ACCOUNT OPENING APPLICATION FORM Please complete in black ink and print in BLOCK CAPITALS and tick where applicable. Terms used in this account opening form shall have the same meaning as in the Account Terms unless otherwise defined. The Customer should complete the account opening form. If any of the Customer's subsidiaries or affiliated companies wish to open an Account, they should complete a separate account opening form. SECTION A: COMPANY/BUSINESS INFORMATION Registered Name of Company: Trading Name (if different from above): Entity Type Issuance of Bearer Share (in full or in part): Bearer Shares (ห นผ ถ อ) are an equity security that is wholly owned by whoever holds the physical stock certificate. Limited Company Partnership Sole Proprietorship Other : Yes (please specify, Bearer Shares deposited with custodian Bearer Shares not deposited with custodian) Nature and Details of Business: Purpose and reason for opening the account or establish the business relationship with HSBC BKH:- (where appropriate, more than one boxes can be marked) - business operating account e.g. credit from sales of proceeds or general service, debit to suppliers, payroll - deposit to other business income than sales of proceeds or general service e.g. rental/sales of assets, dividend, deposit interest etc. - deposit as collateral for / lien under (please specify e.g. loans) - for local investment in securities, unit trust, B/E etc. - for company set up / capital injection - Other (please specify) Sales / Turnover per annum (This may not be applicable to those customers who do not have sales/turnover e.g. banks, non-bank financial institutions, funds, association, embassy etc.) 1) Less Than USD 0.1 M 2) USD 0.1M-USD 0.5 M 3) USD 0.5M-USD 1 M 4) USD 1M-USD 5 M 5) USD 5M-USD 10 M 6) USD 10M-USD 20 M 7) OVER USD 20 M Expected Source and Origin of Funds Passing Through the Account 1) From Business Owner 2) Return on Investment 3) Sales Proceeds 4) Others, please specify Countries from where incomes/funds are expected to originate and estimate percentage of incomes/funds originated from each country : Reason(s) for Setting Up Account in Thailand (If company does not have regular business presence, e.g. office, staff in Thailand): Nature of Activity (i.e. Types of Services/Transactions which will be used) 1) General Banking Services (e.g. Cash, Cheque, Autopay etc.) 2) Remittance Services (e.g. Wire Transfer, Demand Draft) 3) Credit Services (e.g. Loans) 4) Others, please specify Anticipated Level of Activity: (Account Turnover and Number of Transactions per year) Currency: Amount:. of Transactions - 1-25-04-14
SECTION B: REGISTERED OFFICE ADDRESS IN THE PLACE OF INCORPORATION Address: City: State/Province/County: Postal / Zip Code: Country: SECTION C: BUSINESS ADDRESS Same as Registered Address Address: City: State/Province/ County: Postal / Zip Code: Country: SECTION D: CORRESPONDENCE ADDRESS (All correspondence will be mailed to the correspondence address unless specified otherwise) Same as Registered Address Same as Business Address Address: City: State/Province/County: Postal / Zip Code: Country: SECTION E: CONTACT PERSONS INFORMATION Name of Contact. 1: Mobile Phone: Fax Telephone E-Mail Address: Name of Contact. 2: Mobile Phone: Fax Telephone E-Mail Address: Name of Contact. 3: Mobile Phone: Fax Telephone E-Mail Address: SECTION F: ACCOUNT DETAILS THB THB THB Current Savings Fixed Account Account Account Other. Other Other Number of Cheque Books required (each book has 20 cheques) To be collected by (name) Mailed to the correspondence address of the Account I/We agree that I/we will collect the cheque book from HSBC within 60 days from the date specified in the cheque book request column. In case that I/we do not collect the cheque book from HSBC within that period of time. I/We agree and acknowledge that HSBC is entitled to cancel my/our cheque book request. I/We hereby accept that HSBC has the right to charge/debit my/our account with the cost of issuing the cheque book. - 2-25-04-14
I/We are duly aware and agree that upon the Implementation of the Imaged Cheque Clearing and Archive System (ICAS), the seal could be interfering the significant information and signature on the cheque image archived under ICAS, and HSBC reserves the right to dishonour the cheque deposited form clearing/ collection. SECTION G: INFORMATION OF CORPORATE S BENEFICIAL OWNER(S) (must be completed) 1. In relation to a corporation: means an individual who, - owns or controls, directly or indirectly, including through a trust or bearer share holding, not less than 10% of the issued share capital of the corporation; or - is directly or indirectly, entitled to exercise or control the exercise of not less than 10% of the voting rights at general meetings of the corporation; or - exercises ultimate control over the management of the corporation; or - if the corporation is acting on behalf of another person, means the other person. 2. In relation to a partnership: means an individual who, - is entitled to exercise or controls, directly or indirectly, not less than 10% of share of the capital or profits of the partnership; or - is directly or indirectly, entitled to exercise or control the exercise of not less than 10% of the voting rights in the partnership; or - exercises ultimate control over the management of the partnership; or - if the partnership is acting on behalf of another person, means the other person. 3. In relation to a trust: means an individual who, - is entitled to a vested interest in not less than 10% of the capital of the trust property, whether the interest is in possession or in the remainder or reversion and whether it is defeasible or not; or - the settler of the trust; or - a protector or enforcer of the trust; or - an individual who has ultimate control over the trust. 4. In relation to a person other than (1) to (3): means an individual who, - ultimately owns or controls the persons; or - if the person is acting on behalf of another person, mean the other person. 1. Full name: Date of Birth: Type: 2. Full name: Date of Birth: Type: 3. Full name: Date of Birth: Type: 4. Full name: Date of Birth: Type: 5. Full name: Date of Birth: Type: - 3-25-04-14
SECTION H: CUSTOMER DECLARATION By executing this account opening form, I/We acknowledge the receipt of and accept and understand the Account Terms applicable to each Account specified in Section F. I /We authorise HSBC to open the Accounts specified. I/We warrant that all information given by me/us in connection with the applicable Account Terms is complete, true, accurate and in full force and effect. Position: Position: Company Sea/ Chop (if required): *This shall be signed by authorised director(s)/ partner(s), or the attorney(s) as per the authority under a power of attorney) + seal (if required). - 4-25-04-14
Do you wish to use this service? SERVICE ACTIVATION FORM I. CORPORATE PHONEBANKING APPLICATION FORM Section A: Account Information Yes I/We authorise corporate delegate(s) to access the following account(s) through the Phonebanking Service. Account ID: Account Account ID Account 0 1 Section B: I/We authorise the following delegates to utilise the services of my/our phonebanking on the above accounts 1.Full Name: Identification. /.: Signature: 2.Full Name: Identification. /.: Signature: 3.Full Name: Identification. /.: Signature: 4.Full Name: Identification. /.: Signature: te: This section should be signed in accordance with the mandate. For Bank Use Only Data captured by: Checked by: Bank Authorised Signature and Stamp: Signature verified by: Authorized by: Remark: Phonebanking Personal Identification Number (PIN) will be sent by mail. II. STANDING INSTRUCTION (TRANSFER OF FUNDS) BASED ON BALANCE Do you wish to use this service? 1.Primary Account Yes 2.Account Name: 3.Effective (i.e. Date after which first transfer can be effected) 4.Expiry (Leave blank if you wish the instruction to continue until further notice) 5. Priority: (If not specified, this standing instruction will be generated after all other standing instruction (s) based on balance.) Please complete either Option 1 or Option 2 (For the customer who has given standing instruction based on date beforehand, the auto debit instruction will be in compliance with BSI). 6. Option 1: (To Maintain the Primary Account within a chosen balance range) Low Balance Level When the credit balance (less holds) of the Primary Account mentioned above is LOWER than this level, the balance level will be reinstated with funds transferred from the Associates Low Balance Level Account mentioned below. High Balance Level When the credit balance (less holds) of the Primary Account mentioned above is HIGHER than this level, the surplus amount will be transferred to the Associate Account mentioned below. Option 2: (to Transfer funds from the Primary Account) The Transfer Account mentioned below will be transferred to the Associate Account if the credit balance (less holds) of the Primary - 5-25-04-14
High Balance Level Account mentioned above is HIGHER than this level. Transfer Amount: a fixed sum of (please specify Currency and Amount) or the credit balance (less holds) of the Primary Account Less a retention amount * * Amount must be in the same currency as the Primary Account stated in box 1 above. 7. Associate Account (HSBC Account Only) 8. Account Name: 9. Is an advice of each transfer required by the Primary Account Holder? Yes 11. Payment Narrative: (Which will appear on each party's statement and/or advice respectively) Primary Account Holder: 10. Is an advice of each transfer required by the Associate Account Holder? Y es Associate Account Holder: For Bank Use Only Signature Verified & Data Input by Data Input Checked & Verified /Approved by Additional Information Priority Commission Postage Stamp Duty S/I Number Service Activation Declaration Standing Instruction I/We understand and agree that any charges levied (commission, postage and stamp duty) will be debited from my/our account (Primary Account) mentioned above. Furthermore, I/we confirm that if the standing instruction specified above is inactive for 12 consecutive months, HSBC has my/our permission to terminate the instruction without notification to me/us. HSBC reserves the right to terminate this instruction without prior notice at any time as deemed appropriate. HSBC shall have no liability for any cost, expense, loss and damages incurred arising from or in connection with such termination. I/We shall indemnify, and hold harmless to, HSBC for and against all damages, penalties, fees, costs, charges, losses and liabilities which HSBC may incur as a result of HSBC performing in compliance with my/our instruction herein. Company Seal /Chop (if required): *This shall be signed by authorised director(s)/partner(s), or the attorney(s) (as per the authority under a power of attorney)+seal (if required) - 6-25-04-14