joint account information · asked by hsbc savings staff to comply with bsp circular 706 and/or...

RBWM_24Jun2015_00213 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 Savings staff to comply with BSP Circular 706 and/or HKMA requirements.

JOINT ACCOUNT INFORMATION

Joint Accountholder 1*




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 HSBC Savings Bank (Philippines) Inc.Member 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*


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*++

_________________

Customer Initial

Any other countries where you maintain residence, work, and/or

studies? If yes please kindly specify.

-

PERSONAL DETAILS - JOINT ACCOUNTHOLDER 1

MIDDLE NAME





asked by HSBC staff to comply with BSP Circular 706 and/or HKMA requirements.


FIRST NAME

(specify country of birth)

FAMILY NAME

Date of Birth

(dd-mm-yyyy)

Name of

Children

-

-

-

Permanent Address Since+

(dd-mm-yyyy)

Permanent Residence Address*

FIRST NAME

Name of Father

Name of Mother

MIDDLE NAME FAMILY NAME

Name of Guardian

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 HSBC Savings Bank (Philippines) Inc.Member of the Philippine Deposit Insurance Corporation.

Maximum Deposit Insurance For Each Depositor Php500,000. RBWM_24Jun2015_00213


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)



Household Income level - Monthly (i.e. Joint income of spouses, Income of Head of the Family with other related family members )



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)

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.)

Job Title and Nature of Work* (e.g. VP Human Resources)

If professional, please specify(e.g. Lawyer)



real estate)

Contribution/Allowance from

family members/individuals

Proceeds of Retirement/Pension


Inheritance Practice of Profession

Other Income -

(Monthly)

_________________

Customer Initial



Others (please specify): _____________________________ Others (please specify): _____________________________

Country of Tax Identification

Number+

Tax Identification Number (TIN)*

DOCUMENTARY DETAILS

EMPLOYMENT DETAILS

Business Income

Employment Income Proceeds of Retirement/Pension

Practice of Profession

Business Income

Employment Income

Wins from





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 Savings Bank?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: _______________________




Joint Account


-

Customer Number

-

ACCOUNTHOLDER NAME*







-

-

-

-

Postal Code*

Postal Code*

Postal Code*



Fax Number





Present Address

Since+ (dd-mm-yyyy)



(dd-mm-yyyy)





Contact



No. of

Children

Name of

Children

Date of Birth

(dd-mm-yyyy)

-

-

-

-





++


FIRST NAME MIDDLE NAME FAMILY NAME

Name of Father

Name of Mother

Name of Guardian






-





_________________

Customer Initial




Joint Account


SSS or GSIS No.*















Use of Funds*

Purpose of Account*




_________________

Customer Initial

Employment Income Proceeds of Retirement/Pension Employment Income Proceeds of Retirement/Pension

Wins from




Wins from






real estate)



real estate)






Practice of Profession Inheritance Practice of Profession Inheritance

Business Income Sale of Property/Business Business Income Sale of Property/Business

Employment

Status

Tax Identification Number (TIN)* Country of Tax Identification

Number+



Monthly

Salary

Other Income -

(Monthly)

OTHER INFORMATION

DOCUMENTARY DETAILS

EMPLOYMENT DETAILS




Joint Account





Loan Account


Credit Card Account





Recommendation by

friend/family

Employer's bank for


Family has always


_________________

Customer Initial






Convenient location





Joint Account


-

Customer Number

-

ACCOUNTHOLDER NAME*







-

-

-

-

Postal Code*

Postal Code*

Postal Code*



Fax Number







Contact


_________________

Customer Initial


Present Address

Since+ (dd-mm-yyyy)



(dd-mm-yyyy)



Name of Father

Name of Mother

Name of Guardian


No. of

Children

Name of

Children

Date of Birth

(dd-mm-yyyy)

-

-

-

-







++








-





Joint Account


SSS or GSIS No.*















Use of Funds*

Purpose of Account*



Employment

Status



Monthly

Salary

Other Income -

(Monthly)


Wins from




Wins from






real estate)



real estate)

DOCUMENTARY DETAILS

EMPLOYMENT DETAILS


Number+


Business Income Sale of Property/Business Business Income

OTHER INFORMATION








_________________

Customer Initial




Joint Account





Loan Account


Credit Card Account







Convenient location





Recommendation by

friend/family

Employer's bank for


Family has always


_________________

Customer Initial




Joint Account


-

Customer Number

-

ACCOUNTHOLDER NAME*







-

-

-

-

Postal Code*

Postal Code*

Postal Code*



Fax Number







Contact


_________________

Customer Initial

Present Address

Since+ (dd-mm-yyyy)



(dd-mm-yyyy)




No. of

Children

Name of

Children

Date of Birth

(dd-mm-yyyy)

-

-

-

-





++



Name of Father

Name of Mother

Name of Guardian






-








Joint Account


SSS or GSIS No.*















Use of Funds*

Purpose of Account*





real estate)



real estate)


_________________

Customer Initial

Business Income Sale of Property/Business Business Income Sale of Property/Business


Wins from




Wins from




Employment

Status



Monthly

Salary

Other Income -

(Monthly)

OTHER INFORMATION







DOCUMENTARY DETAILS

EMPLOYMENT DETAILS


Number+




Joint Account





Loan Account


Credit Card Account





Convenient location


Recommendation by

friend/family

Employer's bank for


Family has always


_________________

Customer Initial









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) ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___




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.

_________________

Customer Initial

ACCOUNT TOOLS APPLICATION

3rd Party Daily Transfer

Limit Set-up

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

Would you want to be referred to The

Hongkong and Shanghi Banking

Corporation Limited (HSBC) 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.

I authorize HSBC Savings Bank (Philippines) Inc. to provide the necessary information to HSBC in relation to

my request to be referred to them regarding an HSBC Credit Card.




Joint Account

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 HSBC Savings Bank (Philippines) Inc (HSBC Savings Bank) 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 Savings Bank’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 Savings Bank, 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 Savings Bank, and undertake to, at all times, indemnify and keep HSBC Savings Bank 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 Savings Bank’s so acting

upon these instructions, except in case of gross negligence on the part of HSBC Savings Bank.

In view of my/our HSBC Savings Bank ("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.

ELECTRONIC STATEMENTS / E-STATEMENTS




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:


SPECIMEN

SIGNATURE 1

SPECIMEN

SIGNATURE 2

SPECIMEN

SIGNATURE 3

SPECIMEN

SIGNATURE

3


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 Savings Bank 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 Savings Bank liable for any loss, damage, and/or expense which I/we may incur as a result of HSBC Savings Bank's refusal to accept

the funds.

I /we further authorize HSBC Savings Bank 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.


On the death of either or (as the case may be) any of us, we authorize HSBC Savings Bank 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 Savings Bankmay 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 Savings Bank may without notice combine or consolidate our account(s) with any liabilities to HSBC Savings Bankand set-off or transfer any sum(s) standing to the credit

of any such account or any sum(s) owing to us from HSBC Savings Bank in or towards the satisfaction of our liabilities to HSBC Savings Bank 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 Savings Bank’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

JOINT ACCOUNT MANDATE

SPECIMEN

SIGNATURE

1

SPECIMEN

SIGNATURE

3

SPECIMEN

SIGNATURE

2

SPECIMEN

SIGNATURE

1

SPECIMEN

SIGNATURE

2



joint account information · asked by hsbc savings staff to comply with bsp circular 706 and/or...

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