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city bank NON-INDIVIDUAL ACCOUNT OPENING FORM This fornm should be completed in "ENGLISH CAPITAL" icttets Manager City Bank PLC Gulohan Dear Sir, ACCOUNT RELATED INFORMATION Account Title Account Short Name IWe hereby request youto kindly open an Account in your branch. IWe furnish our Account &Organizations detailed infornation hereunder English METRO Type of Account Currency Mode of Operation of A/C: Initial Deposit Amount Organization Name Trade License No. Registration No. Registration Authority E-TIN No. (if any) Company Registered Address V Current A/C Business/Office Address FC AVc English M ETRO Fortune Transactional A/C BDT Single cOMPANY RELATED INFORMATION Branch USD Others/Special instruction: Joint COMPUTER GANGl ADE SH Co , Lt 4 026447 PO C-I9 #6 25 Regintran Proof of tax return 61343233196 Easy Current A/C SND A/C Convertible Taka A/C Yes Division DHA kA EUR Ag sne GBP In Words A/C No. Unique Customer ID No Date Co MPUTER BANGLAD E SH Coy For Bank use only Easy Plus Current AWC Others Fixed Deposit AC Others Date 11 I2 20 24 Issuing Authority Dhaka North City corponation Date 03 10 20 24 ob- 3oit5toek Comoane Finwycountry Banglade five Thovsand Ta ka o nly Postcode BINVAT Registration No. (f any) O0 6 608914 -01O1 If yes, mention assessment year ViWRoad MT-10%,8*"Glbor obAiRower, 24 kemal Ataturk Aeuue, Ranant /A BAN A NI Thana BAN A Nt Division D|A kA Ltd District D H AAA Postcode |2 Country BAN GlADG SH VIUROad 34 boor,58o|a DSsBuilding, Slwrapara,Begun RokeyaSanani Po MI RPURTS 0 Thana District DH A kA 12| 6 Country BAN GLADESH cits bank making sense of money INDIVIDUAL INFORMATION FORM This form should be completed in ENGLISH CAPITAL" letters. Father's Name Please use separate Individual Information Form for other Applicants/Mandate/Guardian/Director/Beneficial Owner/Shareholder Customer's Name in Mother's Name Spouse's Name Date of Birth Resident Status National ID Card No. Birth Certificate No. Passport No. Profession EnglishMALAHL K WASALT Monthly Income Source of Fund Relationship with Account Present Address (Residence) Professional Address Permanent Address Mobile 1 VE-mail ID 1 E-mail ID 2 KIyosHI kAWA SA kI 9INORU MIC HIko kAW SALT 10 0g 94G Resident TT72595+2 BUSTN ESS Vill/Road Division HATRMAN PO Vill/Road 1. Are you a US Resident? Division PO Vill/Road KAWAS AkT Applicant's Name Division PO Non-Resident Thana Thana D Yes VNo Gender Thana MMale Female 2. Are you a US Citizen? Other Photo ID E-TIN (if any) Proof of tax return Nationality If yes, mention assessment year Postcode Unique Customer ID AIC No. Postcode 3-1kaminishlyama-machi,iagnaki Sh, Nagunaki,sapon Postcode Third Gender *Foreigners will provide VISA and Passport copy Yes No BangladeshiOther For Bank use only Mobile 2 District Note: Individual Information Form must be filled in for both the Minor and Guardian. Both forms must be signed by Guardian. 3-1 Vominishiyama-Maehi Nageneki Shh, Nageak, 3apan Country District kai gaj@metroboo ks. co.)p Country Please affix here a recent passport size photograph duly attested by A/C holder District Yes Country No 3. Do Youhold a US Permanent Resident Card (Green Card)? IWe hereby consent for City Bank PLC or any of its affiliates (include branches) (herein after collectively referred to as "Bank") to share my/our information with domestic or overseas regulators or tax authorities or other concerned authorities where necessary and/or required by applicable laws, agreement with regulators or authorities and/or directives. DYes No Where required by domestic or overseas regulators or tax authorities or other concerned authorities, I/we consent and agree that the Bank may withhold, and pay out. from my/our account(s)such amounts as may by required according to applicable laws, regulations, or authorities and directives and Bank shall not be held liable for any consequences thereof. In the event of any loss suffered by bank due to my/our failure or inaction or misrepresentation, /we shall hold the Bank fully indemnified and harmless against all such losses arising thereof. Proof of address required (of any one)