mcb-arif habib savings and investments limited€¦ · 28/11/2019  · mcb-arif habib savings and...

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Yes No Yes No Yes No Yes No 2. Foreign Account Tax Compliance Act (“FATCA) Section (To be filled separately by each Joint Holder) Please complete in BLOCK LETTERS Name: Country of Birth: Please tick ( ) Yes or No for each of the following questions: 1. Are you a U.S. Resident? 2. Are you a U.S. Citizen? 3. Are you holding a U.S. Permanent Resident Card (Green Card)? 4. Are you registered in the US as a tax payer? Declaration: Note: If answer to any of the above-mentioned questions is “Yes” then please complete Form W-9 “Request for Taxpayer Identification Number and Certification”. Country of Residence: 2. Subject to applicable local and foreign laws, I hereby consent for MCB-AH, the Trustee of the Collective Investment Schemes/ Voluntary Pension Schemes or any of their affiliates (including without limitation branches) to share my information with domestic and overseas tax authorities, where necessary to establish my tax liability in any jurisdiction; 3. Subject to the requirements of domestic or overseas laws, I consent and agree that MCB-AH or the Trustee of the Collective Investment Schemes/ Voluntary Pension Schemes may withhold from my account(s) such amounts as may be required according to applicable laws, regulations and directives; 4. I hereby undertake not to initiate any proceedings against MCB-AH and the Trustee of the Collective Investment Schemes/ Voluntary Pension Schemes in case any amounts are withheld from my account and remitted to the local or foreign authorities/regulators; 5. I hereby undertake that I have not granted a Power of Attorney to a person who has an address outside Pakistan to operate the Investor Account (either physically or electronically); 6. I hereby undertake that I have no intention to set up Payment Standing Instruction(s)for the banking account(s) and beneficiary account(s) in a country outside Pakistan; 7. I hereby undertake to notify MCB-AH within thirty (30) calendar days in case of any change in any information whatsoever which I have provided to MCB-AH; and 8. I further agree and accept that the terms and conditions as contained herein shall form part and parcel of the Account Opening Form and the terms and conditions of the Account Opening Form as well other documentation shall remain in full force and effect. 1. I hereby confirm that the information provided above is true, accurate and complete; MCB-Arif Habib Savings and Investments Limited DATE: Investor Registration Number (for official use only) Name of Principal Account Holder CNIC/ NICOP/ PASSPORT NO. Name of Joint Holder 1. KNOW YOUR CUSTOMER (KYC) - MANDATORY INFORMATION (To be filled separately by each Joint Holder) RESIDENTIAL STATUS RESIDENT PAKISTANI NON-RESIDENT PAKISTANI RESIDENT FOREIGN NATIONAL NON-RESIDENT FOREIGN NATIONAL NATIONALITY Yes No PERMANENT RESIDENT IN PAKISTAN (to be filled by NICOP holders only) Occupation Education Annual Income Head of State Name of Ultimate Beneficiary CNIC/ NICOP/ Passport No. Relationship with the Customer Head of Government Senior Politician Senior Government Official Senior Judicial Official Senior Military Official Senior executive of State Owned Corporations Important Political Party Official Senior executive of International Organization Member of the Board of International Organization Head of State Head of Government Senior Politician Senior Government Official Senior Judicial Official Senior Military Official Senior executive of State Owned Corporations Important Political Party Official Senior executive of International Organization Member of the Board of International Organization Business/ Self Employed Stock/ Investment Salary Rental Income Others Pension 1. 2. Inheritance Remittances Savings Are you or have you ever been entrusted with the following functions either in Pakistan or abroad? Source of Income (Please attach Supporting documents) Up to 1 Million Up to 2 Million Up to 4 Million Up to 6 Million Up to 8 Million Up to 10 Million Under graduate Graduate Post graduate Professional Other Over 10 Million Name and address of Employer/ Business (if applicable) If you are acting and investing on behalf of any other person (ultimate beneficiary) please provide the following details of the ultimate beneficiary Have your account ever been refused by any financial institution in Pakistan or abroad? (Yes/ No) if Yes then please explain reason for refusal (Please Specify) (Please Specify) Functions PEPs/ FAMILY MEMBER OR CLOSE ASSOCIATE OF PEP Yes No No Person Yes Note: Ultimate beneficiary is an individual who has any legitimate relationship with the customer. If you do not disclose the ultimate beneficiary, the Management Company will assume that you are the ultimate beneficial owner of the funds invested. ULTIMATE BENEFICIAL OWNER’S DETAILS Are you or have you ever been the family member or close associate of any of these person(s)? Family member is the individual who is related to the Person either directly (blood relatives) or through marriage or similar (civil) forms of partnership. Close associate is the individual who is closely connected to the Person either socially or professionally Signature: Signature/ Left Hand Thumb Impression (male)/ Right hand Thumb Impression (female) In case of unstable/ shaky/ immature signature or thumb impression, attestation of gazetted officer (BPS-17 and above)/ branch manager of the bank/ notary public/ authorized officer of the MCB-AH is required. Witnesses (Adult Male Persons only) Attestation Name: CNIC: Signature: Name: CNIC: Signature: Welfare/ Social Worker Real Estate Dealer/ Builder Self Employed Consultant Armed Forces Personnel Retailer Jeweler/ Precious Metal & Stones Dealer Self Employed Accountant/ Auditor Self Employed Doctor/ Pharmacist Banker Wholesaler Retired/ Pensioner Distributor/ Agent Housewife Manufacturer Private Service Shop Keeper Importer/Exporter Agriculturist/Dairy Farmer Landlord Self Employed Lawyer/ Advocate Government Service Student Others Head Office: 2nd Floor, Adamjee House, I.I. Chundrigar Road, Karachi UAN: (+92-21) 11-11-622-24 (11-11-MCB-AH) URL: www.mcbah.com, Email: [email protected] Please write in block letters using black ink. To be filled by each Joint Holder separately KYC and FATCA Form for Existing / Joint Unitholders

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Page 1: MCB-Arif Habib Savings and Investments Limited€¦ · 28/11/2019  · MCB-Arif Habib Savings and Investments Limited DATE: Investor Registration Number (for official use only) Name

Yes NoYes NoYes NoYes No

2. Foreign Account Tax Compliance Act (“FATCA) Section (To be filled separately by each Joint Holder)

Please complete in BLOCK LETTERSName:Country of Birth: Please tick ( ) Yes or No for each of the following questions: 1. Are you a U.S. Resident?2. Are you a U.S. Citizen?3. Are you holding a U.S. Permanent Resident Card (Green Card)?4. Are you registered in the US as a tax payer?

Declaration: Note: If answer to any of the above-mentioned questions is “Yes” then please complete Form W-9 “Request for Taxpayer Identification Number and Certification”.

Country of Residence:

2. Subject to applicable local and foreign laws, I hereby consent for MCB-AH, the Trustee of the Collective Investment Schemes/ Voluntary Pension Schemes or any of their affiliates (including without limitation branches) to share my information with domestic and overseas tax authorities, where necessary to establish my tax liability in any jurisdiction;3. Subject to the requirements of domestic or overseas laws, I consent and agree that MCB-AH or the Trustee of the Collective Investment Schemes/ Voluntary Pension Schemes may withhold from my account(s) such amounts as may be required according to applicable laws, regulations and directives;4. I hereby undertake not to initiate any proceedings against MCB-AH and the Trustee of the Collective Investment Schemes/ Voluntary Pension Schemes in case any amounts are withheld from my account and remitted to the local or foreign authorities/regulators;5. I hereby undertake that I have not granted a Power of Attorney to a person who has an address outside Pakistan to operate the Investor Account (either physically or electronically);6. I hereby undertake that I have no intention to set up Payment Standing Instruction(s)for the banking account(s) and beneficiary account(s) in a country outside Pakistan;7. I hereby undertake to notify MCB-AH within thirty (30) calendar days in case of any change in any information whatsoever which I have provided to MCB-AH; and 8. I further agree and accept that the terms and conditions as contained herein shall form part and parcel of the Account Opening Form and the terms and conditions of the Account Opening Form as well other documentation shall remain in full force and effect.

1. I hereby confirm that the information provided above is true, accurate and complete;

MCB-Arif Habib Savings and Investments Limited

DATE:

Investor Registration Number (for official use only) Name of Principal Account Holder

CNIC/ NICOP/ PASSPORT NO.Name of Joint Holder

1. KNOW YOUR CUSTOMER (KYC) - MANDATORY INFORMATION (To be �lled separately by each Joint Holder)

RESIDENTIAL STATUS RESIDENT PAKISTANI NON-RESIDENT PAKISTANI RESIDENT FOREIGN NATIONAL NON-RESIDENT FOREIGN NATIONAL

NATIONALITYYes NoPERMANENT RESIDENT IN PAKISTAN(to be filled by NICOP holders only)

Occupation

Education

Annual Income

Head of State

Name of Ultimate Beneficiary CNIC/ NICOP/ Passport No. Relationship with the Customer

Head of Government

Senior Politician

Senior Government Official

Senior Judicial Official

Senior Military Official

Senior executive of State Owned Corporations

Important Political Party Official

Senior executive of International Organization

Member of the Board of International Organization

Head of StateHead of Government

Senior Politician

Senior Government Official

Senior Judicial Official

Senior Military Official

Senior executive of State Owned Corporations

Important Political Party Official

Senior executive of International Organization

Member of the Board of International Organization

Business/ Self Employed

Stock/ Investment

Salary

Rental Income Others

Pension

1.2.

Inheritance Remittances Savings

Are you or have you ever been entrusted with the following functions either in Pakistan or abroad?

Source of Income(Please attach Supportingdocuments)

Up to 1 Million Up to 2 Million Up to 4 Million Up to 6 Million Up to 8 Million Up to 10 Million

Under graduate Graduate Post graduate Professional Other

Over 10 Million

Name and address of Employer/ Business (if applicable)

If you are acting and investing on behalf of any other person (ultimate beneficiary) please provide the following details of the ultimate beneficiary

Have your account ever been refused by any financial institution in Pakistan or abroad? (Yes/ No) if Yes then please explain reason for refusal

(Please Specify)

(Please Specify)

Functions

PEPs/ FAMILY MEMBER OR CLOSE ASSOCIATE OF PEP

Yes No NoPerson Yes

Note: Ultimate beneficiary is an individual who has any legitimate relationship with the customer. If you do not disclose the ultimate beneficiary, the Management Company will assume that you are the ultimate beneficial owner of the funds invested.

ULTIMATE BENEFICIAL OWNER’S DETAILS

Are you or have you ever been the family member or close associate of any of these person(s)?Family member is the individual who is related to the Person either directly (blood relatives) or through marriage or similar (civil) forms of partnership. Close associate is the individual who is closely connected to the Person either socially or professionally

Signature: Signature/ Left Hand Thumb Impression (male)/

Right hand Thumb Impression (female)In case of unstable/ shaky/ immature signature or thumb impression, attestation of gazetted officer (BPS-17 and above)/ branch manager of the bank/ notary public/authorized officer of the MCB-AH is required.

Witnesses (Adult Male Persons only)Attestation

Name:

CNIC:

Signature:

Name:

CNIC:

Signature:

Welfare/ Social Worker

Real Estate Dealer/ Builder

Self Employed Consultant

Armed Forces Personnel

Retailer

Jeweler/ Precious Metal & Stones Dealer

Self Employed Accountant/ Auditor

Self Employed Doctor/ Pharmacist

Banker

Wholesaler

Retired/ Pensioner

Distributor/ Agent

Housewife

Manufacturer

Private Service

Shop Keeper

Importer/ExporterAgriculturist/Dairy Farmer

Landlord

Self Employed Lawyer/ Advocate

Government Service

Student

Others

Head Office: 2nd Floor, Adamjee House, I.I. Chundrigar Road, KarachiUAN: (+92-21) 11-11-622-24 (11-11-MCB-AH)

URL: www.mcbah.com, Email: [email protected]

Please write in block letters using black ink. To be filled by each Joint Holder separatelyKYC and FATCA Form for Existing / Joint Unitholders