months/year(s) In Payment debit my/our account no: signature of account holder : (Sole Applicant) (Joint Applicant) receive cheque no. drawn on (bank name) receive cash Maturity Instructions Unless you instruct us otherwise, it is the Bank s normal practice to continue with these instructions at the rate of interest prevailing on the date of maturity Renew principal plus interest on due date for month(s) / year(s) at the rate of interest prevailing at the time OR Renew principal at prevailing interest rate on due date for month(s) / year(s) and pay interest in cash or to account no: or by cashier s order favouring OR Pay principal and interest to account no: or by cashier s order favouring OR s (please specify) Credit facilities for HSBC Advance Customers Smart Money* Lifestyle Loan* HSBC Advance Credit Card* Obtain a secured Overdraft or a Secured Loan No set up fee Up to 90% of the Time Deposit value Preferential Interest Rates Next day approval No Joining Fee No Annual Fee Special offers and discounts Please speak to our dedicated Advance Representatives for more details. *Terms and conditions apply Features Correspondence Correspondence : Statement Dispatch Method : (Statement will be composite statements) If mail, frequency : Please send all correspondence to my/our residence/office of Primary Applicant Joint Applicant By mail Self obtained through internet banking Monthly Quarterly Half Yearly Yearly Current Account Please note that you are automatically eligible to open a current account. If you have a current account Do you require a cheque book Yes No If yes, process my cheque book and charge costs associated to my account. Number of cheque leaves required 25 50 Current account number 25 leaves cheque book is free of charge Debit Card Do you require a free HSBC Advance Platinum Debit Card Yes No Name as you would want to appear on your debit card Maximum 19 including spaces Please note that exchange rate variance will apply in case your debit card is linked to a foreign currency savings account Accounts to be accessed 1. (Primary Account) Accounts to be accessed 1. (Primary Account) Please deliver my/our debit card(s) to the address stated herein (if different to the correspondence address). C/o: Note: F or security reasons, your debit card personal identification number (PIN) will be mailed to the above address under separate cover. Phonebanking (any time of day we are just a phone call away) Upon opening a current/saving account(s) with us you will be provided with access to our phonebanking service. For security reasons your phonebanking PIN will be mailed to your correspondence address under separate cover.

SMS Alerts Please notify me via SMS when my A/C (s) are debited / credited with funds above Rs. (Minimum Rs 5,000/-) Mobile Number Accounts 1. Personal Internet Banking (PIB) / E-Statements (banking at your convenience) You will have access to your HSBC accounts any time anywhere 24 hours a day, 7 days a week through our personal internet banking (PIB) facility. Use your account number (intital account number linked to the debit card) and debit card personal identification number (PIN) or your personal banking number (PBN) and phonebanking personal identification number (PIN) or your credit card number and credit card personal identification number (PIN). Simply log on to www.hsbc.lk and you will be guided through the registration process on line. Utility Bill Payments through ATMs and Phonebanking You can even pay your regular utility bills such as electricity, telephone, water, internet rentals and mobile phone bills through our phonebanking service and through our ATM network. Would you like to pay your utility bills through ATM / phonebanking? ATM: Yes No Phonebanking: Yes No If yes, please complete the relevant utility bill payment application form (s) available at any of our branches and submit same together with copies of relevant utility bills. Nomination If you are a sole account holder operating time deposit and/or savings account(s) with HSBC, you could nominate a person to be the beneficiary of the balances in your account(s) in case of your death. Would you like to appoint a nominee? Yes No If yes, please complete a notice of nomination form available at any of our branches and deliver to the bank for registration. Declaration The following declaration will govern all HSBC Advance accounts of The Hongkong and Shanghai Banking Corporation, hereinafter referred to as the Bank. 1. I/We have read and accepted the HSBC Advance account terms and conditions, a copy of which has been made available to me/us and agree to be bound by such terms & conditions. I /We have read and accepted the terms and conditions governing current, savings and time deposit accounts, call deposit accounts and others (in foreign currency and/or local currency) as well as terms and conditions governing debit and credit card/s and agree to be bound by them. We have read and accepted terms and conditions which specifically deal with the mandate applicable to joint accounts (for joint account holders only) dated this day of 4. I/We declare that the information given in this application is true and complete. I/we authorise you to confirm the information given in this application from any source you may deem fit including and not limited to requesting for any documentary evidence of my/our monthly/annual income. 5. I/We undertake to advise the Bank immediately when information already provided by me/us in the account opening application has/have changed in order that the Bank may hold the most current and updated information in respect of the account at all times. 6. I/We declare that in the event if I/we do not maintain any monthly minimum balance requirement of HSBC in my/our HSBC Advance sole/joint account/s the Bank shall levy applicable service charge/s that may change from time to time by debiting any of my/our accounts at the Bank. 7. I/We acknowledge that, in the event I/we do not maintain the monthly minimum average credit balance requirement for a continuous period of 3 months in my/our HSBC Advance accounts the Bank shall have the right to discontinue my/our HSBC Advance status and convert all accounts to ordinary accounts and withdraw all benefits enjoyed as a HSBC Advance customer. 8. In the event the HSBC Advance status is discontinued or withdrawn by the Bank and individual accounts under HSBC Advance are re-classified as ordinary accounts, I/we confirm that I/we will agree to be bound by the terms and conditions governing such account(s) (copies of which are available at any HSBC branch and which I/we agree to read and accept). 9. In the case of joint accounts, we confirm that the mandate applicable to joint account(s) under HSBC Advance shall be in force and shall replace all previous joint account mandates we may have had with the Bank. 10. I/We also irrevocably agree to sign any document which may be required by the Bank from time to time in connection with the operation of HSBC Advance or any ordinary accounts held by me/us. 11. I/We agree and acknowledge that usage of the debit card personal identification number (PIN), phonebanking personal identification number (PIN), credit card number, credit card personal identification number (PIN) and personal banking number (PBN) provided by the Bank for accessing phonebanking and personal internet banking (PIB) will be construed as acceptance of the terms and conditions governing these delivery channels. 1 I/We agree and undertake to be bound by the Exchange Control Regulations currently in force and as amended from time to time. 1 I/We agree to use the HSBC Advance debit card(s) and/or credit card(s) solely within the limits authorised by the Bank. 14. I/We undertake to surrender the HSBC Advance debit card(s) to the Bank if I/we migrate or leave Sri Lanka for employment overseas. 15. I/We confirm and agree that I/we am/are responsible for reviewing upon receipt all account statements or other notifications relating to an account and, if I/we fail to do so, the Bank will not be liable to me/us for any losses incurred after the time that such information should have been discovered. 16. I/We agree that in the event of the Bank crediting my/our account/s by error the Bank will be entitled at any stage to reverse the said entry and/or to claim the said amount from me/us or from my/our account/s. 17. I/We confirm that the account will be used by me/us for the sole purpose of my/our banking activity/ies and that all transactions are performed with my/our knowledge and that I/we are not in any manner acting on behalf of a third party. 18. On time deposits opened by me/us, I/we agree and understand a. that no interest will be payable on time deposits released before expiry of the minimum period of 1 month. b. that premature withdrawal of a time deposit is subject to a penalty charge. c. that the operating instructions for deposit accounts are the same as for my/our existing accounts. 19. I/We understand that the HSBC Advance account features communicated through the marketing brochure / leaflet are subject to change without prior notice. 20. I/we further confirm that the said terms and conditions were explained to me/us at the time of me/us making this application and that I/we fully understand the provisions contained in the said terms and conditions and am/are aware that such terms and conditions are available on the HSBC web site - www.hsbc.lk and/or a copy of same can be obtained by me/us from any branch office of the Bank. Note: A monthly service fee of Rs. 1,250/- will be levied if the eligibility requirement is not maintained. I confirm having received a copy of the HSBC Advance terms and conditions booklet on... Signature of Sole Applicant S.V... Signature of Joint Applicant Date: Date:

In the event you are not entirely satisfied in the manner in which you have been served, or if our products do not meet your expectations, please contact us at your earliest using one of the following options ; Contact the Customer Solutions hotline on + 94 114 511 566 E-mail your concerns to customersolutions@hsbc.com.lk Write to us : The Manager Customer Service, Retail banking & wealth management, HSBC Centre, 525 Union Place, Colombo While we prefer to always resolve any concerns raised with us to your complete satisfaction, you can also write to the Office of the Financial Ombudsman and request redress. Contact details of the Ombudsman are ; The Office of the Financial Ombudsman - Sri Lanka, 143 A Vajira Road, Colombo 5 Tel : + 94 112 595 625 Fax : + 94 112 595 624 E-mail : info@financialombudsman.lk Web : www.financialombudsman.lk Please visit our website www.hsbc.lk for translations of this document. In the event of a conflict, the document in English will prevail. For Office Use Only Signature witnessed Identity checked Checked by Data input by: Name Initial Report checked by: Date: Category of foreign currency account NRFC RFC RNNFC General Document Check List: Copy of the National Identity Card Copy of Utility Bill Mandate Copy of the Passport Copy of the ID issued by employer Power of Attorney Copy of Residence Visa Account Opening Form Nomination Form Copy of Student ID Letter of Introduction Utility Bill Payment Application Copy of Membership Card from a recognized club Signature Card s Salary slips bank statements PERC CSM LSL/ Car Loan Promissory Note Letter of Indemnity Promissory Note Terms and Conditions Terms and Conditions Terms and Conditions Letter from the employer Special instructions checked Letter from the employer Standing instructions checked Maturity instructions checked Data input by: Name Initial Report checked by: Date: Debit Card Yes No Debit Card Data Input by: Name Initial V2 2012 Report checked by: Date: ATB Yes No ATB customer documentation sent by: Name and initial Date: ATB data input by: Name and initial Date: Report checked by: Date: ADVAO240613SL