HSBC Bank Limited

Branch ´ôa Date: D D MM YYYY

APPLICATION FOR ADDITIONAL / For Bank Use Only ACCOUNTS/SERVICES (Account Holders) Customer Number Bank/Branch Authorised Signature and Stamp Please where applicable and complete this form in BLOCK LETTERS Account Number

Please delete whichever is not applicable.

Name

Type of Account Required …QÉL ÜÉ°ùM Current Account (CUA) Call Deposit Account (CDP) Term Deposit Account (TMD)

Others (Please specify) Currency of Account

AED GBP USD Others (Please specify) Statement Required

Monthly as at close of business on (Date) Mail to Correspondence Address

Others Frequency (Please specify) Hold for Collection at (Office) Cheque Book Required (For Current Accounts Only)

No. of Books 25 Leaf Small 50 Leaf Small 50 Leaf Large Cheque book(s) to be Collected at (Office) by (Name and identification) mailed to the correspondence address of the account Electronic Banking Service Required

# Telephone Banking ATM / Debit Card Global Access Card (For Domestic Use) (For International Card)

Language: Arabic English Option to transfer funds between accounts

Current or Savings Accounts to be accessed with Card Yes No

Hexagon (Please obtain brochures for details) I/We request you to open an account in my/our name(s) as detailed above. I/We confirm that all instructions, signature details and documentation associated with operations of the account are to be the same as those of my/our existing Account No. already held at HSBC office. Special Instructions (if any) : * Customer Signature(s) and/or Chop(s) For Bank Use Only

Data Input by

Signature and/or Chop (A) Signature and/or Chop (B)

Verified / Approved by

Signature and/or Chop (C) Signature and/or Chop (D) * This should be signed in accordance with the mandate # For Personal/Sole Proprietorship Accounts Only

CSD Item Code: P-519-5

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