The Matalon Business Center, 2nd FloorBelize City, Belize, Central America

STEP 1 - CUSTOMER IDENTIFICATIONName Email Address Passport No. Country of Issue Expire date STEP 2 - ENTER A USERNAME YOU WOULD LIKE TO USE FOR BELIZE BANK INTERNATIONAL ONLINE SERVICE No more than 12 alphanumeric characters

Username Alternate Username

(in case above username is already in use)

STEP 3 - PROVIDE THE FOLLOWING MEMORABLE WORD & HINT*The memorable word you specify will be requested when your first log on, to authenticate your identity. Your memorable word will also be requested should you forget your password any time and need to reset it. Your hint will be provided to you if you ever forget your memorable word. Note: Answers must be between 8 and 20 characters

Memorable word

Hint (should relate to memorable

word)

STEP 4 - LIST ALL ACCOUNTS YOU WOULD LIKE AVAILABLE ONLINE Account Number: Account Type (please check one):1 Current Term Deposit Loan Credit Card2 Current Term Deposit Loan Credit Card3 Current Term Deposit Loan Credit Card4 Current Term Deposit Loan Credit Card5 Current Term Deposit Loan Credit Card6 Current Term Deposit Loan Credit CardSTEP 5 - SIGNATURE I certify that the information provided above is true and accurate and that I have read and agree to the terms and conditions in the Belize Bank International Ltd.'s Online Banking Access Agreement.

X Print Name of Applicant Signature Date (dd/mm/yy)

NOTE: You will receive email notification of your username and password when your Belize Bank account(s) has/have been registered in our system, so please confirm the correct email address in Step 1. Once you receive this notification, you simply log on with your username and password to Belize Bank Online at www.bcbankinternational.com. For additional security, the next screen, after you log on for the first time, will ask you to change your password, provide your Memorable Word (Step3 above) and your ID number (Step 1 above).

For Official Use Only

Approved By: X Date (dd/mm/yy)

Online Banking - Personal Account

Tel: (501) 227-0697 / 1548 Facsimile: (501) 223-0986

Email: services@belizebankinternational.com