State Bank of India FOR BANK USE ONLY

Maldives Operations
CIF No. Scheme

MVR Account

SAVING ACCOUNT OPENING / UPDATE FORM

INDIVIDUAL USD Account

DOCUMENTS CHECK LIST (PLEASE TICK APPROPRIATE BOX)

National Identity Card copy Work Permit (with QR code) / Document Copy Marriage Visa
Passport size photo (pasted) Passport front page copy (mandatory for expatriates) Diplomat Visa
Employer letter (mandatory for expatriates) Passport address page copy (if available) Other: _________________________

ACCOUNT DETAILS
Account Type Savings With Interest Savings Without Interest

Account Currency Maldivian Rufiyaa (MVR) United States Dollar (USD)

Service Required ATM Card Statement by e-mail: Daily Monthly

GENERAL DETAILS
Title Mr Mrs Ms Dr

Full Name

Nationality Place of Birth

Date of Birth D D M M Y Y Y Y Gender Male Female

Marital Status Married Unmarried Other

Illiterate Primary Secondary

Educational
Background High School / Diploma Under/Post Graduate Professional

Salary Credit Savings Business Income

Purpose of
Account Opening
Rent Credit Other; please specify: _____________________________________________
National ID /
Number: Issue Date: D D M M Y Y Y Y Expiry Date: D D M M Y Y Y Y
Work Permit
Passport Number: Issue Date: D D M M Y Y Y Y Expiry Date: D D M M Y Y Y Y

SIGNATURE
Specimen Signature 1 Specimen Signature 2

PHOTO
SA0/0924

Please paste your recent

passport size photograph here

Name

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 CONTACT DETAILS
Country Code Mobile Number
Mobile +

Email (please write in BLOCK letters)

House Name

Street
Present Address
Atoll, Island /
Floor / Apartment
City, State
Postal Code Country

House Name

Street
Permanent Address
Atoll, Island /
Floor / Apartment
State, City
Postal Code Country

EMPLOYMENT AND FINANCIAL DETAILS

Employment Type Salaried Self-employed Unemployed Retired

Employment Sector Government Public Private Other: __________________

Occupation / Designation Worksite

Employer Name

Source of Income / Description Monthly Income

1. Salary (if salaried) CCY

Income Details 2. _____________________________________________ CCY

(Please write all the sources of
income generated)
3. _____________________________________________ CCY

Total Monthly Income: CCY

Dealing with local Banks No Yes, please specify: ___________________________________________________________________

POLITICALLY EXPOSED PERSON (PEP) DECLARATION

Politically Exposed Persons are individuals who are or have been entrusted with prominent public functions in a country e.g. Heads of State /
Governments , Senior Politicians / Senior Governments / Judicial /Military Officers, Senior Executives of State-owned Corporations, important
Political Party Officials, etc.

I confirm that I, or any member of my family or any of my associates, do not hold any position at a public office of prominence,
nor have held any such position in the past & agree to inform the bank, whenever any change in PEP status of me, my family
members and associates

I confirm that I, or any member of my family or any of my associates, hold or held a position at a public office of prominence &
agree to inform the bank whenever any change in PEP status of me, my family members and associates
SA0/0924

(Please fill the PEP Details Form provided by the Bank)

Signature: _________________________________ Page 2 of 3

 TAX STATUS DECLARATION
Are you residing
Yes No, country of residency: ________________________________________________________
in Maldives?

Residency Start Date D D M M Y Y Y Y

I undertake to inform the Bank in the event of any changes in tax residency status in future.
(This information is required to be informed to the bank in accordance to Income Tax Act (Act no. 25/2019) of Maldives)

Tax Information Declaration:

I confirm that I am not registered as a tax resident or pay taxes in any other country/jurisdiction. I undertake to inform the Bank
in the event of acquiring it at any time in the future.

I confirm that I hold tax residency in below mentioned jurisdiction(s) & provide the tax identification number(s) as below. I
undertake to inform the Bank in the event of any changes in tax residency status in future.

Tax Payer Identification Number Country of Tax Residency

If you have more than two TIN, please provide the data seperately

FATCA Undertaking:

I confirm that I do not possess United States (US) green card/ nationality/ passport/ power of attorney given to or received from
a US person as on date. I undertake to inform the Bank in the event of acquiring it at the material time in future and also
authorise SBI to disclose the required information under FATCA to the relevant authority in such eventuality.

I confirm that I possess United States (US) green card / nationality / passport / power of attorney given to or received from a US
person as on date and authorise SBI to disclose the required information under FATCA to the relevant authority.
(Please fill an additional FATCA undertaking form provide by the bank)

TERMS AND CONDITIONS

I agree and declare that the information in this form are true and correct to the best of my knowledge. I undertake to inform the
Bank any changes, therein
I have read and agree to Bank’s Terms and Conditions and agree to abide by, and be bound by the same including any changes
therein from time to time (Terms and Conditions are available on bank’s website https://mv.statebank)
I agree to the Internet Banking Terms and Conditions and agree that internet banking (with transaction rights) can be registered
on my own with the details obtained in this form

D D M M Y Y Y Y
_________________________________

Signature Date

FOR BANK USE ONLY

Form Checked By: Form Verified By: Face to Face Verification: World Check Screening:
I certify that the signatures of the customer has been I certify that the World Check has been done and
obtained face to face no sanctioned entities/adverse remarks found
SA0/0924

Signature: Signature: Signature: Signature:

Name: ______________________________ Name: ______________________________ Name: ______________________________ Name: ______________________________
Employee ID: ________________________ Employee ID: ________________________ Employee ID: ________________________ Employee ID: ________________________
Date: _______________________________ Date: _______________________________ Date: _______________________________ Date: _______________________________

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