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ACCOUNT OPENING FORM - INDIVIDUAL ACCOUNT - PRIORITY BANKING

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02.11

Date D D M M Y Y Y Y

Account No. Branch

ACCOUNT OPENING FORM - INDIVIDUAL ACCOUNT -

PRIORITY BANKING

Page 1 of 7 ACCOUNT HOLDERS Applicant 1 Applicant 2 Applicant 3 Applicant 4

ACCOUNT TYPE (Please tick all that apply)

Sole Account Joint Account Student Account Current Account

Call Deposit Fixed Deposit Other

ACCOUNT CURRENCY (Please tick all that apply)

GBP USD EUR AED Other

ACCOUNT ACTIVITY INFORMATION Purpose of Account

(Must be Specific)

Amount of Initial Deposit

Source of Initial Deposit Cash Banker Transfer Cheque Deposit Other (Please specify)

ANTICIPATED ACCOUNT ACTIVITY PLAN Number per

Quarter Source/Method Purpose Avg Value per Transaction Total Value per Quarter

Cash Deposits/Withdrawals Inward Payments Outward Payments Names of major/regular remitters Names of major/regular beneficiaries Destination/Origin of Remittances (Countries) ACCOUNT ADMINISTRATION

CHEQUE BOOK FACILITY (for Current Accounts only)

Please issue a cheque book and:

Deliver it by courier to my Correspondence/Residence Address I will collect it from the London office

PLEASE PROVIDE ME/US WITH THE FOLLOWING SERVICE(S)

Debit Card for Applicant Debit Card for Joint Applicant(s) I/we want my/our name to appear in Visa Electron Personalised Card(s) as (not to be filled in for jointly operated account): Applicant 1

Applicant 2 Applicant 3 Applicant 4

(2)

02.11 APPLICANT 1 OF - PERSONAL INFORMATION

Title Mr. Mrs. Ms. Dr. Sh. Sha. Other

Surname Forenames

Nationality Date of Birth D D M M Y Y Passport No.

Place of Issue Date of Issue D D M M Y Y Expiry Date D D M M Y Y

MARITAL STATUS GENDER

Single Married Divorced Widowed Male Female

PERMANENT RESIDENTIAL ADDRESS

CORRESPONDENCE ADDRESS (If different from RESIDENTIAL Address. Please note: The address of Applicant 1 will be used for correspondence unless otherwise requested)

ADDITIONAL ADDRESS (e.g. Holiday Home)

CONTACT TELEPHONE NUMBERS

Tel (Residence) Fax (Residence) Personal Email

Tel (Office) Fax (Office) Business Email

Mobile Additional Mobile Tel - Holiday Home(if applicable) APPLICANT 1 OF - EMPLOYMENT/BUSINESS INFORMATION

Occupation Employer Name Department

Employer Address

Nature of Business, including countries in which it operates

IF SELF EMPLOYED

Percentage of Ownership Years in Business

APPLICANT 1 OF - FINANCIAL INFORMATION

SOURCE OF INCOME

Salary Business Earnings Investment Income Rental Income

Other (Please Specify) Estimated Annual Income in GBP

Explanation on the Source of Income (e.g.Type of Investment)

SOURCE OF WEALTH (Net Worth)

Salary Business Earnings Gift/Inheritance Investment Income

Sale of Property Sale of Company/Business Supported by Family Other (Please Specify)

Estimated Total Net Worth (including properties, investments, deposits, etc) Estimated Liquid Net Worth (deposits and liquid investments)

Please provide ADDITIONAL DETAILS on the Source of Wealth

OTHER BANKING RELATIONSHIPS

Name Branch/Address Estimated Relationship Value

Primary Bank Country of Residence Secondary Bank

(3)

02.11 APPLICANT 2 OF - PERSONAL INFORMATION

Title Mr. Mrs. Ms. Dr. Sh. Sha. Other

Surname Forenames

Nationality Date of Birth D D M M Y Y Passport No.

Place of Issue Date of Issue D D M M Y Y Expiry Date D D M M Y Y

MARITAL STATUS GENDER

Single Married Divorced Widowed Male Female

PERMANENT RESIDENTIAL ADDRESS

CORRESPONDENCE ADDRESS (If different from RESIDENTIAL Address. Please note: The address of Applicant 1 will be used for correspondence unless otherwise requested)

ADDITIONAL ADDRESS (e.g. Holiday Home)

CONTACT TELEPHONE NUMBERS

Tel (Residence) Fax (Residence) Personal Email

Tel (Office) Fax (Office) Business Email

Mobile Additional Mobile Tel - Holiday Home(if applicable) APPLICANT 2 OF - EMPLOYMENT/BUSINESS INFORMATION

Occupation Employer Name Department

Employer Address

Nature of Business, including countries in which it operates

IF SELF EMPLOYED

Percentage of Ownership Years in Business

APPLICANT 2 OF - FINANCIAL INFORMATION

SOURCE OF INCOME

Salary Business Earnings Investment Income Rental Income

Other (Please Specify) Estimated Annual Income in GBP

Explanation on the Source of Income (e.g.Type of Investment)

SOURCE OF WEALTH (Net Worth)

Salary Business Earnings Gift/Inheritance Investment Income

Sale of Property Sale of Company/Business Supported by Family Other (Please Specify)

Estimated Total Net Worth (including properties, investments, deposits, etc) Estimated Liquid Net Worth (deposits and liquid investments)

Please provide ADDITIONAL DETAILS on the Source of Wealth

OTHER BANKING RELATIONSHIPS

Name Branch/Address Estimated Relationship Value

Primary Bank Country of Residence Secondary Bank

(4)

02.11 APPLICANT 3 OF - PERSONAL INFORMATION

Title Mr. Mrs. Ms. Dr. Sh. Sha. Other

Surname Forenames

Nationality Date of Birth D D M M Y Y Passport No.

Place of Issue Date of Issue D D M M Y Y Expiry Date D D M M Y Y

MARITAL STATUS GENDER

Single Married Divorced Widowed Male Female

PERMANENT RESIDENTIAL ADDRESS

CORRESPONDENCE ADDRESS (If different from RESIDENTIAL Address. Please note: The address of Applicant 1 will be used for correspondence unless otherwise requested)

ADDITIONAL ADDRESS (e.g. Holiday Home)

CONTACT TELEPHONE NUMBERS

Tel (Residence) Fax (Residence) Personal Email

Tel (Office) Fax (Office) Business Email

Mobile Additional Mobile Tel - Holiday Home(if applicable) APPLICANT 3 OF - EMPLOYMENT/BUSINESS INFORMATION

Occupation Employer Name Department

Employer Address

Nature of Business, including countries in which it operates

IF SELF EMPLOYED

Percentage of Ownership Years in Business

APPLICANT 3 OF - FINANCIAL INFORMATION

SOURCE OF INCOME

Salary Business Earnings Investment Income Rental Income

Other (Please Specify) Estimated Annual Income in GBP

Explanation on the Source of Income (e.g.Type of Investment)

SOURCE OF WEALTH (Net Worth)

Salary Business Earnings Gift/Inheritance Investment Income

Sale of Property Sale of Company/Business Supported by Family Other (Please Specify)

Estimated Total Net Worth (including properties, investments, deposits, etc) Estimated Liquid Net Worth (deposits and liquid investments)

Please provide ADDITIONAL DETAILS on the Source of Wealth

OTHER BANKING RELATIONSHIPS

Name Branch/Address Estimated Relationship Value

Primary Bank Country of Residence Secondary Bank

(5)

02.11 APPLICANT 4 OF - PERSONAL INFORMATION

Title Mr. Mrs. Ms. Dr. Sh. Sha. Other

Surname Forenames

Nationality Date of Birth D D M M Y Y Passport No.

Place of Issue Date of Issue D D M M Y Y Expiry Date D D M M Y Y

MARITAL STATUS GENDER

Single Married Divorced Widowed Male Female

PERMANENT RESIDENTIAL ADDRESS

CORRESPONDENCE ADDRESS (If different from RESIDENTIAL Address. Please note: The address of Applicant 1 will be used for correspondence unless otherwise requested)

ADDITIONAL ADDRESS (e.g. Holiday Home)

CONTACT TELEPHONE NUMBERS

Tel (Residence) Fax (Residence) Personal Email

Tel (Office) Fax (Office) Business Email

Mobile Additional Mobile Tel - Holiday Home(if applicable) APPLICANT 4 OF - EMPLOYMENT/BUSINESS INFORMATION

Occupation Employer Name Department

Employer Address

Nature of Business, including countries in which it operates

IF SELF EMPLOYED

Percentage of Ownership Years in Business

APPLICANT 4 OF - FINANCIAL INFORMATION

SOURCE OF INCOME

Salary Business Earnings Investment Income Rental Income

Other (Please Specify) Estimated Annual Income in GBP

Explanation on the Source of Income (e.g.Type of Investment)

SOURCE OF WEALTH (Net Worth)

Salary Business Earnings Gift/Inheritance Investment Income

Sale of Property Sale of Company/Business Supported by Family Other (Please Specify)

Estimated Total Net Worth (including properties, investments, deposits, etc) Estimated Liquid Net Worth (deposits and liquid investments)

Please provide ADDITIONAL DETAILS on the Source of Wealth

OTHER BANKING RELATIONSHIPS

Name Branch/Address Estimated Relationship Value

Primary Bank Country of Residence Secondary Bank

(6)

02.11

Date D D M M Y Y Y Y

Page 6 of 7

FORM OF AUTHORITY FOR ACCEPTANCE OF INSTRUCTIONS BY WAY OF FACSIMILE TRANSMISSIONS, ELECTRONIC MAIL AND TELEPHONE

1. I/We hereby authorise Emirates NBD Public Joint Stock Company (the “Bank”) to accept this document as my/our authority and to so act upon any facsimile transmission (“fax”) purported to be sent by myself/ourselves to the Bank containing any instructions or information (“Instruction”) whatsoever relating to my/our account(s), whether or not the Bank at its sole discretion obtains from myself/ourselves telephonic confirmation to so act and the fax shall be purported to be sent by myself/ourselves where it contains the name and signature of the person(s) whose name(s) and specimen signature(s) appear below, even though the said fax may actually be compiled or transmitted in error or by negligence or by fraud or by someone other than myself/ ourselves or without my/our actual instruction or knowledge. The Bank may in good faith believe that instructions are genuine and authorised, act upon these instructions. The Bank may wait for confirmation from me/us provided for in Clause 4 of this authority or may, at its sole discretion, act upon my/our Instructions whether a confirmation as per Clause 4, has been received by the Bank or not. The Bank may, at its sole discretion, act upon my/our email instructions whether a confirmation, as per Clause 4 has been received by the Bank or not.

2. I/We hereby authorise the Bank to accept this document as my/our authority and to so act upon any electronic mail (email) instruction purported to be made by myself/ourselves to the Bank relating to my/ our account(s), and such email communication shall be purported to be made by myself/ourselves where the Bank assumes that the email account from which it originates is in the control of myself/ourselves and have been made by the name and signature of the person(s) whose name(s) and specimen signature(s) appear below, even though the email may actually have been made in error or by negligence or by fraud or by someone other than myself/ourselves or without my/our

actual instruction or knowledge or may have been tampered with after it was sent by me/us below. The Bank may, at its sole discretion, act upon my/our email instructions whether a confirmation, as per Clause 4 has been received by the Bank or not.

3. I/We hereby authorise the Bank to accept this document as my/our authority and to so act upon any telephonic instruction purported to be made by myself/ourselves to the Bank relating to my/our account(s), and such telephone calls shall be purported to be made by myself/ourselves where the Bank assumes that the calls have been made by the name and signature of the person(s) whose name(s) and specimen signature(s) appear below, even though the telephone calls may actually have been made in error or by negligence or by fraud or by someone other than myself/ourselves or without my/our actual instruction or knowledge. The Bank may, at its sole discretion, act upon my/our telephonic instructions whether a confirmation, as per Clause 4 below, has been received by the Bank or not.

4. Without prejudice to Clause 1, 2 and 3 of this Authority, I/we agree to clearly mark my/our Letter in confirmation (“Letter”) of the communication whether by telephone call and/or by fax and/ or email made by me/ourselves, with the words “For information only – in confirmation of my/our telephone call and/or by fax and/or email …(date)…” and to deliver the same to the Bank on the same day as the telephone call and/or by fax and/or email and should these words not clearly appear on the Letter, I/we will not hold the Bank, its directors, officers, or employees responsible for any loss or other consequence arising from the duplication of the transaction. I/We further understand that all instructions; telephonic, facsimile or mail may be recorded and retained by the Bank.

Branch

Pursuant to the clauses above I/we elect to communicate instructions to the bank in the following manner(s), please select your preferred means of communicating instructions:

Telephone Facsimile Email

By electing one or more of the options above and affixing my/our signature to the signature boxes provided below in the section “Terms and Conditions” I/we agree to be bound by the terms of this Authority.

(7)

02.11 TERMS & CONDITIONS

I/We agree that the information given above is true and complete and that I/We have received, read, understood and accepted (please select one of the options below):

and those applicable specifically to the type of account chosen by me/us which I/We understand and expressly agree and accept to be bound by them.

Joint Account Only: We agree with the provisions for Joint Account mandates as set out in the General Terms and

Conditions and we understand that we are jointly and severally liable for any overdrawn balances on the account. We also request you to accept the signing authority instructions as set out below by us.

Note: Maximum of four named parties allowed on a Joint Account

Emirates NBD PJSC, London Branch, is authorised and regulated by the Financial Services Authority in the UK Emirates NBD PJSC, Jersey Branch, is regulated by the Jersey Financial Services Commission to take deposits SIGNING INSTRUCTIONS (for Joint Accounts only)

Singly (Any one to sign) Jointly (All to sign) Other (see Special Instructions below) ACCOUNT HOLDER(S) SIGNATURE(S)

SPECIAL INSTRUCTIONS

The General Terms & Conditions for Current Accounts, Call Deposit Accounts, Fixed Deposit Accounts with Emirates NBD PJSC,

London Branch

The General Terms & Conditions for Current Accounts, Call Deposit Accounts, Fixed Deposit Accounts with Emirates NBD PJSC,

Jersey Branch Name Signature Signature Name Signature Name Signature Name Page 7 of 7

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