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1. If your submitting for information update, please complete section A (Section A is
compulsory) and any other relevant parts to be changed.
2. Please sign the application form as per the signature provided to the bank.
3. Should there be any alterations please sign next to those alterations.
4. Please make sure you write all personal information as given on your National Identity Card.
5. If any question is not applicable please write “ dash (-) or nil “.
އޭ ކނޮްމހެނެްވެސް ފުރުއްވނަް މޢަލުޫމތާު އާކުރނަް ފޯރމް ހށުައަޅުއްވނާަމަ، ސެކޝްނަް އޭ (ސެކޝްނަް .1
ހނޭެ) އދަި ބދަލަު ކުރނަް ބޭނުންވާ މޢަލުޫމތާު ފުރުއްވާ ޖެ
ބނޭްކށަް ދފީައިވާ ސޮޔާއި އއެްގތޮށަް ފޯރމްގައި ސޮއި ކުރއަވްާ .2
ޖނެމަަ އތެނަެއް ކައިރީގައި ސޮއި ކރުއަްވާ. އެއްވެސް ކށުެއް ޖހެިއ3ް
. އަމިއލްަ މޢަލުޫމތާު އައިޑީ ކޑާުގައި ދފީައިވާ ގތޮށަް ފުރުއްވ4ާ
ޖައްސަވާ nil) ނުވތަަ -. އެއްވެސް ސުވލާަކއާި ތިޔފަރަތާާއި ގުޅުމެއް ނުވނާަމަ "ޑޝޭް (5
GENERAL INSTRUCTIONS
New Acc: UpdateDormant
CIF No:
D D M M Y Y Y Y
INFORMATION FORMMaldives Islamic Bank
FOR BANK USE ONLY
Mr Ms Mrs Dr Other , Please specify
Full Name (as in ID card/PP for foreigners)
National ID Card No. ID Card Expiry Date
Date of Birth
Passport No. Passport Expiry Date
Work Permit/VisaExpiry Date
(for foreigners) (for foreigners)
Work Permit/Visa No. (for foreigners)
Gender Male Female Single MarriedMarital Status
Other, specify
Educational
Title
Qualification
PassphraseNo. of Dependants
MastersDegreePrimaryBasic Education Professional Secondary/Higher Secondary
SECTION A PERSONAL INFORMATION
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
Flat No/Floor Flat No/Floor
Street Name Street Name
City/Island/Atoll
Postal Code Postal Code
Permanent PresentPreferred mailing address
CONTACT INFORMATIONSECTION B
(as in ID card/Passport) (if different from permanent)
Next of kin (Optional)In case of my death or to ascertain my whereabouts, please enquire from /inform the status of my account to:
Name Relationship
Address
National ID Card No.
Email Address
Mobile/Telephone No.
Nationality
Present Address
Office Number
House/Building Name
Home Number
Mobile Number
House/Building Name
Email Address
City/Island/Atoll
INDIVIDUAL
If you are submitting for an information update, please complete section A and relevant sections to be changed
Profit Income Pension Gi�/Donation
Sale of property
Rent
Family Remittance Other
Other businesses Involved
Name of business
Name of business
Designation
Designation
Name of business Designation
Other Income (in MVR)
SalariedEmployment Status Self employed Unemployed Student Retired
Civil/StateEmployment Sector Private Public Military/Police Political
Volunteer Judiciary Other, please specify
Employer Name
Joined Date:Occupation/Designation
Address of Employer
House/Building Name
Flat No/Floor
Street Name
City/Island/ Atoll
Postal Code
SECTION C
EMPLOYMENT DETAILS:
OTHER FINANCIAL DETAILS:
N/A
Less than 10,000
Monthly Salary (in MVR) (please specify including allowances)
10,000 to 35,000 35,000 to 50,000
(minor account)
Length of Service
(if you have been in your current job for less than one year)Name of previous employer
(please specify the amount accordingly)
More than 50,000
Less than 10,000 10,000 to 35,000 35,000 to 50,000 More than 50,000
If Self Employed, please specify the details:
Since
NoIs your propertymortgaged?
NoIs your propertyInsured?
Yes, list all insured property(s)
Yes, list all the mortgaged property(s)
Loans or other facilities with other institutions
MotorcycleVehicle/Vessel Car Vessel Others, specify
NoIs your vehicle/vessel insured?
Yes, list all insured vehicle(s)
Description Repayment Amount Frequency Expiry Date
Property, please list name and country of each property
Others, please specify
HSBC
If you are operating accounts in other banks, please specify accordingly
SBI MCB BML CBM
BOC HBL Others, specify
Building Land
Fixed Deposit Shares
Provident Fund Pension Fund
Vehicles/ Vessels None
ASSETS:
Less than 15,000 15,000 to 30,000 30,000 to 50,000 50,000 to 200,000
200,000 to 500,000 500,000 to 1,000,000 More than 1,000,000, please specify a minimun amount
Estimated monthly volume of transactions
SECTION D ACCOUNT TRANSACTION INFORMATION )
Estimated monthly value of transactions ( in MVR)
0 - 10 10 - 20 20 - 30 More than 30
None
ASSETS:
ADDITIONAL INFORMATION
1. Please tick the appropriate box if you are in any of the following positions:
OR
2. If none of the above is applicable, please tick any of the following:
I am actively seeking or being considered for above stated positions;
I have been retired for less than 12 months from the above mentioned positions;
My Close Family Members [Parents, Spouses, Children, sibling etc.] – are holding, OR actively seeking OR being considered OR retired for less than 12 months from the above stated positions. (Please Complete below)
Any individual holding any of the above stated position is associated party with my Business and holds more than 25% voting rights/share in your Business/Company; (Please Complete below)
Any individual holding any of the above stated position has significant influence over the policy, business and strategy of my Business/Company implying that the individual takes part in day to day management and the position is not an isolated consultative role or a non—executive role. (Please Complete below)
I have a joint beneficial ownership of a legal entity or a legal arrangement (for example company or trust etc.) or any other close business relationship with an individual holding any of the above stated positions;
I have a sole beneficial ownership of a legal entity or a legal arrangement (for example company or trust etc.) which is set up by a person holding any of the above stated positions;
Heads of State/Heads of Governments (example: President, Vice President, Prime Ministers)
Cabinet Ministers & State Ministers [includes Deputy or Assistant Ministers]
Members of Parliament [Any Similar Legislative Bodies]
Judges & Magistrates
Elected Council Members
Members & Senior Most Officials of a State Agency or Institution [like board members of central banks]
Senior Military Officials
Senior Officials appointed as per the provisions of a specific law (example: Head of FIU)
Senior Political Appointees of a Government (example: Coordinators at various Ministries)
Board Members of State-Owned Enterprises
Foreign and Local Diplomats [include ambassadors, chargés d'affaires etc.]
Senior Political Party Members [including members of the governing bodies of political parties]
Full Name
Occupation / Designation
None of the above
3. If YES, please specify the details
FATCA DECLARATION
NoAre you a citizen ofany other country?
Home Address
Yes, name of the country
NoAre you a work permitholder of USA
Yes NoDo you hold a green card of USA?
I declare that I possess USA nationality/Lawful Permanent Residency/Passport and authorize Maldives Islamic Bank to disclose requiredinformation to Inland Revenue Services of USA under FATCA.
I declare that I do not possess USA nationality/ Lawful Permanent Residency /passport as on date. I further undertake to inform the Bankof obtaining USA Citizenship/Green card/Passport in future within material time and authorize Maldives Islamic Bank to disclose requiredinformation to Inland Revenue Services in USA.
Signature
FOR BANK USE ONLY
CRP Rating
KYC update frequency Annually Once in 3 years
Forms and supporting documents
Received by
Checked by
Authorized by
Staff ID Signature Date
Risk Categorization Low High
D D M M Y Y Y Y
(Please complete Annexure 1 - Customer Risk Rating sheet and attach with this form)
New Signature
Date:
If updating the specimen signature:
Yes
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