BM CN-01/HSTTKH NG K THNG TIN KHCH HNG NGH M TI KHON C NHN

CUSTOMER INFORMATION REGISTRATION- REQUEST FOR ACCOUNT OPENING

S HSKH/CIF No.

Knh gi: Ngn hng TMCP u t v Pht trin Vit Nam, Chi nhnh/S Giao dch.............................(Ngn hng To: Bank for Investment and Development of Vietnam JSC, Branch..................(the Bank) Vi mi trch nhim thuc v mnh, ti/chng ti ngh Ngn hng ng k thng tin v m ti khon cho ti/chng ti vi cc thng tin sau (I/We, taking full legal responsibility to myself/ourselves, would like the Bank to register my/our information and open the account(s) for me/us as follows):
1. THNG TIN V KHCH HNG (CUSTOMER INFORMATION)

H v tn (Full legal name). S CMND/HC/CMSQQNDVN... Ngy cp ./.../.. Ni cp

(ID/Passport No.) (Issued date) (Issued by)
THNG TIN KHC (trong trng hp ti cha ng k thng tin ti Ngn hng): OTHER INFORMATION (in case I have not registered information at the Bank):

Ngi c tr (Resident) Ngi khng c tr (Non-Resident) Ngy sinh (Date of birth)././ M s thu (Tax No.).. Nam (Male) N (Female) Ngh nghip (Occupation) Chc v (Title). a ch lin h (Mailing Address)... a ch thng tr (Registered Address)....... a ch th in t (E-mail address)..... in thoi nh ring (Home phone No.)..in thoi di ng (Mobile phone No.)
Quc tch (Nationality). Ch k mu (Specimen signature) Mu ch k th nht (K v ghi r h tn) st The 1 specimen signature (sign and write full name) Mu ch k th hai (K v ghi r h tn) The 2 specimen signature (sign and write full name)
nd

2. THNG TIN TI KHON (ACCOUNT INFORMATION)

..

Tin gi thanh ton

Current account

Thng thng
Normal

Khc .
Others

Loi tin t:
Currency

VND Hng thng Monthly Trc tip At BIDV Hng qu Quarterly

USD Hng nm Yearly Th in t By email

Khc
Others

Chu k in sao k Statement period

Khi c yu cu Upon request Khc .. Others

Phng thc nhn chng t Document delivery method Tin gi tit kim Saving account

Bu in By post C k hn thng thng Fixed term

Khng k hn Non- term

Khc Other s
1

Loi tin t (Currency):

VND

USD

Khc (Others).

3. THNG TIN NGI I DIN THEO PHP LUT/NGI C U QUYN (nu c)

(INFORMATION OF LEGAL REPRESENTATIVE/AUTHORIZED PERSON) Ngi i din theo php lut Ngi c u quyn LEGAL REPRESENTATIVE AUTHORIZED PERSON H v tn (Full name).. S CMND/HC/CMSQQNDVN (ID/Passport No.)..Ngy cp (Issued date) ././.. Ni cp (Issued by). Ch k mu (Specimen signature) Mu ch k th nht (k v ghi r h tn) st The 1 specimen signature (sign and write full name) Mu ch k th hai (k v ghi r h tn) The 2 specimen signature (sign and write full name)
nd

..

Cc ni dung khc theo Vn bn u quyn/ Vn bn chng minh t cch ca Ngi i din theo php lut nh km ng k ny (Other contents of the Authorization Letter/ Legal representative Agreement are attached to this Registration)
4. BN K CC GIY T KM THEO (ATTACHED DOCUMENTS)

Bn sao Giy t tu thn ca Ch TK (Copies of the Account holders identifications): CMND H chiu CMSQ QND VN ID Passport Bn sao Giy t tu thn ca Ngi i din theo php lut (nu c) (Copies of the Legal representatives identifications): CMND H chiu CMSQ QND VN ID Passport Cc giy t khc (nu c) (other documents): .. .. 1/ Ti/Chng ti cam oan rng mi thng tin nu trn l ng s tht v chnh .., ngy(date) thng (month).. xc. ngh Ngn hng m ti khon cho ti/chng ti theo ng k trn. (I/We nm (year) hereby confirm that the information given above is true and correct and request the Ngi ngh/Applicant Bank to open the account(s) as registered above). (K, ghi r h tn/ Sign and write full name) 2/ Ti/Chng ti xc nhn nhn c bn sao iu khon v iu kin chung v m v s dng ti khon tin gi ti BIDV v c, hiu r v chp nhn v iu kin bn iu khon v iu kin ny. (I/We confirm receipt of a copy of the Terms and Conditions relating to the opening and use of BIDVs account(s) and have read, understood and accepted the Terms and Conditions). 3/ Ti/Chng ti cam kt hon ton chu trch nhim qun l v s dng ti khon theo quy nh ca BIDV v quy nh ca php lut c lin quan. (I/We am/are fully committed to be responsible for the management and use of the account(s) in accordance with the regulations of BIDV and the laws of Vietnam).

PHN DNH CHO NGN HNG/ FOR BANK USE ONLY

S ti khon: Loi tin: . Ngy hiu lc: /../.
B phn tip nhn h s thng tin khch hng Ngy thc hin: .// Cn b (K, ghi r h tn) Cn b kim sot (K, ghi r h tn) B phn cp nht thng tin khch hng Ngy thc hin: .// Cn b (K, ghi r h tn) Cn b kim sot (K, ghi r h tn) B phn qun l thng tin khch hng Ngy thc hin: .// Cn b (K, ghi r h tn) Cn b kim sot (K, ghi r h tn)