Personal Account

Opening Form

Account Opening Date: D D / M M / Y Y Y Y

Account Name..........................................................
In English (Block Letter)
wnmv‡ei bvg (evsjvq) ......................................................
Account CIF...............................................................
(for Bank use only)

Account Number.......................................................
(for Bank use only)

Preferred Branch Name.............................................

Scheme Code...........................................................
Source Code (PSO)....................................................
Monitoring PSO...........................................................
Source Name & PIN...................................................
..................................................................................
Cost Center
Sector Code
(as per Bangladesh Bank SBS 2 Guidelines)

Deposit Code
(as per Bangladesh Bank SBS 2 Guidelines)
 Personal Account Opening Form
Please complete all details in CAPITAL letter and strike out X the fields / boxes which are not applicable.
Manager
……………………………………………… Branch Date: D D M M Y Y Y Y
Dear Sir,
I/we are applying to open the following account in your branch. My/our detailed information are given below:

1: Account Related Information

1. Account Title:

wnmv‡ei bvg (evsjvq): ………………………................................................................................................................................................

2. Type of Account: Savings Current RFCD NFCD NITA Probashi Savings
Probashi Current Others Please specify the product…………….……….….........................................
3. Currency: Taka Dollar Euro Pound Others……….……….……….……...................................................….……....
4. Mode of Operation: Singly Jointly Anyone Either or Survivor Others….…….....................................................….
5. Initial Deposit: BDT In Words ............................................................................ Cash Cheque

I am an existing customer Yes (please write your account/card no. and skip to section 4 directly) No (please fill up from section 2)
Existing Account/Card No. ………………………………………………..........……….. (You must ensure that existing data are correct. If not,
please fill up the specific fields below to update your existing data)

2: Personal information
1. Account holder's Name:

evsjvq: ………………………...................................................................................................................................................................
2. Date of Birth: D D M M Y Y Y Y 3. National ID No.:
4. TIN/e-TIN No. (if any):
5. Passport No.:
(a) Issue Date: D D M M Y Y Y Y (b) Expiry Date: D D M M Y Y Y Y (c) Issue Place: ………........…………

6. Other ID No. ………………………….............……… (in case of NID or Passport is not available) 7. Religion: ................................................................
8. Father's Name:
9. Mother's Name:
10. Spouse Name:
11. Gender: Male Female Transgender 12. Nationality:
(If account holder is a foreign national, passport copy including VISA must be obtained by the bank.)

13. Marital Status: Married Single Others 14: Resident Status: Resident Non-Resident
(Information should be obtained according to Bangladesh Bank Guideline for Foreign Exchange Transactions)
15. Details of Profession:

Public Service Business

Private Service Proprietorship Partnership Limited Company

Multinational Organization Local Organization Self- Employed Others………...………………......….

(a) Organization name: …………………………………………....….......... (b) Position /Designation: …......................................................

(c) Nature/Type of Business: ………………………………………….......… (d) Monthly Income: ……………………....……….....................
(e) Source of Income / Fund: □ Own Business □ Salary □ Commission □ Gift/Inheritance/Return on Investment
□ Others

Signature Signature
-------------------------------- --------------------------------
Account Opened By Account Approved By
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16. Contact Details: (for probashi customer permanent address needs to be in Bangladesh)
Address Present Address Permanent Address Work Address
Flat /House /Road /Block /
Area/Village

Upazila/Thana
City/District
Post Code
Country
Contact No. (Phone/Mobile) Home: Office:
e-Mail Personal: Office:

Preferred Mailing/Communication Address □ Present Address □ Permanent Address □ Work Address

Preferred Contact: *Mobile No. 1: *E-mail: .............................................................................
(*Your mobile number and email address are mandatory)

*If the account holder is a minor, legal guardian must fill up the following information and a separate ”PERSONAL INFORMATION FORM (PIF)”.
As the legal guardian, I hereby declare that the account holder is a minor. His/her relevant information are provided in the form. The
account will be operated under my signature as the legal guardians of the accountholder until further notice or until accountholder
attains maturity.
17. Name of Minor’s Legal Guardian:
18. Relationship with Minor:…………………………………………………….................................................................................................

3: Introducer’s Information (Required only if the account holder/s do not have NID)

1. Name of Introducer:

2. Account No.: 3. Relationship with Applicant: ……………...…………………

4. Signature of Introducer: 5. Signature Verified:

(Name, Date and Seal. Bank use only)

4: Nominee Details
I/We hereby nominate the following person to receive the entire balance in my/our account, upon my/our death. I/We
hereby reserve the right to cancel/amend the below nomination at any point of time. I/We further declare that Bank will not
be liable for any transaction affected according to my/our instruction.
1. Name of Nominee:
2. Date of Birth: D D M M Y Y Y Y 3. No. of Nominee: 4. Percentage: %
(in case of more than one nominee, separate nominee details should be obtained for each nominee) Please attach photograph here
(Nominee)
5. Relationship with Applicant: .....................................................................................................................
6. NID/Passport/Birth Certificate No./Others:
7. Nominee Permanent Address: *(In case of other ID, please specify)

Road/House/Area/Block Upazila /Thana City /District Post Code

Detail information of the receiver of the fund on behalf of the Nominee (in case of Minor Nominee) if the accountholder(s) dies while the nominee is
still minor as per Bank Company Act 1991 section 103(2):
8. Name of Legal Guardian:
a. Relationship with Nominee: ........................................................................................... b. Date of Birth: D D M M Y Y Y Y
c. NID/ Passport /Birth Certificate No./ Others:

c. Legal Guardian’s Address:

Road/House/Area/Block Upazila /Thana City /District Post Code

Signature Signature
-------------------------------- --------------------------------
Account Opened By Account Approved By
2 of 8
Phone: e-mail:
*In case of non-resident nominee, proceed of the relevant account is payable to that non-resident, Exchange Control Regulations will be applicable for outward
remittance.
*In case of Probashi Customer, Nominee's and Legal Guardian's Passport/Birth Certificate number can be acceptable

5: FATCA
1. Country of Residence: …………………………………………………… 2. Country of Birth: ……………………………………………………….
Sl. No Indicia of U.S. Status Yes No
1 Are you a U.S. Resident?
2 Are you a U.S. Citizen?
3 Do you hold a U.S. Permanent Resident Card (Green Card)?
4 Do you have a U.S. address (including P.O. Box) or U.S. phone number or U.S. e-mail address?
5 Have you granted Power of Attorney to someone who has a U.S. address or U.S. phone number or U.S. e-mail address?
6 Do you receive payments sourced from USA? That is Interest, Dividend, Rent, Payment for services
(Salaries) and any other Fixed Determinable Annual Periodical [FDAP] income.
*If you have answered Yes to any of the previous questions, please fill up W9 form.

6: Debit Card, Cheque Book and Alternative Banking Facilities

1. Cheque Book □ Yes □ No 2. Debit Card Facility □ Yes □ No 3. □ Visa □ MasterCard
4. SMS Banking □ Yes □ No
5. E-Statement □ Yes □ No Name to be printed on the card (within 21character including blank spaces)

6. Internet Banking □ Yes □ No *2Factor Authentication is mandatory when it comes to transactions that require OTP and the SMS is
free of cost.

7: Signing Authority
I/We hereby declare that the information I/we have provided in the account opening form are all correct. I/We shall provide any further information
if needed.
1. First Applicant 2. Joint Applicant (Second Applicant) 3. Joint Applicant (Third Applicant/Legal Guardian)

Please attach photograph here Please attach photograph here Please attach photograph here
(First Applicant) (Second Applicant) (Third Applicant/Legal Guardian)

Signature (First Applicant) Signature (Second Applicant) Signature (Third Applicant/Legal Guardian)

Name................................................................... Name................................................................... Name...................................................................

............................................................................. ............................................................................. .............................................................................

8: For Bank Use Only

Reviewed by □ Branch Manager □ RM □ ASM □ ARM /RM Code ………………………………...............………………………….

Business Operations
Account Opened By Account Approved By Data Entry By Data Entry Verified By

............................................ ............................................ ............................................ ............................................

Seal and Signature Seal and Signature Seal and Signature Seal and Signature

3 of 8
 Customer Declaration (Bank’s copy)
Dear Customer, please read and sign this form to confirm that all relevant information regarding your bank account have been provided to you at the time of
account opening.
Accountholder’s Declaration: I confirm that I have understood and agreed with all the following points:
1. I/We hereby declare that the information I/we have provided in the account opening form are all correct. I/We shall provide any further information if needed.
2. I/We have provided all the required documents to open the account and the information in those documents are correct to the best of my/our knowledge.
3. I/We hereby also acknowledge that I/we have read, understood and agreed to the Terms & Conditions governing customer account(s) and all other
products as indicated in BRAC Bank Website (www.bracbank.com).
4. I/We declare that the bank representative has explained to me/us regarding all the rules & regulations and other information related to my/our account and
accordingly I/we have decided to open an account in BRAC Bank Limited.
5. I/We also declare that I am aware of all the fees and charges related to this account and interest rate and rules & regulations to receive interest.
6. I/We understand that Debit Card (charge applicable) is mandatory for my/our account which will be delivered in deactivated status for security reason.
7. I/We also understand that SMS Banking (charge applicable) is mandatory for my/our account and I/we agree to receive promotional SMS/email time to time
from the Bank at my/our communication addresses.
8. If no customer induced transaction takes place for 2 years in case of Savings Account and 1 year in case of Current Account then the account will be
marked as “Dormant”.
9. I/We also declare that I/we have not given any cash or cheque to any Bank representative to open the account without receiving any Bank receipt.
10. BDT 500 will be kept as minimum balance in my/our account to pay Government Excise Duty (applicable annually for all accounts) as per Government Laws
and 15% VAT is applicable for all fees and charges.
11. I hereby consent for BRAC Bank Limited to treat my account as per the directions of FATCA. BRAC Bank Limited or any of its affiliates (including branches) can
share my/our entity information with domestic or oversees or tax authorities where necessary to establish my tax liability in any jurisdiction (if required).Where
required by domestic or overseas or tax authorities, Bank may withhold from my account(s) such amounts as may be required according to applicable laws,
regulations and directive. I undertake to notify BRAC Bank Limited within 30 calendar days if there is a change in any information which I have provided to
the Bank.
*The Bank reserves the right to amend the Schedule of Charges (available in www.bracbank.com) and Interest Rates at any time.
For more details, please refer to Schedule of Charges available at all BRAC Bank branches/Website.

Acceptance Signature of Applicant Bank Official (person who booked the Account)

Name: Name & PIN:

...................................................... ......................................................
Seal/ Signature & Date Seal/ Signature & Date

Customer Declaration (Customer copy)

Dear Customer, please read and sign this form to confirm that all relevant information regarding your bank account have been provided to you at the time of
account opening.
Accountholder’s Declaration: I confirm that I have understood and agreed with all the following points:
1. I/We hereby declare that the information I/we have provided in the account opening form are all correct. I/We shall provide any further information if needed.
2. I/We have provided all the required documents to open the account and the information in those documents are correct to the best of my/our knowledge.
3. I/We hereby also acknowledge that I/we have read, understood and agreed to the Terms & Conditions governing customer account(s) and all other
products as indicated in BRAC Bank Website (www.bracbank.com).
4. I/We declare that the bank representative has explained to me/us regarding all the rules & regulations and other information related to my/our account and
accordingly I/we have decided to open an account in BRAC Bank Limited.
5. I/We also declare that I am aware of all the fees and charges related to this account and interest rate and rules & regulations to receive interest.
6. I/We understand that Debit Card (charge applicable) is mandatory for my/our account which will be delivered in deactivated status for security reason.
7. I/We also understand that SMS Banking (charge applicable) is mandatory for my/our account and I/we agree to receive promotional SMS/email time to time
from the Bank at my/our communication addresses.
8. If no customer induced transaction takes place for 2 years in case of Savings Account and 1 year in case of Current Account then the account will be
marked as “Dormant”.
9. I/We also declare that I/we have not given any cash or cheque to any Bank representative to open the account without receiving any Bank receipt.
10. BDT 500 will be kept as minimum balance in my/our account to pay Government Excise Duty (applicable annually for all accounts) as per Government Laws
and 15% VAT is applicable for all fees and charges.
11. I hereby consent for BRAC Bank Limited to treat my account as per the directions of FATCA. BRAC Bank Limited or any of its affiliates (including branches) can
share my/our entity information with domestic or oversees or tax authorities where necessary to establish my tax liability in any jurisdiction (if required).Where
required by domestic or overseas or tax authorities, Bank may withhold from my account(s) such amounts as may be required according to applicable laws,
regulations and directive. I undertake to notify BRAC Bank Limited within 30 calendar days if there is a change in any information which I have provided to
the Bank.
*The Bank reserves the right to amend the Schedule of Charges (available in www.bracbank.com) and Interest Rates at any time.
For more details, please refer to Schedule of Charges available at all BRAC Bank branches/Website.

Acceptance Signature of Applicant Bank Official (person who booked the Account)

Name: Name & PIN:

...................................................... ......................................................
Seal/ Signature & Date Seal/ Signature & Date

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 MÖvn‡Ki †NvlYvcÎ (e¨vsK Kwc)
wcÖq MÖvnK, AbyMÖn K‡i GB dg© c‡o Ges ¯^v¶i K‡i wbwðZ Kiæb †h, Avcbvi A¨vKvD›UwU †Lvjvi mgq mswkøó mg¯Í Z_¨ Avcbv‡K cÖ`vb Kiv n‡q‡Q|
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1. Avwg/Avgiv GZØviv †NvlYv KiwQ †h, Avwg/Avgiv A¨vKvD›U I‡cwbs d‡g© †h Z_¨vejx cÖ`vb K‡iwQ Zv m¤ú~Y© mwVK| cieZ©x‡Z †h †Kvb Z‡_¨i cÖ‡qvRb n‡j Avwg/Avgiv Zv cÖ`vb Kie|
2. Avwg/Avgiv A¨vKvD›U Lyj‡Z cÖ‡qvRbxq me WKz‡g›U cÖ`vb K‡iwQ Ges H WKz‡g›U¸‡jv‡Z cÖ`Ë Z_¨ Avgvi/Avgv‡`i Rvbv g‡Z mwVK|
3. Avwg/Avgiv GZØviv Av‡iv ¯^xKvi KiwQ †h, Avwg/Avgiv MÖvnK A¨vKvD›U Ges eª¨vK e¨vsK I‡qemvB‡U (www.bracbank.com) wb‡`©wkZ Ab¨ mKj †cÖvWv± mg~n wbqš¿YKvix kZ©vejx c‡owQ,
Abyaveb K‡iwQ Ges m¤§Z n‡qwQ|
4. Avwg/Avgiv GZØviv †NvlYv KiwQ †h, e¨vsK cÖwZwbwa Avgvi/Avgv‡`i A¨vKvD›U mswkøó mg¯Í wbqg-Kvbyb Ges Ab¨vb¨ Z_¨ m¤ú‡K© e¨vL¨v K‡i‡Q Ges †m Abyhvqx Avwg/Avgiv eª¨vK e¨vs‡K A¨vKvD›U Lyj‡Z
wm×všÍ wb‡qwQ|
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6. Avwg/Avgiv eywS †h, Avgvi/ Avg‡`i A¨vKvD‡›Ui Rb¨ †WweU KvW© (PvR© cÖ‡hvR¨) AZ¨vek¨K hv wbivcËvRwbZ Kvi‡Y wbwl&µq Ae¯’vq †cŠ‡Q †`Iqv n‡e|
7. Avwg/Avgiv Av‡iv eywS †h, Avgvi/ Avgv‡`i A¨vKvD‡›Ui Rb¨ GmGgGm e¨vswKs (PvR© cÖ‡hvR¨) AZ¨vek¨K Ges Avwg/ Avgiv gv‡S gv‡S e¨vsK †_‡K Avgvi/Avgv‡`i †hvMv‡hv‡Mi wVKvbvq cÖPviYvg~jK
GmGgGm/ B-‡gBj cvIqvi e¨vcv‡i m¤§Z|
8. mÂqx wnmv‡ei †¶‡Î 2 eQi Ges PjwZ wnmv‡ei †¶‡Î 1 eQ‡ii g‡a¨ hw` MÖvnK Øviv †Kvb †jb‡`b m¤úbœ bv nq Zvn‡j A¨vKvD›UwU ÒWi‡g›UÓ wnmv‡e wPwýZ n‡e|
9. Avwg/Avgiv Av‡iv †NvlYv KiwQ †h, e¨vsK iwm` cvIqv e¨ZxZ Avwg/ Avgiv A¨vKvD›U †Lvjvi Rb¨ †Kvb e¨vsK cÖwZwbwa‡K †Kvb bM` A_© ev †PK cÖ`vb Kwiwb|
10. miKvwi AvBb Abyhvqx, miKvwi AveMvwi ïé (mKj A¨vKvD‡›Ui Rb¨ cÖwZ eQi cÖ‡hvR¨) cÖ`v‡bi Rb¨ Avgvi/Avgv‡`i A¨vKvD‡›U me©wb¤œ 500 UvKv ivLv n‡e Ges mKj dx Ges Pv‡R©i Rb¨ 15% f¨vU
cÖ‡hvR¨ n‡e|
11.Avwg GZØviv m¤§Z †h FATCA Gi wb‡`©kbv Abyhvqx eª¨vK e¨vsK Avgvi A¨vKvD‡›Ui e¨vcv‡i e¨e¯’v wb‡Z cv‡i| eª¨vK e¨vsK wjwg‡UW A_ev Gi Ab¨ †h †Kvb A½ msMVb (kvLvmg~n AšÍf©y³) †Kvb wePvi
cÖwµqvq (cÖ‡hvR¨ †¶‡Î) ïé `vq cÖwZôvq, Avgvi/Avgv‡`i cÖwZôv‡bi Z_¨ †`kx-we‡`kx A_ev ïé KZ©„c‡¶i Kv‡Q Rvbv‡Z cvi‡e| †`kx-we‡`kx A_ev ïé KZ©„c‡¶i cÖ‡qvR‡b, e¨vsK cÖ‡hvR¨ AvBb,
cÖweavb Ges wb‡`©k Abyhvqx Avgvi A¨vKvD›U †_‡K cÖ‡qvRbxq cwigvY UvKv Rã Ki‡Z cvi‡e| Avgvi cÖ`Ë †Kvb Z‡_¨ hw` †Kvb cwieZ©b nq, Z‡e Avwg 30 w`‡bi ga¨ eª¨vK e¨vsK wjwg‡UW‡K Rvbv‡bvi
cÖwZkªæwZ w`w”Q|
*e¨vsK Pv‡R©i ZvwjKv (www.bracbank.com G mnRjf¨) Ges gybvdvi nvi †h‡Kvb mgq ms‡kva‡bi AwaKvi msi¶Y K‡i|
Av‡iv we¯ÍvwiZ Rvb‡Z, AbyMÖn K‡i eª¨vK e¨vs‡Ki mKj kvLv‡Z A_ev I‡qemvB‡U mnRjf¨ Pv‡R©i ZvwjKvwU coyb|

Av‡e`bKvixi MÖnY‡hvM¨ ¯^vÿi e¨vsK Kg©KZ©v (†h A¨vKvD›UwU eyK K‡i‡Qb)

bvg: bvg I wcb:

...................................................... ......................................................
wmj/¯^vÿi I ZvwiL wmj/¯^vÿi I ZvwiL

MÖvn‡Ki †NvlYvcÎ (MÖvnK Kwc)

wcÖq MÖvnK, AbyMÖn K‡i GB dg© c‡o Ges ¯^v¶i K‡i wbwðZ Kiæb †h, Avcbvi A¨vKvD›UwU †Lvjvi mgq mswkøó mg¯Í Z_¨ Avcbv‡K cÖ`vb Kiv n‡q‡Q|
A¨vKvD›U †nvìv‡ii †NvlYv: Avwg wbwðZ KiwQ †h Avwg wb‡¤œ ewY©Z mKj Av‡jvP¨ welq eyS‡Z †c‡iwQ Ges Gi mv‡_ m¤§wZ Ávcb KiwQ|
1. Avwg/Avgiv GZØviv †NvlYv KiwQ †h, Avwg/Avgiv A¨vKvD›U I‡cwbs d‡g© †h Z_¨vejx cÖ`vb K‡iwQ Zv m¤ú~Y© mwVK| cieZ©x‡Z †h †Kvb Z‡_¨i cÖ‡qvRb n‡j Avwg/Avgiv Zv cÖ`vb Kie|
2. Avwg/Avgiv A¨vKvD›U Lyj‡Z cÖ‡qvRbxq me WKz‡g›U cÖ`vb K‡iwQ Ges H WKz‡g›U¸‡jv‡Z cÖ`Ë Z_¨ Avgvi/Avgv‡`i Rvbv g‡Z mwVK|
3. Avwg/Avgiv GZØviv Av‡iv ¯^xKvi KiwQ †h, Avwg/Avgiv MÖvnK A¨vKvD›U Ges eª¨vK e¨vsK I‡qemvB‡U (www.bracbank.com) wb‡`©wkZ Ab¨ mKj †cÖvWv± mg~n wbqš¿YKvix kZ©vejx c‡owQ,
Abyaveb K‡iwQ Ges m¤§Z n‡qwQ|
4. Avwg/Avgiv GZØviv †NvlYv KiwQ †h, e¨vsK cÖwZwbwa Avgvi/Avgv‡`i A¨vKvD›U mswkøó mg¯Í wbqg-Kvbyb Ges Ab¨vb¨ Z_¨ m¤ú‡K© e¨vL¨v K‡i‡Q Ges †m Abyhvqx Avwg/Avgiv eª¨vK e¨vs‡K A¨vKvD›U Lyj‡Z
wm×všÍ wb‡qwQ|
5. Avwg/Avgiv Av‡iv †NvlYv KiwQ †h, Avwg A¨vKvD›U mswkøó mKj dx Ges PvR©, gybvdvi nvi Ges gybvdv cvIqvi wbqg-Kvbyb m¤ú‡K© AeMZ AvwQ|
6. Avwg/Avgiv eywS †h, Avgvi/ Avg‡`i A¨vKvD‡›Ui Rb¨ †WweU KvW© (PvR© cÖ‡hvR¨) AZ¨vek¨K hv wbivcËvRwbZ Kvi‡Y wbwl&µq Ae¯’vq †cŠ‡Q †`Iqv n‡e|
7. Avwg/Avgiv Av‡iv eywS †h, Avgvi/ Avgv‡`i A¨vKvD‡›Ui Rb¨ GmGgGm e¨vswKs (PvR© cÖ‡hvR¨) AZ¨vek¨K Ges Avwg/ Avgiv gv‡S gv‡S e¨vsK †_‡K Avgvi/Avgv‡`i †hvMv‡hv‡Mi wVKvbvq cÖPviYvg~jK
GmGgGm/ B-‡gBj cvIqvi e¨vcv‡i m¤§Z|
8. mÂqx wnmv‡ei †¶‡Î 2 eQi Ges PjwZ wnmv‡ei †¶‡Î 1 eQ‡ii g‡a¨ hw` MÖvnK Øviv †Kvb †jb‡`b m¤úbœ bv nq Zvn‡j A¨vKvD›UwU ÒWi‡g›UÓ wnmv‡e wPwýZ n‡e|
9. Avwg/Avgiv Av‡iv †NvlYv KiwQ †h, e¨vsK iwm` cvIqv e¨ZxZ Avwg/ Avgiv A¨vKvD›U †Lvjvi Rb¨ †Kvb e¨vsK cÖwZwbwa‡K †Kvb bM` A_© ev †PK cÖ`vb Kwiwb|
10. miKvwi AvBb Abyhvqx, miKvwi AveMvwi ïé (mKj A¨vKvD‡›Ui Rb¨ cÖwZ eQi cÖ‡hvR¨) cÖ`v‡bi Rb¨ Avgvi/Avgv‡`i A¨vKvD‡›U me©wb¤œ 500 UvKv ivLv n‡e Ges mKj dx Ges Pv‡R©i Rb¨ 15% f¨vU
cÖ‡hvR¨ n‡e|
11.Avwg GZØviv m¤§Z †h FATCA Gi wb‡`©kbv Abyhvqx eª¨vK e¨vsK Avgvi A¨vKvD‡›Ui e¨vcv‡i e¨e¯’v wb‡Z cv‡i| eª¨vK e¨vsK wjwg‡UW A_ev Gi Ab¨ †h †Kvb A½ msMVb (kvLvmg~n AšÍf©y³) †Kvb wePvi
cÖwµqvq (cÖ‡hvR¨ †¶‡Î) ïé `vq cÖwZôvq, Avgvi/Avgv‡`i cÖwZôv‡bi Z_¨ †`kx-we‡`kx A_ev ïé KZ©„c‡¶i Kv‡Q Rvbv‡Z cvi‡e| †`kx-we‡`kx A_ev ïé KZ©„c‡¶i cÖ‡qvR‡b, e¨vsK cÖ‡hvR¨ AvBb,
cÖweavb Ges wb‡`©k Abyhvqx Avgvi A¨vKvD›U †_‡K cÖ‡qvRbxq cwigvY UvKv Rã Ki‡Z cvi‡e| Avgvi cÖ`Ë †Kvb Z‡_¨ hw` †Kvb cwieZ©b nq, Z‡e Avwg 30 w`‡bi ga¨ eª¨vK e¨vsK wjwg‡UW‡K Rvbv‡bvi
cÖwZkªæwZ w`w”Q|
*e¨vsK Pv‡R©i ZvwjKv (www.bracbank.com G mnRjf¨) Ges gybvdvi nvi †h‡Kvb mgq ms‡kva‡bi AwaKvi msi¶Y K‡i|
Av‡iv we¯ÍvwiZ Rvb‡Z, AbyMÖn K‡i eª¨vK e¨vs‡Ki mKj kvLv‡Z A_ev I‡qemvB‡U mnRjf¨ Pv‡R©i ZvwjKvwU coyb|

Av‡e`bKvixi MÖnY‡hvM¨ ¯^vÿi e¨vsK Kg©KZ©v (†h A¨vKvD›UwU eyK K‡i‡Qb)

bvg: bvg I wcb:

...................................................... ......................................................
wmj/¯^vÿi I ZvwiL wmj/¯^vÿi I ZvwiL

5 of 8
BANK USE ONLY
 Transaction Profile
Account Opening Purpose: □ Personal Transaction □ Savings □ Loan Re-payment □ Foreign Remittance □ Investment
□ Salary □ Others
Nature and Volume of Transaction:
Deposit (monthly) Withdrawal (monthly)

No. of Highest Amount No. of Highest Amount

Deposit Type Transaction Total Amount (for individual Withdrawal Type Transaction Total Amount (for individual
transaction) transaction)
Cash Deposit (including online) Cash Withdrawal (including online, ATM)
Deposit (Transfer/Instrument) Payment (Transfer/Instrument)
Foreign Remittance Deposit Foreign Remittance Withdrawal
Earning from Export Expense through Import
From BO Account (Deposit/Transfer) To BO Account (Deposit/Transfer)
Others (specify) Others (specify)
Total Probable Deposit Total Probable Withdrawal

KYC Profile Form for Individual Customer Account

Bank Use Only

Account Number:

CIF: Branch:

1. Account Title:

2. Type of Account:

3. Profession of Customer (Details):

4. Estimated Monthly Income of the
Customer:
5. Source(s) of Fund(s) (in Details):

1.
6. Documents that Have been
Obtained to Ascertain 2.
Source of Fund:
3.
Have the obtained documents
been verified? □ YES □ NO Has the address of the Accountholder Verified? □ YES □ NO
7. If Yes, How has the Address(es) of the A/C
Holder has/have been verified? (Detail)

8. Whether the Beneficial Owner(s) of the Account has/have been identified ? □ YES □ NO □Not Applicable
(If yes, information about each of the beneficial owners of the account must be collected as per Annexure-1(A).)

9. Identification Document:
Copy Obtained Verified
(a) Passport No.:
□ □ If Applicable
(b) National Identification No.:
□ □ If Applicable
(c) Birth Registration Certificate No.:
□ □ If Applicable
(d) Electronic-Tax ID (E-TIN) No.:
□ □ If Applicable
(e) Driving License No:
□ □ If Applicable
(f) Others

10. Purpose of opening accounts in case

of a non-residents and foreigners:
(a) Type of Visa:
□ Resident □ Work Date of Expiry: D D M M Y Y Y Y

□ Others (please specify): …..…….......…......................................................................................

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(b) Is there the work-permit copy and approval from the competent authority for opening bank accounts of work permit holders?
(If applicable) □ YES □ NO
(For non-resident Bangladeshi customers, copy of passports and for foreign customers, copy of passport with visa must be obtained.)
11. Is the customer a Politically Exposed Person (PEP) / Influential Person (IP) /Chief or High Officials of an International Organization and their
family members or close associates (as per the definition in the circular issued by BFIU)? □ YES □ NO
If yes:
(a) Has the approval been taken from the senior management ? □ YES □ NO
(b) Has a face to face interview of the client been taken? □ YES □ NO
12. While screening, in light of relevant acts, rules, and circulars, has the customer’s name matched with the suspected individuals or entities as listed
under various resolutions of the United Nations Security Council for terrorist activities, financing of terrorism and financing the proliferation of weapons
of mass destruction and banned list of individuals or entities by the government of the people’s republic of Bangladesh? □ YES □ NO
(a) If yes, steps taken in this regard:

13. Risk Grading on Profession/Business:

(a) What does the customer do/What kind of occupation is he/she engaged in?
Sl. Risk Sl. Risk
No. Category Score No. Category Score
1 Jewelry/Gold Business/Precious Metal Business/Gems Trade 5 25 Housewife 4
2 Money Changer/Courier Service/Mobile Banking Agent 5 26 Service in the Information Communication and
3 Real Estate Developer/Agent 5 echnology Sector 4
4 Construction Project Promoter/Contractor 5 27 Player/Media Celebrity/ Producer/Director 4
5 Painting/Antique Dealer 5 28 Freelance Software Developer 4
6 Restaurant/Bar/Night Club/Residential Hotel/Parlor Business 5 29 Business - Agent 3
7 Import/Export 5 30 Government Service 3
8 Manpower Export Business 5 31 House Owner 3
9 Arms Business 5 32 Thread Trader/Garments Waste Trader 3
10 Garments Business/Garments Accessories/Buying House 5 33 Transport Operator 3
11 Pilot/Flight Attendant 5 34 Tobacco & Cigarette Business 3
12 Trustee 5 35 Entertainment Business/Park 3
13 Share/Stock Investor 5 36 Motor Parts/Workshop Business 3
14 Software Business/Information Communication and 37 Private Service Managerial 3
Technology Business 5
38 Teacher (Government/Private/Autonomous
15 Expatriate (Foreigner Working in Bangladesh) 5
Educational Institution) 2
16 Travel Agent 4
39 Service (Private) 2
17 Businessman with Yearly Investment of More than Tk. 1 Crore 4
40 Small Entrepreneur (Annual Turnover Less than Tk. 50 lac) 2
18 Freight/Shipping/Cargo Agent 4
41 Self Employed Professional 2
19 Auto Business (New/Reconditioned Cars) 4
42 Computer/Mobile Phone Dealer 2
20 Business (Leather & Leather Products) 4
43 Manufacturer (Other than arms) 2
21 Home Construction Materials Business 4
44 Student 2
22 Professional (Journalist, Lawyer, Doctor, Engineer,
Chartered Accountant) 4 45 Retired from Service 1
23 Director (Private/Public Limited Company) 4 46 Farmer/Laborer/Fisherman 1
24 Senior Officials of Multinational Company 4 47 Others (Please specify in detail) 1-5

(While assessing the risk associated with the customer, detailed analysis of the customer’s occupation is required; in case of business, the nature of business,
the level of money involved, location and size of the business, the account’s beneficial owner etc. along with other special aspects have to be taken into
consideration to categorize the customer either as a ‘low risk’ or a ‘high risk’ customer. Similarly, in case of service, the risk associated with the customer has to
be assessed after obtaining the details about the job, specially the nature and the responsibilities of the job. Taking all these into consideration, higher score
than the score mentioned may be given to respective customers in serial number 16-47)

(b) Monthly Income of the Customer (c) Customer Acquisition Channel

Amount (BDT) Risk Score Amount (BDT) Risk Score
Up to 1 Lac 0 By Relationship Manager/By Branch 0
> 1 to 3 Lacs 1 By Direct Sales Agent 3
More than 3 Lacs 3 Internet/Non Face to Face 3
Walk-in/Unsolicited 3

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 (d) Estimated Value of the Transactions of the Customer (e) Estimated Number of Transactions of the Customer on
on a Monthly Basis a Monthly Basis
Value of Transaction Value of Transaction Number of Number of
in Current Account in Savings Account Risk Score Transactions in Transactions in
Current Account Risk Score
(Tk.-Lacs) ( Tk.-Lacs) Savings Account
0-10 0-5 0 0-15 0-10 0
>10-20 >5-10 1 16-25 11-20 1
>20 >10 3 >25 >20 3

(f) Estimated Value of the Cash Transactions of the (g) Estimated Number of Cash Transactions of the
Customer on a Monthly Basis Customer on a Monthly Basis
Value of Transaction Value of Transaction Number of Number of
in Current Account in Savings Account Transactions in Transactions in
Risk Score Risk Score
(Tk.-Lacs) ( Tk.-Lacs) Current Account Savings Account
0-5 0-2 0 0-10 0-5 0

>5-10 >2-5 1 11-20 6-10 1

>10 >5 3 >20 >10 3

14. Overall Risk Rating Assessment (Sum of risk scores of

serial no. (a) to (g) above) COMMENT:

Sum of Risk Score Overall Risk Rating

>=14 High
<14 Low

(Even if the risk rating is less than 14, taking the high risk of the beneficial owner into consideration, and stating the reason, a customer may be
categorized as a high risk customer based on subjective judgment)

Prepared by: Reviewed & Confirmed by:

(Account Opening Officer) (BAMLCO)
Signature: Signature:
(with seal) (with seal)
Name: Name:
Date: Date:

……………………………………………………………………………………………………….......................................................................................
(Approving Senior Official for PEP/IP/Senior Official of International Organizations)
Signature, date and seal with name
Reviewed & Updated by Officer:
Date when the information of the account and
the customer was last reviewed and updated: Signature:
(with seal)
D D M M Y Y Y Y
Name:
Date:

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Customer Segmentation Checklist (Bank Use Only)

Div Proposition Segment Sub-segment

Value Code Tick box Value Code Tick box Value Code Tick box Value Code

Retail 3 Mass-TARA 11

EB 12 Kids 31 Null 300

EB-TARA 13
Doctors 301
PB 14 Students 32
Engineers 302
PB-TARA 15
Accountants 303
NRB 16 Professionals 33 Lawyer 304
NRB-TARA 17 Architect 305
Mass 18 Self-Employed 34 Freelancer 306
EB-PB 19 Others 307
EB-PB-TARA 20 Salaried 35
Small 320
NRB-PB 21
Emerging Corporate 321
NRB-PB-TARA 22 Foreigners 36
Corporate 322
Landlord/Lady 323
Homemaker 37 Others 324

Teacher 330
Senior Citizen 38
Bank Financial institution, 331
Security & Insurance (BFSI)
Govt. Employee 332
For Employee Banking: NGO 333
Company code: Local Corporate 334
MNC 335
Company category:
Embassies & Development
336
Organization
RMG 337
Defense & LEA 338
BRAC Family 339
BBL Staffs 340
Others 341

Salary 350
Business person 351

House wife 360

Spouse 361

Null 300
BRAC Bank Employee’s Signature
24-hour Call Centre: 16221
For Overseas Callers: +880 2 55668055-6
www.bracbank.com Version-7