Customer No.:
(For Office Use Only)
2. (i)
(ii)
3.
4.
5.
6.
7.
Employment
8. (i) Name of Employer / Business
(ii) Position Held
9.
10. Customer Profile (High Categorized)
Non-Resident
Customer Dealing in High - value items
NGO/ not-for-profit Organizations & Trusts / Charities
Refused by other Financial Institutions
Holding Public or high profile Position
U.S.A Social Security No.
U.S.A Passport No.
Do you hold U.S.A Permanent Resident Card (Green Card)?
Are your spouse/children U.S.A Resident / Citizen
Spouse
Child 1 U.S.A Passport No.
If yes, please porvide Social Security & Passport No. below:
U.S.A Passport No.
Child 1
Child 2 U.S.A Passport No.
Child 2
Current Mailing Address:
Are you the ultimate beneficiary of this investment account
If no, please provide Name and Social Security No. below:
Name
U.S.A Social Security No.
kindly provide us your completed W-9 or W-8 form