
Original Copy
OMF 19/09 11.19

Branch:


Client Information

Full name: (as appears on proof of identification)

Marital status:
Single

Married

Divorced

Widowed



Nationality:

Other Nationalities:

National ID

Passport (for non-Egyptians)

Proof of identity number:

Place of issuance:
 
Date of issuance:
DD/MM/YYYY

Expiry Date:
DD/MM/YYYY


Client type:
Employed payroll

Self- employed


Employed Expatriates

Self-Employed Expatriates
 
Employed non-payroll

Student

Retired

Housewife

Field of activity:

Occupation

Profession:

Contact Information

Non-residential

Residential

Permanent residential address: (preferably in Arabic language-Matches address on utility bill):

No., Street, Postal Code, City, Governorate, Country:

Country Code

Area code

Number

Real estate situation

Mobile:

Owner

Home telephone:

Tenant

Personal fax:

E-mail address:

Business Information (Preferably to attach business card)

Occupation:

Employer:

Business address (preferably in Arabic language)

No., Street, Postal Code, City, Governorate, country

Country
Code

Area code

Number

Hiring Date:
DD/MM/YYYY

Office Telephone:

E-mail address:

Office Fax:

Correspondence Address

Please send my correspondences to
Business address

Home address


In case there is no selection, please write the preferred correspondence address in detail:

No., street, post, City, Governorate, country:

Additional Contact Information
(In case of other nationalities or American or dual nationalities)


Address in home country: No., street, post code, City, Governorate, country:

Country Code

Area code

Number

Home country telephone number:

Home country mobile number:
 
Home country personal fax:

U.S Green card number:

U.S.A Tax identification number

Visa type & expiry date:

U.S Green card expiry date:
 
Residential Substantial presence
Yes

No
:

Retail Client Information Update & Modification Form

Original Copy
OMF 19/09 11.19
Supplementary Information

Accounts opened in other banks:

Bank name

Account type

1.
2.
3.
Primary sources of income:

Other sources of income or wealth:

Monthly income Bracket (EGP):
 
Less than/1500
1500-5,999
6,000-29,999
30,000-49,999
50,000-74,999
More than or equal /
75,000
References (contacted in case of emergency):

Name

Telephone number

Country Code

Area code

Number

1.
2.
Expected Account Activity

Main types of operations that would be carried out on the account:

In case of international transactions, please specify country and currency:

Country:

Currency


Mail Services Information

Clients’ Accounts:

Frequency required to send the mail:

Annually

Semi-Annually

Quarterly

Monthly

Semi-Annual & Annual periodicities available only to non-credit accounts

Please select the most convenient method to send your mail

Mail Services

Hold mail at the Branch

Courier Delivery

Standard Postal Delivery

Please note that Hold Mail can only be kept at the Bank for 3 months
Undertaking

We undertake that we will update our data if any changes occur, and to
update the opening account form whenever the bank required this.


This data intended for the bank & possibly for its insurers, shall solely be
communicated externally to comply with the Central Bank of Egypt & Money
& Banking Sector's law number 88 for year 2003.


We approve, from the date of signing this contract, on the bank's right to
circulate our data with the local & foreign banks, if required by the working
conditions, and in accordance with the bank's absolute discretion.
  

This contract is considered an integral part of the original opening account
application and complements it.
.
The bank has the right to close the account in case we did not update our
data or if they turned out to be falsified.
.
We undertake that we are the beneficial owners of this account & we
undertake that we will not use this account to accept any transaction from
unknown or suspicious sources.
            
Endorsement

We declare that we have reviewed our statements of accounts with the
bank & we recognized that we have received a copy of them.

We certify on the authenticity of our balances, as shown by the statements
of account at the date of signing this contract.

Client’s Approval

We hereby authorize the Bank to debit our account with the fees of mail
services selected above:

We undertake that we are totally responsible for all information provided in
this application form.

In case of address/ E-mail address change, we must notify the Bank
immediately to be able to deliver the mail correctly; otherwise, we will bear all
the resulting responsibilities and costs.


We read and accepted the terms & conditions for the Bank mailing available
at the back of this application form.

Account holder signature

Date:
DD/MM/YYYY


For Accounts Opening Center Use Only
Type of sensitivity (if yes)
No
Yes
Sensitive
Blacklist Checked
Approval Reference Number
No
Yes
Compliance approval (for sensitive clients)

Client Information modified by:

Client's Information modification reviewed by:

Original Copy
OM F 19/ I.1. A.11

Application number:


Customer ID:


Date of Birth:


Client name:


Address, No., Street:


Post Code, Country:
:
If you fall under any of the following categories please specify as
appropriate:
 

Are you a public official or belonging to one of the/ following Categories?

Yes (please specify hereunder)
No
 
Current/ Former Senior or High-Profile Politicians

High ranking Military Official and Personal
 
Current/ former Head of State / Government

Heads International Institutions (e.g.: UN, IMF, World Bank)

Members of Ruling Royal families

Ministers

Current and Past parliament members
 
Current / former high ranking Official or Political Parties or Public Enterprise
 
Senior Civil / Military Judicial Officials


Senior Members of the Diplomatic Groups (Ambassadors, Chargers D’affaires,
or Members of Boards of Central Banks)

Current / former high ranking in international organizations

Are you connected to any of the above mentioned public official?
 
Yes (please specify hereunder)
No

Business Associate
         (
First degree relation(Spouses / children / parents / brothers / sisters)

Aid or other close advisor

Business / Companies in which an individual has an interest or exercises
influence
If you answered yes to the last 2 previous questions, is any of
these individuals having accounts with us?


Relation
 Number of Account/
 Name /

Dad


Mom


Husband


Wife


Brother


Sister


Son


Daughter


:
Date:

_____________________________
Client ‘signature
  
Politically Exposed Person

Original Copy
OMF 19/09 11.19
Terms & Conditions of the Bank Mails

The Bank must be informed with any change of address with the client's authorized
signature.


The Bank bears no responsibility in case the mail is not delivered to the last client's
address.

All correspondence from the Bank is considered delivered as soon as it has been sent
by mail to the client's last known address as advised to the Bank.

Bank letters (whether received via e-mail, door to door or any other method) shall be
considered conclusive evidence of sending all correspondence and notifications to the
client at the latest address given to the Bank. These letters and correspondence
including the statement of accounts forwarded to us are considered final and
obligatory and conclusive evidence of their correctness and shall be held against the
client unless contested within fifteen days from their receipt.


 

Service rates will be charged on a regular basis on each specific account.

The Bank provides the mailing service without any guarantee whatsoever, whether
explicitly or implicitly.

General Conditions & Regulations

The approval or rejection of the Account Opening Application is at the bank’s sole
discretion. The Bank reserves the right to reject the account opening without assigning
reasons. We also lose our right of recourse to claim any demand, concerning the
above, based upon the terms of liabilities for whatever reason or nature. Therefore, we
declare henceforth to exempt the bank from any contractual responsibility or
delinquency that may arise in this regard.





Based upon the above, it is understood that the approval of this application and our
deposit of any funds related to this subject shall remain pending until the bank
investigates this request and decides whether to approve it or not at its sole discretion.




It is agreed that the deposited funds, subject of this application, shall not yield any
interest payment during the period starting from the date of submitting this application
up to the date the bank approves it. Moreover, no interest payment shall be received
throughout the deposit duration in case the bank rejects this application.





It is understood that the eligibility to interest payment is subject to the conditions and
the type of the requested account from our side.

It is also agreed that in case the bank rejects this application, the bank’s responsibility
is limited to notify us to withdraw the deposited funds relevant to this application. We
hereby declare to exempt the bank from any contractual responsibility or delinquency
that may arise in this regard.




It is understood that the bank’s decision regarding this application shall be taken within
………. working days from the date of its submission whether a decision for approval
and specifying the Account Number or the rejection of this application altogether.


According to this agreement, we authorize the bank to notify us of the above-
mentioned or any other matter related to the account subject of this application via
any means of communication the bank discerns; whether by e-mail sent to our e-mail
address stated in this application; or by registered mail delivered to our address stated
in this application; or by phone call; or SMS message sent to our mobile number
stated in this application. We also, authorize the bank to record the phone
conversation that take place between us and any of the bank’s representatives or
employees with regards to this contract. The bank shall not be held responsible in
case the communicated message is not delivered to our e-mail address or to any
other address recorded at the bank.










We also authorize the bank in case this application is approved to notify us of our
Account number and whatever information related to this regard via an SMS
message sent to our mobile number without any responsibility on the bank.


We declare that the fund deposit made when submitting an account opening
application is subject to the terms and conditions of the account opening application
submitted by us on its date as indicated in this declaration. In case the application is
rejected, the bank’s responsibility is limited to notify us to withdraw these funds via any
means of communication as previously specified.




FATCA Terms & Conditions
FATCA
FATCA Definition: US persons: Refers to any of the following: US government; a
citizen or resident of the US; a domestic partnership; a domestic corporation; any
estate (with certain exceptions); any trust if (i) a court within the US is able to exercise
primary supervision over the administration of the trust, and (ii) one or more US
persons have the authority to control all, US Tax Payer.
  FATCA )  /  (:     : 
             )  
 (      (i)       
    (ii)       )  /  (
   .
FATCA Declaration The customer shall disclose all information to satisfy FATCA
requirements. The Bank reserves the right to request for additional documentary
evidence and waivers, signed undertaking, (W-8 BEN or W-9), if required to support
the customer's US status or FATCA classification.
  FATCA:           FATCA.
            W- 8 BEN W-
9        FATCA 

In case the customer satisfies the definition of US persons as per FATCA regulations,
the customer authorizes the Bank to disclose their personal information with respect
to all banking accounts (existing or new) maintained with the bank to the Internal
Revenue Services (IRS) in the United States of America (or its representatives or
agents) and to any other relevant regulatory authority without any responsibility or
liability on the Bank's part.

 
   IRS 
.
New individual accounts will be reportable to IRS or other relevant regulatory authority
if any of the US indicia’s are found, unless the bank obtains or currently maintains
records supporting the customer's non-US status
          
       
           
 .
In case of change in circumstances by having one or more US indicia and become US
Tax Payer (such that the customer becomes a US Citizen, obtains a US Passport or
US telephone number or US residence address, etc), the customer shall promptly
furnish the Bank with the necessary details and documentation in this regard. .

 FATCA

.
The customer shall hold the Bank harmless from any claims, liabilities, damages and
losses in the event of non-fulfilment of the above undertaking. The customer hereby
understands and acknowledges that the Bank is bound by certain global conditions,
restrictions and legal declaration for providing services to the citizens/residents of the
United States of America and that the citizenship/residency status can affect the
nature and extent of the services that can be derived from the Bank.
                
  .
              
      
We acknowledge that we have received a copy of this Application/Acknowledgement
on the date of its signature for reference and necessary action


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