ADDITIONAL ACCOUNT OPENING/
SERVICES APPLICATION
Date:
D D / MM / Y Y Y Y
Branch: ____________________________________
MY PERSONAL DETAILS
ACCOUNT NAME
EXISTING ACCOUNT NUMBER
ACCOUNT TYPE
1.
1.
1.
2.
2.
2.
Existing Credit Card Details
Please update my Personal Details
Account Holder (1)
Account Holder (2)
Passport Number
Employer Name
Employer Address
Country of birth
Correspondence Address
Residence Address
DD / MM / YYYY
Residing at this address since
DD / MM / YYYY
If residing at the stated
address for less than 3 years,
please provide your previous
residence address details
Do you have multiple
Nationalities or Green Card?
If Yes, please provide all
Nationalities, If No, please
provide only nationality 1:
Nationality 1 ................................................................................................
Nationality 2 ................................................................................................
Nationality 3 ................................................................................................
Nationality 1 ................................................................................................
Nationality 2 ................................................................................................
Nationality 3 ................................................................................................
E-mail Address
Tel. Number(Off)
(Res)
Mobile No.
Salary (AED)
Other Income (AED)
Please change my statement cycle to
Please
Monthly
Open an additional account
Quarterly
Convert my existing account/service
MY NEW ACCOUNT DETAILS
Current
Statement Savings
Time Deposit
Other ________________________________
CURRENCY
AED
USD
GBP
EUR
Other (Specify) ___________________
MY NEW SERVICE DETAILS
Advance:
Deposit based
Salary based
MY TERM DEPOSIT INSTRUCTIONS: (IF APPLICABLE)
Term ____________________________________________ Amount __________________________________________________________
To book my/our deposit please
Debit A/c No. ________________________________________________________________________
Maturity Instructions:
Pay Principal + Interest
Renew my deposit Principal only
Pay Interest by:
by:
A/c No. ____________________
Renewal term____________________________________________________________
A/C No._________________________
Renew my deposit Principal + Interest
Cashier Order/TT/DD
Cashier Order/TT/DD
Renewal Term ____________________________________
PLEASE PROVIDE ME WITH THE FOLLOWING
Debit Card:
New
Replacement
Cheque Book(s): (if applicable)
Quantity ____________ (25 leaves each)
PLEASE REPLACE MY
Debit Card PIN
Phone Banking PIN
Personal Internet Banking Password
MY THIRD PARTY FUNDS TRANSFER LIMIT FOR THE PERSONAL INTERNET BANKING SERVICE
I would like to have the facility of Third Party Funds Transfer* with a daily limit of AED__________when using the Personal
Internet Banking (not to exceed AED 185,000). The default Third Party Funds Transfer Limit applied on your account is zero.
Your requested limit will be applied once you have successfully registered for Personal Internet Banking.
* Third Party Funds Transfer - defined as any funds transfer other than transfers between my own accounts held with HSBC UAE or to effect bill payments.
1. ____________________________
2. ____________________________
3. ____________________________
OVERDRAFT LIMIT
Please cancel my existing
Overdraft limit
Assetlink overdraft limit
Transfer to Account No. __________________________________________
LINK MY NEW ADDITIONAL ACCOUNT
Primary Account
I would like the additional account to appear as my
Secondary Account
On my Debit Card
Choosing Primary Account will entitle you to an additional Debit Card. If you choose Secondary Account, it will be updated on your existing Debit Card.
Kindly note that your Primary Account will be used for both retail and ATM transactions, while your Secondary Account(s) will be used ONLY for ATM Transactions.
MY STANDING INSTRUCTION
Auto-activated
New
Amendment
Cancellation Sl. No. ____________________
Effective date________________________________
TT/DD/Cashier Order
Account transfer
Frequency___________________________________
Beneficiary/associate account__________________________________
No. of payments______________________________
Beneficiary/associate name____________________________________
Amount_______________ (ccy) _________________
Beneficiary Bank_____________________________________________
** Higher limit________________________________
Beneficiary Bank address______________________________________
** Lower limit_________________________________
Narrative ___________________________________________________
Expiry Date__________________________________
I confirm the above Standing Instruction details.
** Applicable for standing instruction based on balance only
______________________________________________________________
Signature
SMS ALERT SERVICES
Please provide the following details to link this account to SMS ALERT Service:
If you do not wish your account number to be displayed on the SMS, specify alternative word/number
Debit Notification for amount exceeding
Balance Notifications if balance falls below
Currency
Currency
________ Credit Notification for amount exceeding:
Amount
________ or exceeds
Amount
Currency
________
Amount
Currency
________
Amount
YOUR DECLARATION
I/We agree that the information given above is true and complete and that I/we have received the Banks General Terms and Conditions for the
Operation of accounts and Electronic Banking Services which I/we understand and expressly agree and accept to be bound by them whether set out
in English and/or Arabic. I/We confirm that all instructions, signature details and documentation associated with operations of the account are to be
the same as those of my/our existing account mentioned above, already held at your office unless otherwise specified. I/We understand that when
I/we am/are applying to convert an account, that my/our old account will be closed and that any debit or credit balance will be transferred to my/our
new account. Any transactions after the closure of the old account will be debited to the new account.
I/We agree and accept to be bound by the Banks Schedule of Services and Tariffs as amended from time to time. A copy of the current tariff is
available at www.hsbc.ae
I understand and agree that HSBC may amend the eligibility criteria for any type of account from time to time and that if I fail to meet the eligibility
criteria then HSBC may re-classify my account at any time. I understand and agree that if my account balance falls below the mi nimum required by
HSBC then a service charge will be levied.
I hereby request and authorise the Bank to grant me the ability to make Third Party Fund Transfer * to the extent (as per the daily amount specified
above) from time to time permitted by the Bank when using Personal Internet Banking and/or Phone Banking Services or any other relevant service
(as such service may be amended, replaced or varied from time to time).
Signing Instructions:
Single
Joint
Either/or
Other
Name 1. _________________________________________________________
Signature 1. _______________________________
Name 2. _________________________________________________________
Signature 2. _______________________________
Name 3. _________________________________________________________
Signature 3. _______________________________
FOR BANK USE ONLY
Authorised Signature
BSI
Card Returned
Y
N
TSI
DSI
For Term Deposit Accounts
Product Type _________________________________________________________________________________________________________
Interest rate type __________________________Spread _______________Spread Approval by ____________________________________
Copyright. HSBC Bank Middle East Limited 2014 ALL RIGHTS RESERVED. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, on any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of HSBC Bank Middle East Limited.
Issued by HSBC Bank Middle East Limited, PO Box 66, Dubai, UAE. Regulated by the Jersey Financial Services Commission and the Central Bank of the United Arab Emirates. CRN XXXXXX
