JOINT ACCOUNT INFORMATION - HSBC · asked by HSBC staff to comply with BSP Circular 706 and/or HKMA...
Transcript of JOINT ACCOUNT INFORMATION - HSBC · asked by HSBC staff to comply with BSP Circular 706 and/or HKMA...
RBWM_24Jun2015_00212 HSBC Account Opening Form
Joint Account
Date (dd-mm-yyyy)
Note: 1. Please complete in BLOCK LETTERS and tick where applicable -
Customer Number
-
ACCOUNT PACKAGE: HSBC Premier HSBC Advance HSBC Classic
Mailing Instruction: E-statement via Online Banking
Printed Statements Deliver to: Correspondence 1
Contact Details*Country
CodeArea Code
Residence Telephone Number Mobile Number
Office Telephone Number E-mail Address
Fax Number
Anyone Jointly Others (please specify):
-
2. Please fill out completely the fields marked by an asterisk (*) as required by R.A. 9160,
Anti-Money Laundering Act of 2001, as amended by R.A. 9194, and fields marked by a plus sign (+)
as required by FATCA.
3. Fields marked by a double plus sign (++) : Additional questions or supporting documents may be
asked by HSBC staff to comply with BSP Circular 706 and/or HKMA requirements.
JOINT ACCOUNT INFORMATION
Joint Accountholder 1*
Joint Accountholder 2*
Joint Accountholder 3*
Joint Accountholder 4*
FIRST NAME
JOINT ACCOUNT NAME*
LAST NAMEMIDDLE NAME
4. Kindly indicate N/A in fields where it is not applicable.
CORRESPONDENCE and CONTACT DETAILS
Correspondence Primary Address (Correspondence 1)*
SIGNING INSTRUCTION
Area Code Telephone NumberCountry Code
Notes:
1. If Correspondence 1 or Correspondence 2 is selected, only one statement of account will be generated under the joint account package and will be delivered to the
Correspondence 1 address.
2.Note for HSBC Advance: For printed statements, please debit my Account Number _______________________________ for the prevailing printed statement fee.
Enrollment to Online Banking is required in order to receive your E-statement via this service.
Telephone Number
Correspondence 2
Postal Code*
Correspondence Primary Address (Correspondence 2)*
Postal Code*
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of The Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance for Each Depositor Php500,000 .
____________________________
Customer Initial/s
HSBC Account Opening Form
Joint Account
Note: 1. Please complete in BLOCK LETTERS and tick where applicable Date (dd-mm-yyyy)
-
Customer Number
-
ACCOUNTHOLDER NAME*
Date of Birth (dd-mm-yyyy)* Place of Birth*+
If below 18 years old, please supplement the following details:
Date of Birth (dd-mm-yyyy)
Gender* Male Female Philippine Resident? Yes No Country of Residence*
Nationality+Marital Status* Single Married Widowed Separated Living Together
If married, name of Spouse
-
-
-
-
Postal Code*
Postal Code*
Postal Code*
Residence Telephone Number Mobile Number
Office Telephone Number
Fax Number
Residence Type owned renting (private) renting (public) Car Ownership owned mortgaged
living with parents/relatives company residence mortgaged company car no car
Educational Background Limited/None Primary Secondary Tertiary Post Graduate
If current status is still student, please provide the expected year of graduation:
Former/Maiden Name*++
Date of Birth
(dd-mm-yyyy)
-
PERSONAL DETAILS - JOINT ACCOUNTHOLDER 1
MIDDLE NAME
2. Please fill out completely the fields marked by an asterisk (*) as required by R.A. 9160,
Anti-Money Laundering Act of 2001, as amended by R.A. 9194, and fields marked by a plus sign (+)
as required by FATCA.
3. Fields marked by a double plus sign (++) : Additional questions or supporting documents may be
asked by HSBC staff to comply with BSP Circular 706 and/or HKMA requirements.
4. Kindly indicate N/A in fields where it is not applicable.
FIRST NAME
(specify country of birth)
FAMILY NAME
Permanent Address Since+
(dd-mm-yyyy)
Permanent Residence Address*
FIRST NAME
Name of Father
Name of Mother
MIDDLE NAME FAMILY NAME
Name of Guardian
Name of
Children
-
-
-
_________________
Customer Initial
Any other countries where you maintain residence, work, and/or
studies? If yes please kindly specify.
Previous Residence Address+
(if staying at present address for less than 3 years)
Contact
Details* E-mail address
Other Nationalities+
No. of
Children
Present Residence Address*
Present Address
Since+ (dd-mm-yyyy)
Other Name (aliases or
name in another language
eg. Chinese name if any) *
++
-
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
VALID ID* (Type) ID Number*
SSS or GSIS No.*
Full Time Part Time Housewife Overseas Filipino Worker
Self-Employed Self-Employed Professional Student Unemployed Retired
Employer/Business Name* Nature of Business*
Employer/Business Address
Name of Previous Employer
Job Tenure Current Employer years months Previous EmployerPrevious Employer years months
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
(e.g. Rental, Interest Income, Dividends, Investments)
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Household Income level - Monthly (i.e. Joint income of spouses, Income of Head of the Family with other related family members )
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Use of Funds*
Purpose of Account*
Are you opening the account for the benefit or on behalf of another person?* Yes No
If so, what's the name of that person?
Employment
Status
Monthly
Salary
OTHER INFORMATION
Inheritance
Sale of Property/Business
Wins from
Lottery/Betting/Casino
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Sale of Property/Business
Inheritance Practice of Profession
Business Income
Employment Income Proceeds of Retirement/Pension
Practice of Profession
Business Income
Employment Income
Wins from
Lottery/Betting/Casino
Other Income -
(Monthly)
_________________
Customer Initial
Contribution/Allowance from
family members/individuals
Source of Wealth (i.e. Net Worth)* ++ refers to the origin of all existing
cash/wealth including those that will not be deposited in HSBC. (Please
tick all that apply.)
Source of Funds* ++ refers to the means to fund the account and all
other regular sources of future deposits. (Please tick all that apply.)
Others (please specify): _____________________________ Others (please specify): _____________________________
Job Title and Nature of Work* (e.g. VP Human Resources)
If professional, please specify(e.g. Lawyer)
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Contribution/Allowance from
family members/individuals
Proceeds of Retirement/Pension
Country of Tax Identification
Number+
Tax Identification Number (TIN)*
DOCUMENTARY DETAILS
EMPLOYMENT DETAILS
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Have you stayed in the Philippines for an aggregate period of more than 180 days in any calendar year? Yes No
Do you plan/intend to stay in the Philippines for an aggregate period of more than 180 days? Yes No
Reason for opening an account in the Philippines+
Are you an existing HSBC Customer? Yes No Why did you choose HSBC?If yes: Deposit Account Existing customer relationship Prize related reasons
Loan Account
Investment Account Service related reasons
Credit Card Account
Kindly indicate branch:
Existing HSBC Account Number
Existing HSBC Credit Card Number
Time with HSBC years months Other Bank Relationships
++Do you have any relatives that hold senior positions in government (executive, legislative & judiciary) and/or the uniformed service (police or
military)? If yes, please state the relative's name and how you are related.
Name _____________________________________________________________ Relationship _____________________________________
FOR NON-RESIDENT ONLY
YOUR BANKING RELATIONSHIP
_________________
Customer Initial
Convenient location
of bankResponse to particular advertising
Recommendation by
friend/family
Employer's bank for
salary paymentDissatisfaction with previous bank
Family has always
banked with HSBCOthers: _______________________
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Note: 1. Please complete in BLOCK LETTERS and tick where applicable Date (dd-mm-yyyy)
-
Customer Number
-
ACCOUNTHOLDER NAME*
Date of Birth (dd-mm-yyyy)* Place of Birth*+
If below 18 years old, please supplement the following details:
Date of Birth (dd-mm-yyyy)
Gender* Male Female Philippine Resident? Yes No Country of Residence*
Nationality+Marital Status* Single Married Widowed Separated Living Together
If married, name of Spouse
-
-
-
-
Postal Code*
Postal Code*
Postal Code*
Residence Telephone Number Mobile Number
Office Telephone Number
Fax Number
Residence Type owned renting (private) renting (public) Car Ownership owned mortgaged
living with parents/relatives company residence mortgaged company car no car
Educational Background Limited/None Primary Secondary Tertiary Post Graduate
If current status is still student, please provide the expected year of graduation:
Permanent Residence Address*
Permanent Address Since+
(dd-mm-yyyy)
Previous Residence Address+
(if staying at present address for less than 3 years)
Any other countries where you maintain residence, work, and/or
studies? If yes please kindly specify.
Contact
Details* E-mail address
No. of
Children
Name of
Children
Date of Birth
(dd-mm-yyyy)
-
-
-
-
Present Residence Address*
Present Address
Since+ (dd-mm-yyyy)
(specify country of birth)
FIRST NAME MIDDLE NAME FAMILY NAME
Name of Father
Name of Mother
Name of Guardian
Other Nationalities+
2. Please fill out completely the fields marked by an asterisk (*) as required by R.A. 9160,
Anti-Money Laundering Act of 2001, as amended by R.A. 9194, and fields marked by a plus sign (+)
as required by FATCA.
3. Fields marked by a double plus sign (++) : Additional questions or supporting documents may be
asked by HSBC staff to comply with BSP Circular 706 and/or HKMA requirements.
-
4. Kindly indicate N/A in fields where it is not applicable.
PERSONAL DETAILS - JOINT ACCOUNTHOLDER 2
FIRST NAME MIDDLE NAME FAMILY NAME
Former/Maiden Name*++
Other Name (aliases or
name in another language
eg. Chinese name if any) *
++
_________________
Customer Initial
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
VALID ID* (Type) ID Number*
SSS or GSIS No.*
Full Time Part Time Housewife Overseas Filipino Worker
Self-Employed Self-Employed Professional Student Unemployed Retired
Employer/Business Name* Nature of Business*
Employer/Business Address
Name of Previous Employer
Job Tenure Current Employer years months Previous EmployerPrevious Employer years months
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
(e.g. Rental, Interest Income, Dividends, Investments)
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Household Income level - Monthly (i.e. Joint income of spouses, Income of Head of the Family with other related family members )
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Use of Funds*
Purpose of Account*
Are you opening the account for the benefit or on behalf of another person?* Yes No
If so, what's the name of that person?
Others (please specify): _____________________________ Others (please specify): _____________________________
_________________
Customer Initial
Employment Income Proceeds of Retirement/Pension Employment Income Proceeds of Retirement/Pension
Wins from
Lottery/Betting/Casino
Contribution/Allowance from
family members/individuals
Wins from
Lottery/Betting/Casino
Contribution/Allowance from
family members/individuals
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Source of Wealth (i.e. Net Worth)* ++ refers to the origin of all existing
cash/wealth including those that will not be deposited in HSBC. (Please
tick all that apply.)
Source of Funds* ++ refers to the means to fund the account and all
other regular sources of future deposits. (Please tick all that apply.)
Practice of Profession Inheritance Practice of Profession Inheritance
Business Income Sale of Property/Business Business Income Sale of Property/Business
Employment
Status
Job Title and Nature of Work* (e.g. VP Human Resources)
If professional, please specify(e.g. Lawyer)
Monthly
Salary
OTHER INFORMATION
DOCUMENTARY DETAILS
EMPLOYMENT DETAILS
Tax Identification Number (TIN)* Country of Tax Identification
Number+
Other Income -
(Monthly)
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Have you stayed in the Philippines for an aggregate period of more than 180 days in any calendar year? Yes No
Do you plan/intend to stay in the Philippines for an aggregate period of more than 180 days? Yes No
Reason for opening an account in the Philippines+
Are you an existing HSBC Customer? Yes No Why did you choose HSBC?If yes: Deposit Account Existing customer relationship Prize related reasons
Loan Account
Investment Account Service related reasons
Credit Card Account
Kindly indicate branch:
Existing HSBC Account Number
Existing HSBC Credit Card Number
Time with HSBC years months Other Bank Relationships
++Do you have any relatives that hold senior positions in government (executive, legislative & judiciary) and/or the uniformed service (police or
military)? If yes, please state the relative's name and how you are related.
Name _____________________________________________________________ Relationship _____________________________________
FOR NON-RESIDENT ONLY
YOUR BANKING RELATIONSHIP
Convenient location
of bankResponse to particular advertising
Recommendation by
friend/family
Employer's bank for
salary paymentDissatisfaction with previous bank
Family has always
banked with HSBCOthers: _______________________
_________________
Customer Initial
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Note: 1. Please complete in BLOCK LETTERS and tick where applicable Date (dd-mm-yyyy)
-
Customer Number
-
ACCOUNTHOLDER NAME*
Date of Birth (dd-mm-yyyy)* Place of Birth*+
If below 18 years old, please supplement the following details:
Date of Birth (dd-mm-yyyy)
Gender* Male Female Philippine Resident? Yes No Country of Residence*
Nationality+Marital Status* Single Married Widowed Separated Living Together
If married, name of Spouse
-
-
-
-
Postal Code*
Postal Code*
Postal Code*
Residence Telephone Number Mobile Number
Office Telephone Number
Fax Number
Residence Type owned renting (private) renting (public) Car Ownership owned mortgaged
living with parents/relatives company residence mortgaged company car no car
Educational Background Limited/None Primary Secondary Tertiary Post Graduate
If current status is still student, please provide the expected year of graduation:
Previous Residence Address+
(if staying at present address for less than 3 years)
Any other countries where you maintain residence, work, and/or
studies? If yes please kindly specify.
Contact
Details* E-mail address
_________________
Customer Initial
-
-
-
-
Present Residence Address*
Present Address
Since+ (dd-mm-yyyy)
Permanent Residence Address*
Permanent Address Since+
(dd-mm-yyyy)
FIRST NAME MIDDLE NAME FAMILY NAME
Name of Father
Name of Mother
Name of Guardian
Other Nationalities+
No. of
Children
Name of
Children
Date of Birth
(dd-mm-yyyy)
4. Kindly indicate N/A in fields where it is not applicable.
PERSONAL DETAILS - JOINT ACCOUNTHOLDER 3
FIRST NAME MIDDLE NAME FAMILY NAME
Former/Maiden Name*++
Other Name (aliases or
name in another language
eg. Chinese name if any) *
++
(specify country of birth)
2. Please fill out completely the fields marked by an asterisk (*) as required by R.A. 9160,
Anti-Money Laundering Act of 2001, as amended by R.A. 9194, and fields marked by a plus sign (+)
as required by FATCA.
3. Fields marked by a double plus sign (++) : Additional questions or supporting documents may be
asked by HSBC staff to comply with BSP Circular 706 and/or HKMA requirements.
-
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
VALID ID* (Type) ID Number*
SSS or GSIS No.*
Full Time Part Time Housewife Overseas Filipino Worker
Self-Employed Self-Employed Professional Student Unemployed Retired
Employer/Business Name* Nature of Business*
Employer/Business Address
Name of Previous Employer
Job Tenure Current Employer years months Previous EmployerPrevious Employer years months
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
(e.g. Rental, Interest Income, Dividends, Investments)
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Household Income level - Monthly (i.e. Joint income of spouses, Income of Head of the Family with other related family members )
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Use of Funds*
Purpose of Account*
Are you opening the account for the benefit or on behalf of another person?* Yes No
If so, what's the name of that person?
EMPLOYMENT DETAILS
Tax Identification Number (TIN)* Country of Tax Identification
Number+
Employment
Status
Job Title and Nature of Work* (e.g. VP Human Resources)
If professional, please specify(e.g. Lawyer)
Monthly
Salary
Other Income -
(Monthly)
DOCUMENTARY DETAILS
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Source of Wealth (i.e. Net Worth)* ++ refers to the origin of all existing
cash/wealth including those that will not be deposited in HSBC. (Please
tick all that apply.)
Source of Funds* ++ refers to the means to fund the account and all
other regular sources of future deposits. (Please tick all that apply.)
Practice of Profession Inheritance Practice of Profession Inheritance
Business Income Sale of Property/Business Business Income
OTHER INFORMATION
Sale of Property/Business
Employment Income Proceeds of Retirement/Pension Employment Income Proceeds of Retirement/Pension
Wins from
Lottery/Betting/Casino
Contribution/Allowance from
family members/individuals
Wins from
Lottery/Betting/Casino
Contribution/Allowance from
family members/individuals
Others (please specify): _____________________________ Others (please specify): _____________________________
_________________
Customer Initial
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Have you stayed in the Philippines for an aggregate period of more than 180 days in any calendar year? Yes No
Do you plan/intend to stay in the Philippines for an aggregate period of more than 180 days? Yes No
Reason for opening an account in the Philippines+
Are you an existing HSBC Customer? Yes No Why did you choose HSBC?If yes: Deposit Account Existing customer relationship Prize related reasons
Loan Account
Investment Account Service related reasons
Credit Card Account
Kindly indicate branch:
Existing HSBC Account Number
Existing HSBC Credit Card Number
Time with HSBC years months Other Bank Relationships
_________________
Customer Initial
++Do you have any relatives that hold senior positions in government (executive, legislative & judiciary) and/or the uniformed service (police or
military)? If yes, please state the relative's name and how you are related.
Name _____________________________________________________________ Relationship _____________________________________
FOR NON-RESIDENT ONLY
YOUR BANKING RELATIONSHIP
Convenient location
of bankResponse to particular advertising
Recommendation by
friend/family
Employer's bank for
salary paymentDissatisfaction with previous bank
Family has always
banked with HSBCOthers: _______________________
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Note: 1. Please complete in BLOCK LETTERS and tick where applicable Date (dd-mm-yyyy)
-
Customer Number
-
ACCOUNTHOLDER NAME*
Date of Birth (dd-mm-yyyy)* Place of Birth*+
If below 18 years old, please supplement the following details:
Date of Birth (dd-mm-yyyy)
Gender* Male Female Philippine Resident? Yes No Country of Residence*
Nationality+Marital Status* Single Married Widowed Separated Living Together
If married, name of Spouse
-
-
-
-
Postal Code*
Postal Code*
Postal Code*
Residence Telephone Number Mobile Number
Office Telephone Number
Fax Number
Residence Type owned renting (private) renting (public) Car Ownership owned mortgaged
living with parents/relatives company residence mortgaged company car no car
Educational Background Limited/None Primary Secondary Tertiary Post Graduate
If current status is still student, please provide the expected year of graduation:
_________________
Customer Initial
Permanent Residence Address*
Permanent Address Since+
(dd-mm-yyyy)
Previous Residence Address+
(if staying at present address for less than 3 years)
Any other countries where you maintain residence, work, and/or
studies? If yes please kindly specify.
Contact
Details* E-mail address
No. of
Children
Name of
Children
Date of Birth
(dd-mm-yyyy)
-
-
-
-
Present Residence Address*
Present Address
Since+ (dd-mm-yyyy)
(specify country of birth)
FIRST NAME MIDDLE NAME FAMILY NAME
Name of Father
Name of Mother
Name of Guardian
Other Nationalities+
4. Kindly indicate N/A in fields where it is not applicable.
PERSONAL DETAILS - JOINT ACCOUNTHOLDER 4
FIRST NAME MIDDLE NAME FAMILY NAME
Former/Maiden Name*++
Other Name (aliases or
name in another language
eg. Chinese name if any) *
++
2. Please fill out completely the fields marked by an asterisk (*) as required by R.A. 9160,
Anti-Money Laundering Act of 2001, as amended by R.A. 9194, and fields marked by a plus sign (+)
as required by FATCA.
3. Fields marked by a double plus sign (++) : Additional questions or supporting documents may be
asked by HSBC staff to comply with BSP Circular 706 and/or HKMA requirements.
-
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
VALID ID* (Type) ID Number*
SSS or GSIS No.*
Full Time Part Time Housewife Overseas Filipino Worker
Self-Employed Self-Employed Professional Student Unemployed Retired
Employer/Business Name* Nature of Business*
Employer/Business Address
Name of Previous Employer
Job Tenure Current Employer years months Previous EmployerPrevious Employer years months
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
(e.g. Rental, Interest Income, Dividends, Investments)
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Household Income level - Monthly (i.e. Joint income of spouses, Income of Head of the Family with other related family members )
ZERO income Below P30,000 Php30,001 - Php70,000 Php70,001 - 120,000
Php120,001 - 250,000 Php250,001- 500,000 Php500,001 - 1,000,000 Above Php1,000,000
Use of Funds*
Purpose of Account*
Are you opening the account for the benefit or on behalf of another person?* Yes No
If so, what's the name of that person?
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Active Wealth/Investments (trading of securities/
currencies, franchises, inventions, royalties, patents,
real estate)
Others (please specify): _____________________________ Others (please specify): _____________________________
_________________
Customer Initial
Business Income Sale of Property/Business Business Income Sale of Property/Business
Employment Income Proceeds of Retirement/Pension Employment Income Proceeds of Retirement/Pension
Wins from
Lottery/Betting/Casino
Contribution/Allowance from
family members/individuals
Wins from
Lottery/Betting/Casino
Contribution/Allowance from
family members/individuals
Monthly
Salary
Other Income -
(Monthly)
OTHER INFORMATION
Source of Wealth (i.e. Net Worth)* ++ refers to the origin of all existing
cash/wealth including those that will not be deposited in HSBC. (Please
tick all that apply.)
Source of Funds* ++ refers to the means to fund the account and all
other regular sources of future deposits. (Please tick all that apply.)
Practice of Profession Inheritance Practice of Profession Inheritance
DOCUMENTARY DETAILS
EMPLOYMENT DETAILS
Tax Identification Number (TIN)* Country of Tax Identification
Number+
Employment
Status
Job Title and Nature of Work* (e.g. VP Human Resources)
If professional, please specify(e.g. Lawyer)
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Have you stayed in the Philippines for an aggregate period of more than 180 days in any calendar year? Yes No
Do you plan/intend to stay in the Philippines for an aggregate period of more than 180 days? Yes No
Reason for opening an account in the Philippines+
Are you an existing HSBC Customer? Yes No Why did you choose HSBC?If yes: Deposit Account Existing customer relationship Prize related reasons
Loan Account
Investment Account Service related reasons
Credit Card Account
Kindly indicate branch:
Existing HSBC Account Number
Existing HSBC Credit Card Number
Time with HSBC years months Other Bank Relationships
Convenient location
of bankResponse to particular advertising
Recommendation by
friend/family
Employer's bank for
salary paymentDissatisfaction with previous bank
Family has always
banked with HSBCOthers: _______________________
_________________
Customer Initial
++Do you have any relatives that hold senior positions in government (executive, legislative & judiciary) and/or the uniformed service (police or
military)? If yes, please state the relative's name and how you are related.
Name _____________________________________________________________ Relationship _____________________________________
FOR NON-RESIDENT ONLY
YOUR BANKING RELATIONSHIP
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
Telephone and Online Banking Yes No
Telephone Banking: PHP _______________________________ (maximum of PHP500,000)
Online Banking: PHP ___________________________________ (maximum of PHP500,000) (maximum of PHP5,000,000 pre-designated)
(maximum of PHP3,000,000 non-designated)
Checkbook Yes No # of Booklets __________________
Debit Card (for Peso accounts) Yes No ATM Card (for foreign currency accounts) Yes No
Name on Card (19 characters only) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Name on Card (19 characters only) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Name on Card (19 characters only) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Name on Card (19 characters only) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Yes No
Notes:
- Your request for an HSBC credit card is subject to HSBC's credit policies and requirements.
- For secured credit card application, please arrange to complete a Deed of Assignment separately.
If HSBC is unable to grant you a regular Premier or Advance credit card at this time,
would you want a secured credit card?
Yes
No
3rd Party Daily Transfer
Limit Set-up
_________________
Customer Initial
ACCOUNT TOOLS APPLICATION
Regular checkbook will be provided unless otherwise requested. The cost of the checkbook/s ordered will be debited from the checking account. Please ensure this account is sufficiently
funded for us to process your order.
Joint Account 1:
Joint Account 2:
Joint Account 3:
Joint Account 4:
HSBC CREDIT CARD
Do you want to apply for an HSBC
credit card?
Note:
HSBC Premier credit card will be issued for Premier clients and HSBC Advance credit card will
be issued for Advance clients. You will be required to fill-out a Card Declaration Form for
both Primary and supplementary credit card applications.
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
ELECTRONIC STATEMENTS / E-STATEMENTS
I/we declare under penalty of perjury that the information indicated in the account opening form and the application forms for various products and services contained in this document, is true
and accurate of my/our own personal knowledge. I/we undertake to notify you of any change in information indicated herein.
I/we declare that I/we have read and understood, and agree to be bound by the terms and conditions that govern the availment/enjoyment of the account/s, product/s and/or service/s that
I/we have applied for. This serves as my/our agreement for The Hongkong Shanghai Banking Corporation Limited (HSBC) to proceed with my/our application for the said products/services.
I /we acknowledge that the use of my/our account/s, service/s and/or product/s offered by HSBC are governed by and subject to the specific Terms and Conditions set by HSBC for such
account/service/product and An Easy Guide to Bank Services and Charge (Easy Guide), copies of which I/we have received, read and understood and to which I/we agree to be bound.
I/we agree that I/we shall not use any of the accounts/services/products offered without first having read and understood the specific Terms and Conditions and Easy Guide governing the
same and that my/our use and/or availment of the benefits signify my/our understanding of and agreement to be bound by the applicable Terms and Conditions, and Easy Guide of the
accounts/products/services.
I/we understand that if I/we indicated my/our email address in this Account Opening Form, a welcoming email will be sent to me/us within two (2) banking days once the account has been
opened, which will include the Terms and Conditions (T&C) for HSBC’s Products and Services (the Terms and Conditions), and an Easy Guide to Bank Services and Charges (the Tariff Guide).
Otherwise, the T&Cs and Tariff Guide can be accessed at the Bank website of www.hsbc.com.ph. I/we undertake to read the Terms and Conditions and I/we agree that by using, maintaining
and availing the benefits of my/our present and any future account/s with HSBC, I/we will be deemed to have agreed and accepted to the Terms and Conditions and the Tariff Guide.
I/we hereby expressly, absolutely and unconditionally release and discharge HSBC, and undertake to, at all times, indemnify and keep HSBC free and harmless from any and all claims, liabilities,
obligations, actions, proceedings, loss, damage, costs and expenses arising from or in connection with, directly or indirectly, HSBC’s so acting upon these instructions, except in case of gross
negligence on the part of HSBC.
In view of my/our HSBC ("The Bank") account opening, I/we agree and understand that I/we will receive my/our written confirmations and Statement of Account via electronic means only.
I/we agree to register myself/ourselves in HSBC’s Online Banking (the “Service”), and subscribe to receive the advices, confirmations and Statement of Account via this Service.
The Bank will send me/us advices, confirmations of transactions executed upon my/our instructions and/or Statements of Account, electronic or otherwise at its discretion, showing the
transactions and balances in relation to my/our account/s and such other banking services as may be specified by the Bank from time to time. I/we agree to examine each advice, confirmation
and Statement of Account and notify the Bank by delivering within ten (10) days from delivery, in the case of bank advices and confirmation, or sixty (60) days from mailing or posting, in the
case of periodic statement of account, a written notice of alleged errors or omissions therein. I/we acknowledge and agree that should I/we fail to give the Bank any such written notice of
errors or omissions within the periods aforementioned, I/we waive any right to raise any objection to, or to contest, and shall be deemed to have agreed to, the correctness and validity of said
advice, confirmation or Statement of Account. For written confirmations or Statement of Account sent electronically, the same shall be considered as received by me/us as soon as the same is
posted and becomes available for my/our viewing.
I/we agree that I/we shall check the account statements, advices, confirmations and communications relating to my/our Account through your internet banking services at least once a month
and undertake to immediately inform you of any errors, discrepancies, omissions or inaccuracies.
AGREEMENT TO THE BANK TERMS AND CONDITIONS
For Non-Residents:
If I am /we, now or at any time subsequent to the opening of my/our Philippine currency account, a non-resident of the Philippines, I/we affirm and acknowledge that
my/our Philippine currency account can only be funded by Philippine currency proceeds of foreign currency from the following sources and supported by the documents
as provided for by requirements on non-resident owned accounts as introduced by BSP Circulars 794 and 815.
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212
HSBC Account Opening Form
Joint Account
JOINT ACCOUNTHOLDER 1 JOINT ACCOUNTHOLDER 2
PRINTED NAME: PRINTED NAME:
Please ensure that signature does not overlap the box provided
SPECIMEN
SIGNATURE 1
SPECIMEN
SIGNATURE 2
SPECIMEN
SIGNATURE 3
JOINT ACCOUNTHOLDER 3 JOINT ACCOUNTHOLDER 4
PRINTED NAME: PRINTED NAME:
Please ensure that signature does not overlap the box provided
SPECIMEN
SIGNATURE 1
SPECIMEN
SIGNATURE 2
SPECIMEN
SIGNATURE 3
SPECIMEN
SIGNATURE
2
Please ensure that signature does not overlap the box provided
continuation Non-Residents
Further, I/we agree that each time I/we make or cause a deposit to be made, transfers or remits funds into my account, I/we am deemed to make the above representations.
I/we affirm and acknowledge that HSBC may refuse to accept any deposit, transfer, or remittance of funds into my/our account as a result of my/our failure to present the above described
documents. I/we agree not to hold HSBC liable for any loss, damage, and/or expense which I/we may incur as a result of HSBC's refusal to accept the funds.
I /we further authorize HSBC to inform the Commission of Internal Revenue or equivalent officer of the government that as a non-resident I am/we exempt from tax on interest income from
foreign currency deposits.
This is to authorize the Bank to inform the Bureau of Internal Revenue (BIR, the Philippines' tax authority) that the undersigned depositor is a non-resident of the Philippines and to disclose or
submit such information as may be necessary to establish such non-resident status. Upon establishment of the non-resident status of the undersigned and the submission to the BIR by the
Bank of the account name, account numbers and related details to which such non-resident status attaches, its foreign currency deposits maintained with the Bank should be exempted from
Philippine withholding taxes.
It is understood that the undersigned undertakes to provide or submit such documents or information as may be required by the BIR or the Bank to support its non-resident status and that this
permission is executed as a pre-requisite to the entitlement of the undersigned to the withholding tax exemption privilege under existing tax rules.
Please ensure that signature does not overlap the box provided
On the death of either or (as the case may be) any of us, we authorize HSBC to hold any credit balance on any account or accounts in our joint names, and any securities, deeds, boxes and
parcels and their contents, and property of any description held in our joint names to the order of the survivor or (if more than one) the survivors of us, without prejudice, however, to any
rights HSBC may have in respect thereof arising out of any lien, mortgage, charge, pledge, set-off, counter-claim or otherwise whatsoever and also subject to compliance with the law, including
the payment of taxes.
In the absence of any directions to the contrary, all accounts subsequently opened shall be operated and dealt with upon the terms set out above insofar as the same may be applicable.
We agree that HSBC may without notice combine or consolidate our account(s) with any liabilities to HSBC and set-off or transfer any sum(s) standing to the credit of any such account or any
sum(s) owing to us from HSBC in or towards the satisfaction of our liabilities to HSBC on any other account or in any other respect whether such liabilities be actual or contingent, primary or
collateral and several or joint and that HSBC’s rights hereunder shall not be affected by our death or the death of any one or more of us.
JOINT ACCOUNT CUSTOMER SERVICE SIGNATURES
SPECIMEN
SIGNATURE
3
SPECIMEN
SIGNATURE
1
SPECIMEN
SIGNATURE
3
JOINT ACCOUNT MANDATE
SPECIMEN
SIGNATURE
1
SPECIMEN
SIGNATURE
2
Issued by The Hongkong and Shanghai Banking Corporation LimitedMember of the Philippine Deposit Insurance Corporation.
Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00212