basic savings bank deposit account – non-resident
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Basic Savings Bank Deposit Account New Account Opening Form (Non-Resident Only)
For NRE, NRO BSBDA accounts withThe Hongkong and Shanghai Banking Corporation Limited, India (HSBC India)
Key things you should know
• Basic Savings Bank Deposit Account (BSBDA) makes it convenient for you to avail of basic banking services without any fees or charges, andwithout maintaining any minimum balance in the account
• Services offered under this account include:– Debit cards with no annual charges, having a daily cash withdrawal limit of `25,000 and a daily purchase limit of `10,000– Simple and convenient banking from the comfort of your home through free access to Internet Banking and PhoneBanking– Cheque books on the account– Unlimited free deposits in the account– Upto 4 free withdrawals per month across demand drafts, pay orders, cheque issuances, electronic transfers (including RTGS and NEFT),
ATM withdrawals and cash withdrawal requests placed through any of our branches– Monthly bank statements
• As a BSBDA holder, you are not eligible to have or open any other savings bank account with HSBC in India. If you have any other existingsavings account with HSBC in India, you are required to close the same within 30 days from the date of opening the Basic Savings BankDeposit Account, or else we will be constrained to close such other savings account that you hold with HSBC India
• HSBC will notify you of any changes in the terms and conditions of this account with a prior notice of one month
Definition – ‘Bank/HSBC India/HSBC’ means The Hongkong and Shanghai Banking Corporation Limited, India (HSBC), a company incorporated with limited liability under the Companies Ordinance of the Hong Kong Special Administrative Region (HKSAR), having its registered office at 1, Queen’s Road Central, Hong Kong and their India Corporate Office in India at 52/60, Mahatma Gandhi Road, Mumbai - 400 001.
Account Opening Information and Choice of Accounts
Please check √ the relevant option
A. Account typesg Sole account g Joint account Minor g Yes g No
B. Type of customer: g NRg NRE Savings g NRO Savings g NRE Current g NRO Current
C. Types of account:g
g
Savings account – It is the most common operating account mainly for individuals. A savings account helps people to put through day-to-day banking transactions, besides earning interest on the balances maintained in the account.
Current account – No interest is paid on the balance in the current account.
D. I have an existing HSBC relationshipSole/First accountholder g Yes g NoJoint accountholder 1 g Yes g NoJoint accountholder 2 g Yes g No
E. Do you hold an account/product with HSBC in any other countries g Yes g No
Country ___________________________________________ Account number gggggggggggggggggggggCountry ___________________________________________ Account number gggggggggggggggggggggCountry ___________________________________________ Account number gggggggggggggggggggggCountry ___________________________________________ Account number ggggggggggggggggggggg
F. Instruction to fill form• To find out which type of account best suits your requirements, read ‘Helping you choose the right account’ in Annexure I• Please fill the form in CAPITAL letters• Please countersign any overwriting• To avail of the nomination facility, please ensure that you fill in the nomination form enclosed in this form. While the nomination facility is optional,
we recommend that you avail of it• If you wish to give one of your family members in India access to your account, please fill a separate letter of authorisation available on
www.hsbc.co.in under ‘Application Forms’• For service charges and tariffs, please visit www.hsbc.co.in or your nearest HSBC branch in India• In case of all downloaded and printed/photocopied account opening forms, signatures of all accountholders are required at the bottom of all the
pages of the formThe ‘Code of Bank’s Commitment to Customers’ was released by the Banking Codes and Standards Board of India (BCSBI) in July 2006; and revised in August 2009.The Bank is a member of the BCSBI. To obtain your copy of the code, please visit www.hsbc.co.in or one of our branches.G. Purpose of account opening
g Household Expenses g Personal Expenses g Major Personal Purchases g Regular Mandated Credit g Regular Mandated Debit g Major Purchase g Savings g Children’s Education or School Fees
Please open an account at your City
Branch
2
Personal Details (Sole/First accountholder/Minor)
Residential status g Resident g Non-Resident g Foreign national g Person of Indian Origin
Salutation g Mr. g Mrs. g Ms. g Mst. Title g Dr. g Prof. g Not Applicable g Any other ________________________
Full name (In the order of First Name, Middle name, Last name)
Are you known by any other names: g Yes g No
Former/Other name (If any) (In the order of First Name, Middle name, Last name)
Maiden name (If any) (In the order of First Name, Middle name, Last name)
Name (Same as per ID proof) (provide if different from Full name)
How would you like to be addressed in our communication?
Date of birth Gender M F Third Gender
Place/City of Birth ___________________________________________ Country of birth _____________________________________________
Nationality/Citizenship of _____________________________________
Multiple Nationality Yes No
Nationality/Citizenship 1 _____________________________________ Nationality/Citizenship 2 _____________________________________
KYC number (number would be given by the Central KYC registry) (If available)
Father’s name
Spouse’s name (If available)
Mother’s name
Marital status g Married g Single g Other ______________________
My Identification details:
It is mandatory to provide a self attested copy of Passport for Non-resident customer.
It is mandatory to provide a self-attested copy of the PAN card (or Form 60, as applicable).
Permanent Account Number (PAN) g or ‘Form 60 attached’ g PAN number
Officially Valid Documents - Proof of Identity (any one)
PAN number g Yes g No PAN number
Aadhaar card g Yes g No Aadhaar card number
Passport g Yes g No Passport number & expiry date (For NR passport mandatory)
Voters ID g Yes g No Voters ID number
NREGA job card g Yes g No NREGA job card number
Driving licence g Yes g No Driving licence number & expiry date
Officially Valid Documents - Proof of Address (any one)
g Aadhaar card g Passport g Voters ID g NREGA job card g Driving licence g Others# ____________________
#For information on additional documents acceptable as identity/address proof please get in touch with the nearest HSBC branch in India or your Relationship Manager or call the HSBC India Contact Centre.
Documents accepted as a proof of address should mention the address details.
In case Proof of Identity does not contain Date of Birth an additional proof for the same is required.
CRS - Individual Tax Residency Self-Certification
Aadhaar Number issued by UIDAI (if available) (if not provided above)
Please complete the following table indicating(i) The country where the account holder is resident for tax purposes.
(ii) The accountholder’s TIN (Tax Identification Number) for each country indicated.
If the accountholder is tax resident in more than three countries please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C (Please refer the Annexure section for definitions of reasons A,B and C)
Country of tax residence/Country of TIN issuance TIN If no TIN available enter Reason A, B or C
1.
2.
3.
D D M M Y Y Y Y
3
Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above.
1.
2.
3.
Even if you have already provided information in relation to the United States Government’s Foreign Account Tax Compliance Act (FATCA), you are still needed to provide additional information for the CRS as this is a separate requirement under the local regulation.
Current Residential address (For NR customers provide ‘overseas’ residential address)
Is this address residential and business Yes No
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Note: In case of only P. O. Box address, it is mandatory to provide the Area/Landmark details.
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Mobile number: (ISD code)
Mobile Alerts Registration* Required Not required
E-mail:
Alerts will be sent to your mobile number registered in HSBC India’s records for transactions in your HSBC Advance/HSBC Savings Account in India which results into a debit of 5,000 or a credit of 10,000 and above. In case you wish to modify the standard threshold alerts and/or the existing alerts, you will have to provide written instructions to HSBC India. However, you will receive alerts on all transactions done using HSBC Debit and/or Credit Card. To know more about the list of mobile alerts available and the procedure of registering for the same, please visit www.hsbc.co.in
I would like to opt for statement by e-mail. Yes No
At this address since
I am staying at the current residential address temporarily Yes No
g I am currently residing at a temporary current residential address. I will update with my current residential address along with the required proof with the Bank once my current residential address is confirmed.
Signature of customer Sole/first accountholder
Do you have any alternate residential address(es) Yes No
Other residential address
Permanent address
If Same as Current Resident Yes No
if different
Address Type: Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Telephone (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
D D M M Y Y Y Y
4
Current Address in the jurisdiction details where applicant is resident for Tax Purposes
If Same as Current Resident/Permanent address/Overseas address Yes No
If different,
Address Type:
Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Previous address (if resident at current address for less than 3 years)
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Country(s) where your current net worth has been accumulated:
Country 1: ________________________ Country 2: ____________________________ Country 3: ______________________
Existing HSBC relationship
Bank account g Yes g No Loan account g Yes g No
Credit card account g Yes g No
Foreign Account Tax Compliance Act (FATCA) Declaration
Are you a US Person+ g Yes g No
+The term ‘United States person’ means:
(a) an individual, being a citizen or resident of the United States of America;
(b) a partnership or corporation organized in the United States of America or under the laws of the United States of America or any State thereof;
(c) a trust if:(i) a court within the United States of America would have authority under applicable law to render orders or judgments concerning substantially all issues regarding
administration of the trust; and(ii) one or more US persons have the authority to control all substantial decisions of the trust; or
(d) an estate of a decedent who was a citizen or resident of the United States of America;
A US person also includes a person who meet substantial present test in US
Generally, you will meet substantial present test in US if you were physically present in the United States on at least -
1. 31 days during the current calendar year, and
2. 183 days during current year and preceding two years, counting• All the days you were present in the current year (+)• 1/3 of the days you were present in the first year before the current year (+)• 1/6 of the days you were present in the second year before the current year
For exemptions, as applicable, kindly refer http://www.irs.gov/Individuals/International-Taxpayers/Substantial-Presence-Test
You will also be required to complete a Form W9/W8 with explanation, if any of the information in the account opening form indicates any US indicia (i.e. if you fulfil the above US criteria). The Form W9/W8 will be available on an external website.
Personal Details (Guardian)
Residential status Resident Non-Resident Foreign national Person of Indian Origin
Salutation g Mr. g Mrs. g Ms. g Mst. Title g Dr. g Prof. g Not Applicable g Any other ________________________
Full name (In the order of First Name, Middle name, Last name)
Are you known by any other names: g Yes g No
Former/Other name (If any) (In the order of First Name, Middle name, Last name)
Maiden name (If any) (In the order of First Name, Middle name, Last name)
Name (Same as per ID proof) (provide if different from Full name)
How would you like to be addressed in our communication?
Relationship with Minor applicant: ___________________________ Date of birth
Gender M F Third Gender Place/City of Birth ___________________________________________
D D M M Y Y Y Y
5
Country of birth _______________________________________________ Nationality/Citizenship of _____________________________________
Multiple Nationality Yes No
Nationality/Citizenship 1 _____________________________________ Nationality/Citizenship 2 _____________________________________
KYC number (number would be given by the Central KYC registry) (If available)
Father’s name
Spouse’s name (If available)
Mother’s name
Marital status g Married g Single g Other ______________________
My Identification details:
It is mandatory to provide a self attested copy of Passport for Non-resident customer.
It is mandatory to provide a self-attested copy of the PAN card (or Form 60, as applicable).
Permanent Account Number (PAN) g or ‘Form 60 attached’ g PAN number
Officially Valid Documents - Proof of Identity (any one)
PAN number g Yes g No PAN number
Aadhaar card g Yes g No Aadhaar card number
Passport g Yes g No Passport number & expiry date (For NR passport mandatory)
Voters ID g Yes g No Voters ID number
NREGA job card g Yes g No NREGA job card number
Driving licence g Yes g No Driving licence number & expiry date
Officially Valid Documents - Proof of Address (any one)
g Aadhaar card g Passport g Voters ID g NREGA job card g Driving licence g Others# ____________________
#For information on additional documents acceptable as identity/address proof please get in touch with the nearest HSBC branch in India or your Relationship Manager or call the HSBC India Contact Centre.
Documents accepted as a proof of address should mention the address details.
In case Proof of Identity does not contain Date of Birth an additional proof for the same is required.
CRS - Individual Tax Residency Self-Certification
Aadhaar Number issued by UIDAI (if available) (if not provided above)
Please complete the following table indicating(i) The country where the account holder is resident for tax purposes.
(ii) The accountholder’s TIN (Tax Identification Number) for each country indicated.
If the accountholder is tax resident in more than three countries please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C (Please refer the Annexure section for definitions of reasons A,B and C)
Country of tax residence/Country of TIN issuance TIN If no TIN available enter Reason A, B or C
1.
2.
3.
Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above.
1.
2.
3.
Even if you have already provided information in relation to the United States Government’s Foreign Account Tax Compliance Act (FATCA), you are still needed to provide additional information for the CRS as this is a separate requirement under the local regulation.
Current Residential address
Is this address residential and business Yes No
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Note: In case of only P. O. Box address, it is mandatory to provide the Area/Landmark details.
6
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Mobile number: (ISD code)
Mobile Alerts Registration* Required Not required
E-mail:
Alerts will be sent to your mobile number registered in HSBC India’s records for transactions in your HSBC Advance/HSBC Savings Account in India which results into a debit of 5,000 or a credit of 10,000 and above. In case you wish to modify the standard threshold alerts and/or the existing alerts, you will have to provide written instructions to HSBC India. However, you will receive alerts on all transactions done using HSBC Debit and/or Credit Card. To know more about the list of mobile alerts available and the procedure of registering for the same, please visit www.hsbc.co.in
I would like to opt for statement by e-mail. Yes No
At this address since
I am staying at the current residential address temporarily Yes No
g I am currently residing at a temporary current residential address. I will update with my current residential address along with the required proof with the Bank once my current residential address is confirmed.
Signature of customer Sole/first accountholder
Do you have any alternate residential address(es) Yes No
Other residential address
Permanent address
If Same as Current Resident Yes No
if different
Address Type: Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Current Address in the jurisdiction details where applicant is resident for Tax Purposes
If Same as Current Resident/Permanent address/Overseas address Yes No
If different, Address Type:
Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Previous address (if resident at current address for less than 3 years)
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Country(s) where your current net worth has been accumulated:
Country 1: ________________________ Country 2: ____________________________ Country 3: ______________________
D D M M Y Y Y Y
7
Existing HSBC relationship
Bank account g Yes g No Loan account g Yes g No
Credit card account g Yes g No
Foreign Account Tax Compliance Act (FATCA) Declaration
Are you a US Person+ g Yes g No
+The term ‘United States person’ means:
(a) an individual, being a citizen or resident of the United States of America;
(b) a partnership or corporation organized in the United States of America or under the laws of the United States of America or any State thereof;
(c) a trust if:(i) a court within the United States of America would have authority under applicable law to render orders or judgments concerning substantially all issues regarding
administration of the trust; and(ii) one or more US persons have the authority to control all substantial decisions of the trust; or
(d) an estate of a decedent who was a citizen or resident of the United States of America;
A US person also includes a person who meet substantial present test in US
Generally, you will meet substantial present test in US if you were physically present in the United States on at least -
1. 31 days during the current calendar year, and
2. 183 days during current year and preceding two years, counting• All the days you were present in the current year (+)• 1/3 of the days you were present in the first year before the current year (+)• 1/6 of the days you were present in the second year before the current year
For exemptions, as applicable, kindly refer http://www.irs.gov/Individuals/International-Taxpayers/Substantial-Presence-TestYou will also be required to complete a Form W9/W8 with explanation, if any of the information in the account opening form indicates any US indicia (i.e. if you fulfil the above US criteria). The Form W9/W8 will be available on an external website.
Personal Details (Joint accountholder 1)
Residential status Resident Non-Resident Foreign national Person of Indian Origin
Salutation g Mr. g Mrs. g Ms. g Mst. Title g Dr. g Prof. g Not Applicable g Any other ________________________
Full name (In the order of First Name, Middle name, Last name)
Are you known by any other names: g Yes g No
Former/Other name (If any) (In the order of First Name, Middle name, Last name)
Maiden name (If any) (In the order of First Name, Middle name, Last name)
Name (Same as per ID proof) (provide if different from Full name)
How would you like to be addressed in our communication?
Date of birth Gender M F Third Gender
Place/City of Birth ___________________________________________ Country of birth _____________________________________________
Nationality/Citizenship of _____________________________________
Multiple Nationality Yes No
Nationality/Citizenship 1 _____________________________________ Nationality/Citizenship 2 _____________________________________
KYC number (number would be given by the Central KYC registry) (If available)
Father’s name
Spouse’s name (If available)
Mother’s name
Relationship with the First Applicant
Father Mother (including step-mother) Spouse Son (including step-son)
Son’s wife Daughter (including step-daughter) Father’s father Father’s mother
Mother’s mother Mother’s father Son’s son Son’s son’s wife
Son’s daughter Son’s daughter’s husband Daughter’s husband Daughter’s son
Daughter’s son’s wife Daughter’s daughter Daughter’s daughter’s husband Brother (including step-brother)
Brother’s wife Sister (including step-sister) Sister’s husband
Marital status g Married g Single g Other ______________________
Note: Resident individuals have been permitted to include resident close relative(s) as defined in the Companies Act, 1956 as a joint accountholder(s) in this EEFC bank account.
Resident individuals have been permitted to include non-resident close relative(s) as defined in the Companies Act, 1956 as a joint accountholder(s) in this Resident bank account.
D D M M Y Y Y Y
8
My Identification details:
It is mandatory to provide a self attested copy of Passport for Non-resident customer.
It is mandatory to provide a self-attested copy of the PAN card (or Form 60, as applicable).
Permanent Account Number (PAN) g or ‘Form 60 attached’ g PAN number
Officially Valid Documents - Proof of Identity (any one)
PAN number g Yes g No PAN number
Aadhaar card g Yes g No Aadhaar card number
Passport g Yes g No Passport number & expiry date (For NR passport mandatory)
Voters ID g Yes g No Voters ID number
NREGA job card g Yes g No NREGA job card number
Driving licence g Yes g No Driving licence number & expiry date
Officially Valid Documents - Proof of Address (any one)
g Aadhaar card g Passport g Voters ID g NREGA job card g Driving licence g Others# ____________________
#For information on additional documents acceptable as identity/address proof please get in touch with the nearest HSBC branch in India or your Relationship Manager or call the HSBC India Contact Centre.
Documents accepted as a proof of address should mention the address details.
In case Proof of Identity does not contain Date of Birth an additional proof for the same is required.
CRS - Individual Tax Residency Self-Certification
Aadhaar Number issued by UIDAI (if available) (if not provided above)
Please complete the following table indicating(i) The country where the account holder is resident for tax purposes.
(ii) The accountholder’s TIN (Tax Identification Number) for each country indicated.
If the accountholder is tax resident in more than three countries please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C (Please refer the Annexure section for definitions of reasons A,B and C)
Country of tax residence/Country of TIN issuance TIN If no TIN available enter Reason A, B or C
1.
2.
3.
Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above.
1.
2.
3.
Even if you have already provided information in relation to the United States Government’s Foreign Account Tax Compliance Act (FATCA), you are still needed to provide additional information for the CRS as this is a separate requirement under the local regulation.
Current Residential address (For NR customers provide ‘overseas’ residential address)
Is this address residential and business Yes No
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Note: In case of only P. O. Box address, it is mandatory to provide the Area/Landmark details.
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Mobile number: (ISD code)
Mobile Alerts Registration* Required Not required
E-mail: Alerts will be sent to your mobile number registered in HSBC India’s records for transactions in your HSBC Advance/HSBC Savings Account in India which results into a debit of 5,000 or a credit of 10,000 and above. In case you wish to modify the standard threshold alerts and/or the existing alerts, you will have to provide written instructions to HSBC India. However, you will receive alerts on all transactions done using HSBC Debit and/or Credit Card. To know more about the list of mobile alerts available and the procedure of registering for the same, please visit www.hsbc.co.in
I would like to opt for statement by e-mail. Yes No
At this address since D D M M Y Y Y Y
9
I am staying at the current residential address temporarily Yes No
g I am currently residing at a temporary current residential address. I will update with my current residential address along with the required proof with the Bank once my current residential address is confirmed.
Signature of customer Sole/first accountholder
Do you have any alternate residential address(es) Yes No
Other residential address
Permanent address
If Same as Current Resident Yes No
if different
Address Type: Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Current Address in the jurisdiction details where applicant is resident for Tax Purposes
If Same as Current Resident/Permanent address/Overseas address Yes No
If different, Address Type:
Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Previous address (if resident at current address for less than 3 years)
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Country(s) where your current net worth has been accumulated:
Country 1: ________________________ Country 2: ____________________________ Country 3: ______________________
Existing HSBC relationship
Bank account g Yes g No Loan account g Yes g No
Credit card account g Yes g No
Foreign Account Tax Compliance Act (FATCA) Declaration
Are you a US Person+ g Yes g No
+The term ‘United States person’ means:
(a) an individual, being a citizen or resident of the United States of America;
(b) a partnership or corporation organized in the United States of America or under the laws of the United States of America or any State thereof;
(c) a trust if:(i) a court within the United States of America would have authority under applicable law to render orders or judgments concerning substantially all issues regarding
administration of the trust; and(ii) one or more US persons have the authority to control all substantial decisions of the trust; or
10
(d) an estate of a decedent who was a citizen or resident of the United States of America;
A US person also includes a person who meet substantial present test in US
Generally, you will meet substantial present test in US if you were physically present in the United States on at least -
1. 31 days during the current calendar year, and
2. 183 days during current year and preceding two years, counting• All the days you were present in the current year (+)• 1/3 of the days you were present in the first year before the current year (+)• 1/6 of the days you were present in the second year before the current year
For exemptions, as applicable, kindly refer http://www.irs.gov/Individuals/International-Taxpayers/Substantial-Presence-TestYou will also be required to complete a Form W9/W8 with explanation, if any of the information in the account opening form indicates any US indicia (i.e. if you fulfil the above US criteria). The Form W9/W8 will be available on an external website.
Personal Details (Joint accountholder 2)
Residential status g Resident g Non-Resident g Foreign national g Person of Indian Origin
Salutation g Mr. g Mrs. g Ms. g Mst. Title g Dr. g Prof. g Not Applicable g Any other ________________________
Full name (In the order of First Name, Middle name, Last name)
Are you known by any other names: g Yes g No
Former/Other name (If any) (In the order of First Name, Middle name, Last name)
Maiden name (If any) (In the order of First Name, Middle name, Last name)
Name (Same as per ID proof) (provide if different from Full name)
How would you like to be addressed in our communication?
Date of birth Gender M F Third Gender
Place/City of Birth ___________________________________________ Country of birth _____________________________________________
Nationality/Citizenship of _____________________________________
Multiple Nationality Yes No
Nationality/Citizenship 1 _____________________________________ Nationality/Citizenship 2 _____________________________________
KYC number (number would be given by the Central KYC registry) (If available)
Father’s name
Spouse’s name (If available)
Mother’s name
Relationship with the First Applicant
Father Mother (including step-mother) Spouse Son (including step-son)
Son’s wife Daughter (including step-daughter) Father’s father Father’s mother
Mother’s mother Mother’s father Son’s son Son’s son’s wife
Son’s daughter Son’s daughter’s husband Daughter’s husband Daughter’s son
Daughter’s son’s wife Daughter’s daughter Daughter’s daughter’s husband Brother (including step-brother)
Brother’s wife Sister (including step-sister) Sister’s husband
Marital status g Married g Single g Other ______________________
My Identification details:
It is mandatory to provide a self attested copy of Passport for Non-resident customer.
It is mandatory to provide a self-attested copy of the PAN card (or Form 60, as applicable).
Permanent Account Number (PAN) g or ‘Form 60 attached’ g PAN number
Officially Valid Documents - Proof of Identity (any one)
PAN number g Yes g No PAN number
Aadhaar card g Yes g No Aadhaar card number
Passport g Yes g No Passport number & expiry date (For NR passport mandatory)
Voters ID g Yes g No Voters ID number
NREGA job card g Yes g No NREGA job card number
Driving licence g Yes g No Driving licence number & expiry date
D D M M Y Y Y Y
11
Officially Valid Documents - Proof of Address (any one)
g Aadhaar card g Passport g Voters ID g NREGA job card g Driving licence g Others# ____________________
#For information on additional documents acceptable as identity/address proof please get in touch with the nearest HSBC branch in India or your Relationship Manager or call the HSBC India Contact Centre.
Documents accepted as a proof of address should mention the address details.
In case Proof of Identity does not contain Date of Birth an additional proof for the same is required.
CRS - Individual Tax Residency Self-Certification
Aadhaar Number issued by UIDAI (if available) (if not provided above)
Please complete the following table indicating(i) The country where the account holder is resident for tax purposes.
(ii) The accountholder’s TIN (Tax Identification Number) for each country indicated.
If the accountholder is tax resident in more than three countries please use a separate sheet. If a TIN is unavailable please provide the appropriate reason A, B or C (Please refer the Annexure section for definitions of reasons A,B and C)
Country of tax residence/Country of TIN issuance TIN If no TIN available enter Reason A, B or C
1.
2.
3.
Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above.
1.
2.
3.
Even if you have already provided information in relation to the United States Government’s Foreign Account Tax Compliance Act (FATCA), you are still needed to provide additional information for the CRS as this is a separate requirement under the local regulation.
Current Residential address (For NR customers provide ‘overseas’ residential address)
Is this address residential and business Yes No
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Note: In case of only P. O. Box address, it is mandatory to provide the Area/Landmark details.
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Mobile number: (ISD code)
Mobile Alerts Registration* Required Not required
E-mail:
Alerts will be sent to your mobile number registered in HSBC India’s records for transactions in your HSBC Advance/HSBC Savings Account in India which results into a debit of 5,000 or a credit of 10,000 and above. In case you wish to modify the standard threshold alerts and/or the existing alerts, you will have to provide written instructions to HSBC India. However, you will receive alerts on all transactions done using HSBC Debit and/or Credit Card. To know more about the list of mobile alerts available and the procedure of registering for the same, please visit www.hsbc.co.in
I would like to opt for statement by e-mail. Yes No
At this address since
I am staying at the current residential address temporarily Yes No
g I am currently residing at a temporary current residential address. I will update with my current residential address along with the required proof with the Bank once my current residential address is confirmed.
Signature of customer Sole/first accountholder
Do you have any alternate residential address(es) Yes No
Other residential address
D D M M Y Y Y Y
12
Permanent address
If Same as Current Resident Yes No
if different
Address Type: Residential/Business Residential Business Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Telephone: (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code)
Current Address in the jurisdiction details where applicant is resident for Tax Purposes
If Same as Current Resident/Permanent address/Overseas address g Yes g No
If different, Address Type:
g Residential/Business g Residential g Business g Registered office
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Previous address (if resident at current address for less than 3 years)
Flat number and building name:
Road number/name:
Area and landmark:
City: ________________________ District: ___________________________ State: ___________________________ Country: ____________________________
Pin Code:
Country(s) where your current net worth has been accumulated:
Country 1: ________________________ Country 2: ____________________________ Country 3: ______________________
Existing HSBC relationship
Bank account g Yes g No Loan account g Yes g No
Credit card account g Yes g No
Foreign Account Tax Compliance Act (FATCA) Declaration
Are you a US Person+ g Yes g No
+The term ‘United States person’ means:
(a) an individual, being a citizen or resident of the United States of America;
(b) a partnership or corporation organized in the United States of America or under the laws of the United States of America or any State thereof;
(c) a trust if:(i) a court within the United States of America would have authority under applicable law to render orders or judgments concerning substantially all issues regarding
administration of the trust; and(ii) one or more US persons have the authority to control all substantial decisions of the trust; or
(d) an estate of a decedent who was a citizen or resident of the United States of America;
A US person also includes a person who meet substantial present test in US
Generally, you will meet substantial present test in US if you were physically present in the United States on at least -
1. 31 days during the current calendar year, and
2. 183 days during current year and preceding two years, counting• All the days you were present in the current year (+)• 1/3 of the days you were present in the first year before the current year (+)• 1/6 of the days you were present in the second year before the current year
For exemptions, as applicable, kindly refer http://www.irs.gov/Individuals/International-Taxpayers/Substantial-Presence-TestYou will also be required to complete a Form W9/W8 with explanation, if any of the information in the account opening form indicates any US indicia (i.e. if you fulfil the above US criteria). The Form W9/W8 will be available on an external website.
13
Mode of Funding
Do you intend to make an initial deposit Yes No
Mode of initial funds to be transferred to the account Cash Non-Cash Both
Provide details of the source of the initial funds in case of Cash deposit: ______________________________________________________________________
What is the source of the initial transfer to the account
Salary payment Account holder’s accounts with other banks/financial institutions Other
Which country(ies) do the funds originate from
Country 1 ________________________ Country 2 ________________________ Country 3 ________________________
Cheque number Drawn on ____________________ Branch _______________________
Debit HSBC account number RTGS/NEFT Transfer
Other ________________________________ Intial Transfer Amount `
Please tick applicable box(es), if you do not have any of the above ‘mode of funding’.
New Mortgage Customer Existing Customer Staff
HSBC Debit Card
Debit card(s)* Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2 Required
Not required
Sole/First accountholder’s name to be printed on debit card (name to fit)
Please tick þ in case the debit Cardholder is a minor+
Date of birth (of the minor debit Cardholder)
+Debit card will be issued to minors above 16 years only, with the parent/guardian’s consent and request.
Additional debit card for joint accountholder(s) (name to fit)
1.
2.
Debit card usage+ (Please tick the preferred debit card usage mode)
Debit card(s)* Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2 Domestic usage1 only
International and domestic usage2
Please note in absence of usage preference, HSBC India shall issue a debit card with domestic usage only.1Enables usage of debit card in India only. Any overseas transaction including online transactions on international websites are prohibited.2Enables usage of card both in India and overseas. (Not applicable for NRO accounts and POA).+In line with RBI guidelines, w.e.f. 1 December 2013, customers need to indicate their preference regarding domestic and international usage at the time of application.
*The annual charges on the debit card are waived for the first year. Each debit card, including additional cards is available at `150 plus taxes per annum from the second year onwards.
Issuance of debit card is mandatory in case of instant welcome packs.
Other Instructions
Nomination
Required (Please complete the nomination form in the optional section.)
Not required
14
Level of activity anticipated
Initial and ongoing sources of your wealth or income:
Please select from the options provided
Earning from work Earning from business interest Inheritance
Personal savings Return on investment/Investment matured Earning given by spouse
Sale of an asset (e.g. car, property, etc.) Winning lottery prize money Others. Please specify ______________________
Total credits per month: Number of transactions Transaction amount (`)
Total debits per month: Number of transactions Transaction amount (`)
Types of service which will be used (and nature of activity)
General banking services (e.g. cash, cheques, autopay, etc.) Investment and insurance services
Credit services (e.g. mortgage, loans, credit cards, etc.) Remittance services (e.g. wire transfer, demand draft)
Others. Please specify ________________________________
Value of the funds to be deposited in the account(s) within 12 months of opening (in local currency) ________________
Other than usual day to day living credits and transactions will you be conducting any other cash transactions on a regular basis Yes No
Anticipated cash deposit monthly :
Number of transactions: _________________________________________________ Amount of transactions (INR): ___________________________________________
‘Purpose of cash deposits:
Household Expenses Regular Mandated debits
Personal Expenses Major Purchase
Major Personal Purchases Savings
Regular Mandated credits Children’s Education / School fees
Other ___________________________
Anticipated cash withdrawal monthly:
Number of transactions: _________________________________________________ Amount of transactions (INR): ___________________________________________
‘Purpose of cash deposits:
Household Expenses Regular Mandated debits
Personal Expenses Major Purchase
Major Personal Purchases Savings
Regular Mandated credits Children’s Education / School fees
Other ___________________________
Would you conduct banking transactions from this account outside of India: Yes No
Cross Border Transactions (total of receipts & payment made):
Total Volumes of transaction: _____________________________________________
Total Value of transaction (INR): __________________________________________ Total Value of transaction (USD): _________________________________________
Country (ies) you intend to make or receive regular international payments:
Country 1 _____________________ Country 2 _____________________ Country 3 _____________________
Details of expected inward Remittance (monthly)
Number of transactions _________________________________________________ Amount of transactions (INR) ___________________________________________
Purpose of inward remittance: __________________________________________
Details of expected outward Remittance (monthly)
Number of transactions _________________________________________________ Amount of transactions (INR) ___________________________________________
Purpose of onward remittance: __________________________________________
15
Personal Details
Please check þ the boxes an d fill the requested information under sole/first accountholder, joint accountholders 1 and 2. First/Sole a/c holder Joint a/c holder 1 Joint a/c holder 2Employment status Employed (i.e Salaried) Self-employed Not Employed If salaried Nature of organisation
MNC Government PSU Public Ltd. Private Ltd. Proprietorship Partnership HUF
Others _____________ _____________ _____________ (please specify)Occupation detailsSenior MGMT Manager/Executive Non-Executive Teacher Police Armed forces Salaried Seafarer If self-employed Your firm is Proprietorship Partnership Private Ltd. Your profession is CA Journalist Architect Consultant Lawyer
Others _____________ _____________ _____________ (please specify)Employment RoleBusiness Owner Key Controller Sole Trader Employee To be filled by both salaried and self-employed customers:Nature of businessSoftware IT Hardware Finance Insurance FMCG Engineering Infrastructure Textile Leather
Others _____________ _____________ _____________ (please specify)
Other details
First holder
1. Company name _________________________________________________ Designation _____________________________________________________
Department _____________________________________________________ Gross Annual Salary/Earnings _____________________________________
Joint holder 1
2. Company name _________________________________________________ Designation _____________________________________________________
Department _____________________________________________________ Gross Annual Salary/Earnings _____________________________________
Joint holder 2
3. Company name _________________________________________________ Designation _____________________________________________________
Department _____________________________________________________ Gross Annual Salary/Earnings _____________________________________
16
If Not Employed
Student Housewife Retired Unemployed
If you are a student provide
Course start date _____________ _____________ _____________
Course end date _____________ _____________ _____________
If you are unemployed - Social security benefits received- Yes No Yes No Yes No
Company Address of All accountholder
Sole/First accountholder
Building no. and name
Road no./name
Area and landmark
City
District
State
Country
Pin code
Telephone (Off.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code) (Facsimile) Please mention ‘NA‘ if you do not have a facsimile number (ISD code) (STD code) Joint accountholder 1
Building no. and name
Road no./name
Area and landmark
City
District
State
Country
Pin code
Telephone (Off.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code) (Facsimile) Please mention ‘NA‘ if you do not have a facsimile number (ISD code) (STD code)
Joint accountholder 2
Building no. and name
Road no./name
Area and landmark
City
District
State
Country
Pin code
Telephone (Off.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code) (Facsimile) Please mention ‘NA‘ if you do not have a facsimile number (ISD code) (STD code)
Address for Communication
Current residential address Permanent address Company address
Connected Party
Please list the connected/associated parties who have control or influence over your account without necessarily signing on your account. Please approach the bank staff for further clarifications.
Connected parties Yes No
KYC number (number would be given by the registry) (If available)
Connected party details: Individual Entity
Existing Customer Yes No
17
Customer ID (if existing customer):
Account number (if existing customer):
Relationship with applicant:
POA Guardian
Letter of Authority Contributor Deputy for safe deposit access POA for Mortgages
Executor Additional Cardholder
Type of arrangement in place:
Legal Written Informal
Salutation: Mr. Ms. Miss. Mst. Mrs. Title: Dr. Prof. Not Applicable
Full name (In the order of First Name, Middle name, Last name)
Connected Party is known by any other names: Yes No
Former/other name (If any) (In the order of First Name, Middle name, Last name)
Date of birth Nationality/Citizenship of
My Identification details:It is mandatory to provide a self-attested copy of the PAN card (or Form 60, as applicable)
Permanent Account Number (PAN) or ‘Form 60 attached’ PAN number Officially Valid Documents - Proof of Identity (any one)
PAN number Yes No My PAN number Aadhaar card Yes No Aadhaar card number
Passport Yes No Passport number & expiry date
(For NR passport mandatory)
Voters ID Yes No Voters ID number
NREGA job card Yes No NREGA job card number
Driving licence Yes No Driving licence number & expiry date
Residential Address
Flat number and building name
Road number/name
Area and landmark
City
District
State
Country
Pin code
Note: In case of only P. O. Box address, it is mandatory to provide the Area/ Landmark details.
Correspondence Address
Flat number and building name
Road number/name
Area and landmark
City
District
State
Country
Pin code
Telephone (Res.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code) Telephone (Off.) Please mention ‘NA‘ if you do not have a telephone number (ISD code) (STD code) Mobile number (ISD code)
D D M M Y Y Y Y
18
Customer Declaration
I/We confirm having read and understood the account rules and hereby agree to be bound by the terms and conditions and amendments governing the account(s) or changes thereof and any further amendments made by the Bank from time to time. (Copy of account rules/terms and conditions is available on www.hsbc.co.in.
I/We agree that the Bank shall have the right to modify the account rules and the terms and conditions at its sole discretion, which shall be put up on the website from time to time.
I undertake to verify the Bank’s website for modification to the account rules from time to time.
I/We confirm that the Non-Resident accounts (NRE/NRO and FCNR) opened with the Bank shall be operated and maintained for the purpose of conducting bona fide transactions in Rupees and permissible currencies (as may be designated by Reserve Bank from time to time) in accordance with the provisions of the Foreign Exchange Management Act, 1999 (Act) and the rules and regulations made thereunder and that such opening, operation and maintenance shall not in any manner contravene or violate the provisions of the Act and the rules and regulations made thereunder.
I/We confirm that, upon opening and operating my/our NRO account, I/we shall not make available to any person resident in India, foreign currency against reimbursement in Rupees or in any other manner in India.
I/We undertake that in case of debits to the NRO account for the purpose of investment in India, and credits representing sale, proceeds of investments, I/we will ensure that such investments/disinvestments will be in accordance with the regulations made by the Reserve Bank of India in this regard.
I/We understand that the account(s) applied hereunder, will be opened by The Hongkong and Shanghai Banking Corporation Limited, India (hereinafter referred to as the Bank) on the basis of the declarations made by me/us. I/We also agree that, if any such declarations made by me/us are found to be incorrect, the Bank is not bound to pay any interest on the account(s) opened by me/us and is entitled to terminate the account relationship. I/We understand and acknowledge that any violation or non-observance of the undertakings given herein will be subject to action under FEMA.
I/We understand that all NRI deposits and lending thereagainst are under FEMA and are subject to the laws of India, as amended from time to time, and are consequently subject to the sovereign risk arising therefrom. I/We agree to abide by the provisions of FEMA concerning the NRE/NRO/FCNR(B) accounts scheme.
I/We understand and acknowledge that deposits under this programme are with the Bank’s branches in India and that such deposits shall be payable only at the branch in India where the deposit is placed and that there is no right of recourse against the Head Office of the Bank in Hong Kong or any other office of any HSBC Group entity worldwide.
I/We understand and acknowledge that:
• Changes in laws and rules in India governing NRI deposits may affect the liability of the Bank to repay any depositor outside India
• Deposits/Investments made with non-UK members of the group do not benefit from the protection provided under the UK Financial Services and Markets Act 2000, including the UK Financial Services Compensation Scheme
• NRI deposits with the Bank are not insured by Federal Deposit Insurance Corporation (FDIC) of the USA, nor by any other insurance company or corporation outside India
• Under current US Tax laws, US citizens and residents are subject to tax on their worldwide income (please consult your tax advisor regarding the tax treatment of these deposits in the USA or any other country where you are subject to tax, including your country of residence/nationality)
I/We agree and accept that the Bank may need to share or transfer data or information about the customer(s) to any third party service provider, whether located overseas or in India, who provides outsourced services to the Bank in connection with the operation of the Bank’s business, in accordance with the applicable guidelines of the Reserve Bank of India. Any such sharing or transfer of information will be done strictly on a confidential basis and the Bank will endeavour to maintain strict confidentiality of such information. However, the Bank or such third party service providers, whether located in India or overseas, may disclose information if required or permitted by any law, rule or regulation or at the request of any public or regulatory authority or if such disclosure is required for the purposes of preventing fraud, without any further specific consent or authorisation from me/us.
I/We hereby undertake to intimate the Bank about any change in my residential status i.e., upon my/our return to India for permanent settlement, for taking up employment, or for carrying on business or vocation or for any other purpose indicating my/our intention to stay in India for an uncertain period, immediately on arrival in India.
I/We declare that I am a tax resident/non-resident as per the provisions of Section 6 of the Indian Income-tax Act, 1961. In case there is any change in the tax residential status I/we undertake to promptly inform the Bank in writing. I/We also undertake to indemnify the Bank for any loss (including but not limited to tax, interest and penalty) suffered by the Bank as a result of either relying on this declaration or my/our delay/default in confirming the change, if any, in the facts mentioned above. The obligation to indemnify shall continue in any such event and notwithstanding a case where I/we am/are no longer a customer of the Bank.
I/We further declare that the information given herein by me/us is true and correct and the Bank is entitled to verify the same either directly or through any third party agent.
I/We confirm having received, read and understood the Bank’s account rules, and hereby agree to be bound by the terms and conditions governing the account(s).
I/We understand that the NRE account(s)/NRE term deposits/FCNR(B) deposits held jointly with resident close relative (as defined in Section 6 of the Companies Act, 1956) will be operated on ‘former or survivor’ basis.
NRI deposits are under the Reserve Bank of India programme for Non-Resident Indians and are governed by the rules in effect from time to time relating to such programmes, are subject to the sovereign risk arising from, and governed by the laws of, or any changes to the laws of India. NRI deposits/accounts are held with The Hongkong and Shanghai Banking Corporation Limited, India (HSBC India), and are not insured by any insurance company or corporation outside India and are payable only at the branch in India where the deposit is made.
NR accounts and NRI services are offered by The Hongkong and Shanghai Banking Corporation Limited in India (HSBC India) under the Reserve Bank of India Non-Resident Indian programme.
Approved for issue in the UK by HSBC Bank plc. 8 Canada Square, London E14 5HQ. Deposits/Investments made with non-UK members of the group do not benefit from the protection provided under the UK Financial Services and Markets Act 2000, including the UK Financial Services Compensation Scheme.
NR deposits with the Bank in India are not insured by Federal Deposit Insurance Corporation (FDIC) of the USA, nor by any other insurance company or corporation outside of India and are payable only at the branch in India where the deposit is made. Under current US tax laws, US citizens and residents are subject to tax on their worldwide income. You should consult your tax advisor for the US treatment of income from these deposits.
NRI accounts and services are offered by The Hongkong and Shanghai Banking Corporation Limited, India (HSBC India). HSBC India is a branch of The Hongkong and Shanghai Banking Corporation Limited. The Hongkong and Shanghai Banking Corporation Limited has a representative office in the UAE licenced by the Central Bank of the United Arab Emirates.
NR deposits/accounts held with HSBC India are not protected deposits under the Hong Kong Deposit Protection Scheme and are not protected by such scheme.
For residents within the Kingdom of Bahrain, we remind you that deposits made with HSBC India, do not benefit from the protection provided under the Deposit Protection Scheme established by the Central Bank of Bahrain regulation concerning the establishment of a Deposit Protection Scheme and a Deposit Protection Board.
NRI services are provided by HSBC India. HSBC India is the branch of The Hongkong and Shanghai Banking Corporation Limited and HSBC India is not regulated in Canada. NR deposits with the Bank in India are not insured by Canadian Deposit Insurance Corporation (CDIC), nor by any other insurance company or corporation outside of India and are payable only at the branch in India where the deposit is made. You should consult your tax advisor for the Canada treatment of income from these deposits.
Deposits and accounts held with HSBC India are not protected by the Australian Financial Claims Scheme.
For debit Cardholders: I/We confirm having read and understood the terms and conditions of usage of the debit card and agree to be bound by the same.
ATM funds transfer: I/We authorise the Bank to transfer funds from my/our account through the ATM, subject to the Bank’s policies, to the third party beneficiaries as specified during operation of the ATM.
19
I/We understand and acknowledge that:
• HSBC India does not provide any tax advice to its customers
• I/We understand, it is my/our responsibility to comply with tax laws and accordingly I/we would comply with the worldwide tax reporting and filing obligation as applicable
• I/We am/are obliged to provide any information requested by HSBC India, that is required by law
• I/We understand that where a referral by HSBC India is made to an external organisation for specific tax advice for me/us, the contract for such tax advice is between me/us and the third party, and any advice provided is the responsibility of such third party, and not HSBC India
Consent clause:
1. I/We, understand that as pre-condition, relating to grant of the loans/advances/other non-fund-based credit facilities to me/us, the Bank, requires my/ our consent for the disclosure, by the Bank of information and data relating to me/us, of the credit facility availed of/to be availed, by me/us, obligations assumed/to be assumed, by me/us, in relation thereto and default, if any, committed by me/us, in discharge thereof.
2. Accordingly, I/we, hereby agree and give consent for the disclosure by the Bank of all or any such:
a) information and data relating to me/us;
b) the information or data relating to any credit facility availed of/to be availed, by me/us, and
c) default, if any, committed by me/us, in discharge of my/our such obligation as the Bank may deem appropriate and necessary, to disclose and furnish to Credit Information Bureau (India) Ltd. (CIBIL) and/or any other agency authorised in this behalf by the Reserve Bank of India.
3. I/We, declare that the information and data furnished by me/us to the Bank are true and correct.
4. I/We, undertake that:
a) the CIBIL and/or any other agency so authorised may use, process the said information and data disclosed by the Bank; and
b) the CIBIL and/or any other agency so authorised may furnish for consideration, the processed information and data or products thereof prepared by them, to banks/financial institutions and other credit grantors, as may be specified by the RBI in this behalf.
E-mail Statement:
HSBC India will be deemed to have delivered the statement to me/us upon HSBC not receiving a delivery failure notification. Should I/We experience any difficulty in accessing the electronically delivered statement, I/we shall promptly advise HSBC for delivery through alternate means. Failure to advise HSBC of such difficulty within 30 days after receiving the statement shall serve as an affirmation regarding the acceptance of the statement by me/us. I/We confirm(s) that I/we is/are aware of all security risks involved in receiving the electronically delivered statement. I/We agree(s) that I/we shall not hold HSBC in any way responsible for the same.
I/We agree that the statement will not be generated if no transactions are effected during the stipulated period of the statement cycle.
I/We agree that duplicate statements of past transactions are issued against payment of charges as per the Bank’s current Tariff.
In case of receiving e-statements through HSBC Internet Banking, I/We agree to be bound by the terms and conditions mentioned on the website www.hsbc.co.in
CRS, FATCA and CKYCR Declaration/Consent clause:I have read and understood the information requirements and the Terms and Conditions mentioned in this Form (and hereby confirm that the information provided by me on this Form is true, correct and complete. I hereby agree and confirm to inform The Hongkong and Shanghai Banking Corporation Limited, India (HSBC India) for any modification to this information promptly. I further agree to abide by the provisions relating to ‘Foreign Account Tax Compliance Act (FATCA) and Common Reporting Standards (CRS) on Automatic Exchange of Information (AEOI) provided in Rules 114F to 114H of the Income Tax Rules, 1962’.I authorize you to update your records basis the above information. I also authorize you to share the given information provided by me with the any statutory/regulatory authorities, as appropriate or HSBC group entities.I understand that the details provided in the form will be reconciled with your existing records and any discrepancy thereof will be duly highlighted to me for further rectification/updation of records.I acknowledge that the information contained in this form and information regarding the accountholder and any Reportable Account(s) may be provided to the tax authorities of the country in which this account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the accountholder may be tax resident pursuant to intergovernmental agreements to exchange financial account information.I certify that I am the accountholder (or am authorized to sign for the accountholder) of all the account(s) to which this form relates.I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I under take to inform you of any changes therein immediately.In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.I hereby consent for receiving information from Central KYC Registry through SMS/Email on the above mentioned registered number/email address.I certify that where I have provided information regarding any other person (such as a Controlling Person or other Reportable Person to which this form relates) that I will, within 30 days of signing this form, notify those persons that I have provided such information to HSBC and that such information may be provided to the tax authorities of the country in which the account(s) is/are maintained and exchanged with tax authorities of another country or countries in which the person may be tax resident pursuant to intergovernmental agreements to exchange financial account information.I undertake to advise The Hongkong and Shanghai Banking Corporation Limited within 30 days of any change in my circumstances which affects the tax residency status or causes the information contained herein to become incorrect, and to provide HSBC with a suitably updated self-certification and declaration within 90 days of such change in circumstances.
AcknowledgementI/We acknowledge that the Bank remains entitled to assign any activities to any third party agencies/service providers at its sole discretion.
I/We further acknowledge the right of the Bank to provide details of my/our account and sharing or transfer of information which will be on a confidential basis to HSBC Group offices or other third party agencies/service providers, whether located in India or overseas for the purpose of availing support services of any nature by the Bank, and also may disclose information, if required or permitted by any law, rule or regulation or at the request of any public or regulatory authority or if such disclosure is required for the purposes of preventing fraud, without any further specific consent or authorisation from me/us.
• I/We understand that Basic Savings Bank Deposit Account (BSBDA) allows me/us to bank with HSBC in India with a zero minimum balance requirement
• I/We also understand that I/we am/are not eligible to open any other savings bank account with HSBC in India and any existing savings bank account will be required to be closed within 30 days from the date of opening the BSBDA, else HSBC India would be constrained to close the account after giving due notice
20
Account Operating Instruction
Singly Former or survivor Any one or survivor
Latter or survivor) Jointly by _________________________ or by survivor(s)* Any other ________________________________________________
I/We hereby confirm to have received, read and understood the terms and conditions pertaining to savings account, fixed deposit, debit card, provided to me/us vide a separate booklet. I/We do acknowledge, accept and agree to be bound by the said terms and conditions.
Photographs
Customer signatures
Name: ______________________________ Name: ______________________________ Name: ______________________________
Note: If you are not the accountholder and signing under a guardianship order (for court appointed guardians) please attach a certified copy of the guardianship order.
Capacity: ____________________________ Capacity: ____________________________ Capacity: ____________________________
Date I certify that the signature(s) and photograph(s) of the accountholders shown in this form are genuine and correct.
_____________________________________ Signed in my presence (by Bank staff)
Employee name _____________________________________________________ Employee number _______________________________________________________
Seafarer’s Declaration (required in case of seafarers)(This declaration may be provided on a separate sheet, in case there are more than one accountholders who are seafarers).
I hereby declare and confirm that I am a Non-Resident Indian (NRI), as per the definition under FEMA, 1999, and the rules and regulations made thereunder,
and I am on contract with ___________________________________________________________________________________________________ (company) registered in
______________________________________________________________________________________________________________________________________________________
___________________________________________ (address of the principal). Request you to open an NRI account in my/our name on the basis of the submitted documents.
I also confirm that I will inform the Bank, in the event my status of NRI is altered and take such necessary action as is required under FEMA.
Date:
Signature of applicant
2nd applicant 3rd applicant1st applicant
1
Please sign acrossyour photograph and the
account opening formafter it has been pasted
on the form.
1st applicant
2
Please sign acrossyour photograph and the
account opening formafter it has been pasted
on the form.
2nd applicant
3
Please sign acrossyour photograph and the
account opening formafter it has been pasted
on the form.
3rd applicant
D D M M Y Y Y Y
D D M M Y Y Y Y
21
Annexure
Instructions/ Check list / Guidelines for filling Individual Application Form
Self-Certification of documents is mandatory.
The generation of KYC number/identifier will be performed by the Bank subject to availability of necessary technology.
Clarification / Guidelines on filling details for CRS purposes.
Reason A The country where I am liable to pay tax does not issue TINs to its residents.
Reason B The accountholder is otherwise unable to obtain a TIN or equivalent number. (Please explain why you are unable to obtain a TIN in the below table if you have selected this reason)
Reason C No TIN is required.
(Note: Only select this reason if the authorities of the country of tax residence entered in the table do not require the TIN to be disclosed)
Appendix – Definitions
Note: These are selected definitions provided to assist you with the completion of this form. Further details can be found within the Income Tax Rules, 1961 and OECD Common Reporting Standard for Automatic Exchange of Financial Account Information (the CRS), the associated Commentary to the CRS, and domestic guidance. This can be found at the following link www.oecd.org/tax/automatic-exchange/.
If you have any questions then please contact your tax adviser or domestic tax authority.
Tax identification Number (TIN): TIN (including functional equivalent) – The term TIN means Taxpayer Identification Number assigned to a person in the country or territory in which he is resident for tax purposes and includes a functional equivalent in case no such number is assigned. A TIN is a unique combination of letters or numbers assigned by a jurisdiction to an individual or an Entity and used to identify the individual or Entity for the purposes of administering the tax laws of such jurisdiction. Further details of acceptable TINs can be found at the following link: www.oecd.org/tax/automatic-exchange/.
Some jurisdictions do not issue a TIN. However, these jurisdictions often utilise some other high integrity number with an equivalent level of identification (a functional equivalent). Examples of that type of number include, for individuals, a social security/insurance number, citizen/personal identification/service code/number, and resident registration number, PAN (Permanent Account number) and resident registration number)
Accountholder – The term ‘accountholder’ means the person listed or identified as the holder of a Financial Account by the financial institution that maintains the account. A person, other than a Financial Institution, holding a Financial Account for the benefit of another person as an agent, a custodian, a nominee, a signatory, an investment advisor, an intermediary, or as a legal guardian, is not treated as the accountholder. In these circumstances that other person is the accountholder. For example in the case of a parent/child relationship where the parent is acting as a legal guardian, the child is regarded as the accountholder. With respect to a jointly held account, each joint holder is treated as an accountholder.
CKYCR – Central KYC Registry
Controlling Person – This is a natural person who exercises control over an entity and includes a beneficial owner as determined under sub-rule (3) of rule 9 of the Prevention of Money-Laundering (Maintenance of Records) Rules, 2005.
In determining the beneficial owner, the procedure specified in the following circular as amended from time to time shall be applied, namely:
(i) DBOD.AML.BC. No.71/14.01.001/2012-13, issued on 18 January 2013 by the Reserve Bank of India; or
(ii) CIR/MIRSD/2/2013, issued on 24 January 2013 by the Securities and Exchange Board of India; or
(iii) IRDA/SDD/GDL/CIR/019/02/2013, issued on 4 February 2013 by the Insurance Regulatory and Development Authority.
In the case of a trust, the controlling person means the settlor, the trustees, the protector (if any), the beneficiaries or class of beneficiaries, and any other natural person exercising ultimate effective control over the trust, and in the case of a legal arrangement other than a trust, the said expression means the person in equivalent or similar position.
Where an entity accountholder is treated as a Passive Non-Financial Entity (NFE) then a Financial Institution must determine whether such Controlling Persons are Reportable Persons. If the account is maintained for an entity of which the individual is a Controlling Person, then the ‘Controlling Person tax residency self-certification’ form should be completed instead of this form.
Entity – The term ‘Entity’ means a legal person or a legal arrangement, such as a corporation, organisation, partnership, trust or foundation.
FATCA – Foreign Account Tax Compliance Act
Financial Account – A ‘Financial Account’ is an account maintained by a Financial Institution and includes: Depository Accounts; Custodial Accounts; Equity and Debt interest in certain Investment Entities; Cash Value Insurance Contracts; and Annuity Contracts.
Reportable Account – The term ‘Reportable Account’ means an account held by one or more Reportable Persons or by a Passive NFE with one or more Controlling Persons that is a Reportable Person (relevant extract for CRS).
Reportable Person
Reportable person means,
(a) one or more persons other than,
(i) a corporation, the stock of which is regularly traded on one or more established securities markets;
(ii) any corporation that is a related entity of a corporation mentioned in item (i);
(iii) a Governmental entity;
(iv) an International organization;
(v) a Central bank; or
(vi) a financial institution,
that is a resident of any country or territory outside India (except the United States of America) under the tax laws of such country or territory or an estate of a descendent who was a resident of any country or territory outside India (except the United States of America) under the tax laws of such country or territory; (relevant extract for CRS).
Dual resident individuals may rely on the tiebreaker rules contained in tax conventions (if applicable) to solve cases of double residence for purposes of determining their residence for tax purposes.
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Account Opening Document Checklist(To be submitted along with account opening form) The Hongkong and Shanghai Banking Corporation Limited, India (Bank)
Applicable only to Non-Resident Accounts
Account opening requirements
a. Completed account opening form.
b. Passport-size photograph for each accountholder signed on the front.
c. PAN card. (This is mandatory. If you do not have a PAN card, please provide us with duly signed Form 60 along with the requisiteenclosures.)
d. Nomination form. (Please avail of the nomination facility.)
e. Attested photocopies of the passport of each applicant of pages showing passport details, work permit/Visa details as well as the pageindicating the last date of arrival in India.
f. Separate proof of Non-Resident status, if overseas Residence Visa/Permit or Work Permit is not included in the passport.
g. Proof of Indian Origin, if any, (e.g. PIO Card) in case of foreign passport holders.
h. In case of minors, please attach a photocopy of guardian’s passport and guardian’s photograph signed on the front.
i. Proof of address for each applicant.
j. For employees of foreign shipping company/merchant navy, the following documents are required in addition to proof of residentialaddress:
• For permanent employees - initial work contract and last wage slip
• For contract employees - current work contract or last work contract with a letter from local agent confirming next date of joining vessel
Purpose of account opening _______________________________________________
List A (Proof of Identity) any one (Please check þ the relative option) (mandatory for NR customers)
1. Official Valid Document - Proof of Identity
Passport (must include valid Visa Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2 /work permit) (mandatory forNR customers)
2. Officially Valid Document - Proof of Address* (any one)
Passport Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Election/Voter’s ID Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Permanent driving licence Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Permanent Account Number (PAN card) Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Aadhaar card Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
NREGA job card (National Rural Employment Guarantee Act job card) Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
For information on additional documents acceptable as address proof please get in touch with the nearest HSBC India branch or your Relationship Manager or the HSBC India Contact Centre.
Documents accepted as a proof of address should mention the address details.
Acceptable Proof of Indian Origin (any one)
Indian passport Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Overseas Citizen of India (OCI) card Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Person of Indian Origin (PIO) card Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2
Foreign passport with place of birth Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2 in India and date of birth post-Indian
Independence
Additional documents required from seafarers
Self-attested copy of valid Continuous Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2 Discharge Certificate
Self-attested copy of the valid Sole/First a/c holder Joint a/c holder 1 Joint a/c holder 2 employment/contract letter from the employer
The residential address of a seafarer could be in India or overseas Please note: If you do not have any of the above mentioned Proof of Identity/Proof of Address, please contact HSBC representative.
Optional Services
Marketing Offers Consent
Help us to know you better form
(NAME OF SOLE/FIRST ACCOUNTHOLDER)
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Customer ID no. (For Bank use only)
Contents
• Help Us Know You Better • Marketing Offers Consent• Form 60 • Nomination Form (Form DA-1) for Bank account
OPTIONAL SERVICES BOOKLET(This section is optional)
The Hongkong and Shanghai Banking Corporation Limited, India (Bank)
Marketing Offers Consent
1. Marketing offers From time to time, HSBC India communicates various features/products/promotional
offers which offer significant benefits to its customers and may use the services of third party agencies to do so. Do you wish to be informed about such benefits?
I/We expressly authorise HSBC India to use information or data relating to me/us, for communicating marketing offers as outlined above.
No, I/we do not wish to receive offers as outlined above. For customers who wish to receive such marketing offers, but do not wish to be communicated the same by way of telephone calls/SMSes from HSBC India, we offer a ‘do-not-call’ service. To register for this, please visit our website www.hsbc.co.in
I/We expressly authorise HSBC India to give or make available to any member of the HSBC Group*, information or data relating to me/us, whether provided by me/us or otherwise, in connection with the offer, sale or distribution of products and services offered by such entities, in which I/we have expressed interest. I/We understand that my/our information will be protected by a strict Code of secrecy and security to which all members of the HSBC Group and their staff are subject to.
2. Assignment of activities to third party agencies I/We acknowledge that HSBC India remains entitled to assign any activities to any
third party agencies/service providers at its sole discretion. I/We further acknowledge the right of HSBC India to provide details of my/our account and sharing or transfer of information which will be on a confidential basis to HSBC Group offices or other third party agencies/service providers, whether located in India or overseas for the purpose of availing of support services of any nature by HSBC India and also may disclose information, if required or permitted by any law, rule or regulation or at the request of any public or regulatory authority or if such disclosure is required for the purposes of preventing fraud, without any further specific consent or authorisation from me/us.
________________________ ________________________ ________________________Signature Signature Signature
________________________ ________________________ ________________________Name Name Name
________________________ ________________________ ________________________Date Date Date
________________________ ________________________ ________________________Customer ID/Account no. Customer ID/Account no. Customer ID/Account no.
*HSBC Group means HSBC Holdings plc, its subsidiaries, associated and affiliated companies.
HELP US TO KNOW YOU BETTER FORM The Hongkong and Shanghai Banking Corporation Limited, India (Bank)
Please check the boxes and fill in the requested information under applicant 1, 2 or 3.
Sole/First Joint Joint a/c holder a/c holder 1 a/c holder 2 Number of children Please specify the number of children Education 1. Undergraduate 2. Graduate 3. Postgraduate 4. Professional 5. Others House ownership 1. Company residence 2. Fully-owned private house 3. Mortgage property 4. Rented house 5. Living with parents/relatives 6. Others 7. PG/hostel Car ownership 1. Yes
How did you decide to open an account with HSBC India?
1. Recommendation by family/friends 2. Family has always banked
with HSBC India
3. Response to an advertisement
4. Response to direct mailer 5. Dissatisfaction with previous bank
6. Convenient branch location
7. Employer’s bank for salary payment 8. Approached by HSBC India
representative/telemarketing unit 9. Convenient ATM locations/
other reasons
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Form 60 (See second provison to rule 114B) Income-tax Rules, 1962Form for declaration to be filed by an individual or a person (not being a company or firm) who does not have a permanent account number and who enters into any transaction specified in rule 114B
1. First Name
Middle Name
Surname
2. Date of Birth/Incorporation of declarant D D M M Y Y Y Y
3. Father’s Name (in case of individual)
First Name
Middle Name
Surname
4. Flat/Room No. 5. Floor No.
6. Name of premises 7. Block Name/No.
8. Road/Street/Lane 9. Area/Locality
10. Town/City 11. District 12. State
13. Pin code 14. Telephone Number (with STD code) 15. Mobile Number
16. Amount of transaction (`)
17. Date of transaction D D M M Y Y Y Y
18. In case of transaction in joint names, number of persons involved in the transaction
19. Mode of transaction: Cash Cheque Card Draft/Banker’s Cheque Online transfer Other
20. Aadhaar Number issued by UIDAI (if available)
21. If applied for PAN and it is not yet generated enter date of application and acknowledgement number D D M M Y Y Y Y
22. If PAN not applied, fill estimated total income (including income of spouse, minor child, etc. as per section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is held
a Agricultural income (`)
b Other than agricultural income (`)
23. Details of document beingproduced in support of identity in Column 1 (Refer Instruction overleaf)
Documentcode
Document identificationnumber
Name and address of the authority issuing the document
24. Details of document beingproduced in support of addressin Columns 4 to 13 (Refer Instruction overleaf)
Documentcode
Document identificationnumber
Name and address of the authority issuing the document
Verification
I, _______________________________________________ do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I do not have a Permanent Account Number and my/our estimated total income (including income of spouse, minor child, etc. as per section 64 of Income-tax Act, 1961) computed in accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction is held will be less than maximum amount not chargeable to tax.
Verified today, the ______________ day of ______________ 20_____________.
Place: ________________________ (Signature of declarant)
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Note:
1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this form is true, correct and complete in all respects. Any person making a false statement in the declaration shall be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable,
(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall not be less than six months but which may extend to seven years and with fine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may extend to two years and with fine.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the nature referred to in item 22b exceeds the maximum amount which is not chargeable to tax, unless PAN is applied for and Column 21 is duly filled.
Instruction:(1) Documents which can be produced in support of identity and address (not required if applied for PAN and item 20 is filled):
Sl. No.
Nature of Document DocumentCode
Proof ofIdentity
Proof ofAddress
A For Individuals and HUF
1. Aadhaar card 01 Yes Yes
2. Bank/Post office passbook bearing photograph of the person 02 Yes Yes
3. Elector’s photo identity card 03 Yes Yes
4. Ration/Public Distribution System card bearing photograph of the person 04 Yes Yes
5. Driving Licence 05 Yes Yes
6. Passport 06 Yes Yes
7. Pensioner photo card 07 Yes Yes
8. National Rural Employment Guarantee Scheme (NREGS) Job card 08 Yes Yes
9. Caste or Domicile certificate bearing photo of the person 09 Yes Yes
10. Certificate of identity/address signed by a Member of Parliament or Member of Legislative Assembly or Municipal Councillor or a Gazetted Officer as per Annexure A prescribed in Form 49A
10 Yes Yes
11. Certificate from employer as per Annexure B prescribed in Form 49A 11 Yes Yes
12. Kisan passbook bearing photo 12 Yes No
13. Arm’s licence 13 Yes No
14. Central Government Health Scheme/Ex-servicemen Contributory Health Scheme card 14 Yes No
15. Photo identity card issued by the Government/Public Sector Undertaking 15 Yes No
16. Electricity bill (Not more than 3 months old) 16 No Yes
17. Landline Telephone bill (Not more than 3 months old) 17 No Yes
18. Water bill (Not more than 3 months old) 18 No Yes
19. Consumer gas card/book or piped gas bill (Not more than 3 months old) 19 No Yes
20. Bank account statement (Not more than 3 months old) 20 No Yes
21. Credit card statement (Not more than 3 months old) 21 No Yes
22. Depository account statement (Not more than 3 months old) 22 No Yes
23. Property registration document 23 No Yes
24. Allotment letter of accommodation from Government 24 No Yes
25. Passport of spouse bearing name of the person 25 No Yes
26. Property tax payment receipt (Not more than one year old) 26 No Yes
B For Association of persons (Trusts)
Copy of trust deed or copy of certificate of registration issued by Charity Commissioner 27 Yes Yes
C For Association of persons (other than Trusts) or Body of Individuals or Local authority or Artificial Juridical Person)
Copy of agreement or copy of certificate of registration issued by Charity Commissioner or Registrar of cooperative society or any other competent authority or any other document originating from any Central or State Government Department establishing identity and address of such person.
28 Yes Yes
(2) In case of a transaction in the name of a minor, any of the abovementioned documents as proof of identity and address of any of parents/guardians of such minor shall be deemed to be the proof of identity and address for the minor declarant, and the declaration should be signed by the parent/guardian.
(3) For HUF any document in the name of Karta of HUF is required.
(4) In case the transaction is in the name of more than one person the total number of persons should be mentioned in Sl. No. 18 and the total amount of transaction is to be filled in Sl. No. 16.
In case the estimated total income in Column 22b exceeds the maximum amount not chargeable to tax the person should apply for PAN, fill out item 21 and furnish proof of submission of application.
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Bank Copy
Nomination Form (Form DA-1) for Bank Account(While the nomination facility is optional, we recommend that you avail of it.)
For bank’s use
Account/Receipt no.
(Form DA1: Nomination under Section 45 ZA of the Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules, 1985 in respect of bank deposits)
I/We [enter name(s) and address(es) of account holder(s)]
Name of account holder: _________________________________________ Address as per bank record: __________________________________________
_________________________________________________________________ _____________________________________________________________________
_________________________________________________________________ _____________________________________________________________________
E-mail: __________________________________________________________ Phone no.: _______________________________________ (For bank records update)
nominate the following person to whom in the event of my/our/minor’s death the amount of the deposit, particulars whereof are given below, may be returned by The Hongkong and Shanghai Banking Corporation Limited [enter name and address of branch/office in which deposit is held]
________________________________________________________________________________________________________________________________________
Deposit Nominee
Nature of deposit#,distinguishing no.$
Additionaldetails, if any
Name AddressRelationship withdepositor, if any
Age(Years)
If nominee is aminor+, date of birth
+As the nominee is a minor on this date, I/we appoint Shri/Smt/Kum (Name and Address): ___________________________________________________
________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________ Age: ___________________to receive the amount of the deposit on behalf of the nominee in the event of my/our/minor’s death(s) during the minority of the nominee.
PRINT NOMINEE NAME on statement/passbook/fixed deposit receipt: Yes No
Signature/Thumb impression of applicant(s)*
1st Applicant 2nd Applicant 3rd Applicant
Date: Place: _______________________________________________________________
Witness(es) (refer point 6)
(1) Name: ____________________________________________________ (2) Name: ___________________________________________________________
Signature: Signature:
Address: _____________________________________________________ Address: ____________________________________________________________
______________________________________________________________ _____________________________________________________________________* Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act on behalf of the minor.1. As per the prevailing Banking Companies (Nomination) Rules, Nomination can be made only in favour of an individual and there cannot be more than one nominee on an account.2. Nomination made by the account holder(s)/Guardians can be modified any time.3. Request for registration/variation/cancellation of nomination should be submitted in the prescribed form (in duplicate) duly signed by the account holder(s)/Guardians and should be submitted to any branch of the Bank in India.4. If there is more than one account holder, then the Nomination Form should be signed by all account holder(s). A copy of the Nomination Form will be held in the Bank’s records and the other copy will be dispatched to the account holder(s)/Guardian on the address notified in the Bank’s records.5. Any registration of nomination, cancellation or change in the nomination has to be duly witnessed.6. In case a thumb impression is affixed by the account holder(s)/Guardian on the Nomination Form, two witnesses are required, one of which has to be a bank official and the other an external person (known to the customer) as per the RBI guidelines.7. Each fixed deposit is an individual account and therefore different nominations can be given on each account. Please mention a correct fixed deposit number against each nomination.# State ‘Current Account’, ‘Savings Account’, ‘Fixed Deposit Account’ or as the case may be.$ State account number or receipt number as may be applicable.
ACKNOWLEDGMENTReceived the nomination and registered in the Bank’s books. Payment in terms of the nomination will be effected on the nominee furnishing proof of his/her claim in the prescribed form.The Bank may at its discretion accept such claim or prescribe compliance of additional formalities before effecting payment.
Branch: _____________________________ For The Hongkong and Shanghai Banking Corporation Limited
Date: Authorised signature:
D D M M Y Y Y Y
D D M M Y Y Y Y
Issued by The Hongkong and Shanghai Banking Corporation Limited, India. Incorporated in Hong Kong SAR with limited liability.
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Customer Copy
Nomination Form (Form DA-1) for Bank Account(While the nomination facility is optional, we recommend that you avail of it.)
For bank’s use
Account/Receipt no.
(Form DA1: Nomination under Section 45 ZA of the Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules, 1985 in respect of bank deposits)
I/We [enter name(s) and address(es) of account holder(s)]
Name of account holder: _________________________________________ Address as per bank record: __________________________________________
_________________________________________________________________ _____________________________________________________________________
_________________________________________________________________ _____________________________________________________________________
E-mail: __________________________________________________________ Phone no.: _______________________________________ (For bank records update)
nominate the following person to whom in the event of my/our/minor’s death the amount of the deposit, particulars whereof are given below, may be returned by The Hongkong and Shanghai Banking Corporation Limited [enter name and address of branch/office in which deposit is held]
________________________________________________________________________________________________________________________________________
Deposit Nominee
Nature of deposit#,distinguishing no.$
Additionaldetails, if any
Name AddressRelationship withdepositor, if any
Age(Years)
If nominee is aminor+, date of birth
+As the nominee is a minor on this date, I/we appoint Shri/Smt/Kum (Name and Address): ___________________________________________________
________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________ Age: ___________________to receive the amount of the deposit on behalf of the nominee in the event of my/our/minor’s death(s) during the minority of the nominee.
PRINT NOMINEE NAME on statement/passbook/fixed deposit receipt: Yes No
Signature/Thumb impression of applicant(s)*
1st Applicant 2nd Applicant 3rd Applicant
Date: Place: _______________________________________________________________
Witness(es) (refer point 6)
(1) Name: ____________________________________________________ (2) Name: ___________________________________________________________
Signature: Signature:
Address: _____________________________________________________ Address: ____________________________________________________________
______________________________________________________________ _____________________________________________________________________* Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act on behalf of the minor.1. As per the prevailing Banking Companies (Nomination) Rules, Nomination can be made only in favour of an individual and there cannot be more than one nominee on an account.2. Nomination made by the account holder(s)/Guardians can be modified any time.3. Request for registration/variation/cancellation of nomination should be submitted in the prescribed form (in duplicate) duly signed by the account holder(s)/Guardians and should be submitted to any branch of the Bank in India.4. If there is more than one account holder, then the Nomination Form should be signed by all account holder(s). A copy of the Nomination Form will be held in the Bank’s records and the other copy will be dispatched to the account holder(s)/Guardian on the address notified in the Bank’s records.5. Any registration of nomination, cancellation or change in the nomination has to be duly witnessed.6. In case a thumb impression is affixed by the account holder(s)/Guardian on the Nomination Form, two witnesses are required, one of which has to be a bank official and the other an external person (known to the customer) as per the RBI guidelines.7. Each fixed deposit is an individual account and therefore different nominations can be given on each account. Please mention a correct fixed deposit number against each nomination.# State ‘Current Account’, ‘Savings Account’, ‘Fixed Deposit Account’ or as the case may be.$ State account number or receipt number as may be applicable.
ACKNOWLEDGMENTReceived the nomination and registered in the Bank’s books. Payment in terms of the nomination will be effected on the nominee furnishing proof of his/her claim in the prescribed form.The Bank may at its discretion accept such claim or prescribe compliance of additional formalities before effecting payment.
Branch: _____________________________ For The Hongkong and Shanghai Banking Corporation Limited
Date: Authorised signature:
D D M M Y Y Y Y
D D M M Y Y Y Y
Issued by The Hongkong and Shanghai Banking Corporation Limited, India. Incorporated in Hong Kong SAR with limited liability.
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Bank use section
Step 1
1. SV Yes No
2. CV Yes No
3. NS (IWP) Yes No
4. Existing customer Yes No
5. RVTV and approval Yes No
Step 2
1. SCC/PEP Yes No
2. HRC Yes No
3. MRC Yes No
4. SRC Yes No
5. Screening checks/Sixth filter Yes No
6. Simplified (For LRC) Yes No
Step 3
1. NOM Yes No
2. POA Yes No
3. SPL INST Yes No
4. INM Yes No
5. PI and PA variation Yes No
Does the customer have or are they applying for one lower risk product? (excluding credit cards) Yes No
Is the customer applying for or already has a Credit Card only product Yes No
State the number of credit cards?
Is the customer applying for or already have Minimum Risk Insurance products only? Yes No
Walk-in Yes No
Channel Type – Branch MSF Contact Center Postal Digital
Does the Jurisdiction of Tax Residency appear inconsistent with the Customers residential address(es), correspondence address(es) and nationality/Citizenship or TIN provided? Yes No
Has the Customer’s Identity been verified in line with the required standards and have true copies of the original documents been obtained? Yes No
Is the customer able to provide required ID? Yes No
Specify category of special circumstances
Benefit or Social Welfare claimants Individuals on probation
Individual in care homes / sheltered accomodations/ refuge Students
Prisoners Individual who lack the capacity to manage their own affairs
Minors Refugees
Economic Migrants Other _________________
Asylum seekers Not Applicable
Is a CDD Risk Acceptance request required to be submitted to Business and FCC Yes No
Was the CDD Risk Acceptance request approved by Business Risk/FCC? Yes No
Why is the Customer applying for an account in a country/territory which is not their country of residence? _______________________
Confirm the customer’s occupation as a student has been validated Yes No
Select a currency to apply to all intended transactions (default value is INR): _______________
Does the customer have, or is asking for, a safe Custody product? Yes No
On average how much funds does the customer intend to retain in their account over the next 12 months (TRB) ? INR ____________
Will the Customer be premier Top Tier (to identify HNWI)? Yes No
Is a manual EDD trigger required for the customer? Yes No
What are the categories of Products the customer is opening?
ATM or Debit Card Credit Cards
Current A/c Savings A/c
Fixed Term Loan-Unsecured Instant Access Savings A/c
Secured Fixed Term Loans Secured Revolving Line Of Credit
Term Deposits Unsecured Revolving Line Of Credit
Has the source of cash deposit been validated? Yes No
Upload documentary evidence Yes No
Confirm the purpose of opening the account(s) is consistent with the expected account activity and the Customer’s profile,
including their Source of Funds and Source of Wealth (where applicable)? Yes No
Is the customer likely to engage in funds transfers to/from high risk or sensitive sanctioned countries Yes No
What level of influence does the Connected Party have over the account?
Control Direct
Beneficiary Contribute
Rationale for connection ________________________________________
Is the connected party’s customer record in the same system as the main party’s? Yes No
Confirm that the identity of the connected party (full name, residential address) has been verified Yes No
Is there a reasonable connection between the connected party and the customer? Yes No
Is the connected party a Politically Exposed Person (PEP) ? Yes No
33
Was Connected Party’s Identity verified through the use of Electronic or Documentary sources? Yes No
Were any exceptions (to global CDD policy) noted during the Connect Party verification process? Yes No
Provide the rationale for the upwards revision of the risk rating and any other relevant information that you wish to note in relation to the Customer that may affect their application? __________________
Account record checked by (To be checked by the account opening staff)
Employee name ____________________________________________________
New account number (only in case of IWP)
CEP code/category (A/B/C) ____________________________________________
KYC completed and account opening authorised
Opened by MSF Branch Date of submission of all documents KYC completed and account opening authorised by (Branch Manager/Regional Head details)
Employee Name ____________________________________________________ Staff number
Employee Designation ____________________________________________________
Employee signature
Your branch _______________________________________________________________ Your cluster _______________________________________________________
Name of HSBC Relationship Manager ________________________________________ HSBC Secondary Relationship Manager code ________________________
AAA aligned to customer profile Yes No
I have verified the name of the customer on AOF with the KYC documents provided and confirm that it meets the standards of CDD.
I also hereby confirm that customer’s photo on PI and PA (if photo ID) matches with the photo on AOF Yes No
Branch Manager/Regional Head name ________________________________________ Branch Manager/Regional Head staff number
Branch Manager’s/Regional Head’s signature
Issued by The Hongkong and Shanghai Banking Corporation Limited, India. Incorporated in Hong Kong SAR with limited liability.
NR
_BS
BD
A_U
AO
F_C
DD
_12/
16