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Page-03
wnmve bs :
Account Number
MÖæc AvBwW bs : (Group ID)
ZvwiL (Date) :
D D M M Y Y Y YAe¨w³K wnmve (Non-Individual Account)
e¨e¯’vcK,
Managerdv÷© wmwKDwiwU Bmjvgx e¨vsK wjwg‡UW
First Security Islami Bank Limited
gynZvivg (Muhtaram)Avm&mvjvgy AvjvBKzg (Assalamu Alaikum)
Avwg/Avgiv Avcbvi kvLvq GKwU
wnmve msµvšÍ we¯ÍvwiZ Z_¨ wb‡gœ cÖ`vb Kijvg:
wnmve †Lvjvi Rb¨ Av‡e`b KiwQ| Avgvi/Avgv‡`i cÖwZôv‡bi
kvLv (Branch)
(Account Name)
SBSCIB
evsjv‡`k e¨vsK †m±i †KvW t
wnmve †Lvjvi Av‡e`b dig (Account Opening Form)
&
Title of Account (in Block Letter) :
1. wnmv‡ei wk‡ivbvg (evsjvq)
ˆe‡`wkK:-
Ab¨vb¨ (Others):
FC RFCD NFCD ERQ NITA Others
mÂqx (SB) GmGbwW (SND) gy`vivev mÂqx:-
Avj-Iqvw`qvn:- PjwZ (CD) wcÖwgqvg (Shomman) gh©v`v (Morjada) 2. wnmv‡ei cÖKvi (wUK wPý w`b)
Type of Account (Please Tick)
GKwU wnmve †Lvjvi †ÿ‡Î
GKwU dig cÖ‡hvR¨)
9. cÖwZôv‡bi wVKvbv (Organization's Address):
K. †iwR÷vW© wVKvbv (Registered Address):
L. e¨emv¯’j/Awd‡mi wVKvbv (Business/Office Address):
M. KviLvbv/wkí cÖwZôv‡bi wVKvbv (Factory/Industry Address):
N. †UªW jvB‡mÝ bs : Bmy¨ ZvwiL ( Issue Date) : †Uwj‡dvb (Tel) : Trade Licence No.
Bmy¨Kvix KZ…©cÿ (Issuing Authority) : †gqv` (Validity) :
wbeÜb b¤^i : ZvwiL (Date) : wbeÜb KZ…©cÿ I †`k:
Reg. No. Reg. Authority & CountryO. B‡jKUªwbK-U¨v· AvBwW bs (E-TIN No. ): P. f¨vU †iwR.(hw` _v‡K):
10. cÖwZôv‡bi aib (wUK w`b) (Nature of Organization)
13. MÖvn‡Ki we‡kl wb‡`©k t Avwg/Avgiv, GB wnmve n‡Z Avgvi/Avgv‡`i wnmve b¤^i †Z D³ wnmv‡ei
(Customer's Special Instruction):
gvwmK wKw¯Íi A_© ¯’vbvšÍ‡ii gva¨‡g Rgv Kivi Rb¨ Aby‡iva KiwQ (¯‹x‡gi Rb¨ cÖ‡hvR¨)
(I/we are requesting to transfer the amount of monthly installment of the Scheme accountfrom my/our this account no.)
Bangladesh Bank Sector Code
GwUGg KvW© (ATM Card), Kv‡W© bvg †hfv‡e †`L‡Z Pvb (m‡e©v”P 17 Aÿi):
¯^vÿi (Signature)
GKKfv‡e
(Singly) †hŠ_fv‡e
(Jointly) †h †Kvb GKRb
(Any One) Ab¨vb¨
(Others) †h †Kvb GKRb A_ev RxweZ e¨w³
(Any one or Survivor) 4. wnmve cwiPvjbv msµvšÍ †NvlYv (hw` _v‡K):
Account Operation Related Instruction (If Any)
6. cÖv_wgK Rgvi cwigvY (Initial Deposit) :K_vq (In Word) :
5. wnmve †Lvjvi D‡Ïk¨ :
cÖvB‡fU wjt †Kv¤úvbx
Private Ltd. CompanyAskx`vix
Partnership
†hŠ_ D‡`¨vM
Joint Venture
GKK gvwjKvbv
Proprietorship
miKvix
Govt. Avav miKvix/ ¯^vqËkvwmZ
Semi Govt. / Autonomus
Gb.wRI/ GbwcI
N.GO /NPO
K¬ve/†mvmvBwU
Club/Society
wkÿv cÖwZôvb
Educational Center
K) e¨emvi aiY : †UªwWs †mev Drcv`b
M) e¨emvq wb‡qvwRZ †gvU Rbej (¯’vqx Ges A¯’vqx) : N) evwl©K Uvb©Ifvi/weµq :
O cÖwZôv‡bi wbU m¤ú` : P) Ab¨vb¨ Z_¨ (cÖ‡hvR¨ †ÿ‡Î) :
L) cY¨ ev †mevi aiY :
agx©q cÖwZôvb
Religious CenterUªv÷
TrustAb¨vb¨ (wbw`ófv‡e D‡jøL Kiæb)
(Others Details Mark)
cvewjK wjt †Kv¤úvbx
Public Ltd. Company
VAT Reg. No. (if any):
12. MÖvn‡Ki Ab¨ e¨vsK wnmv‡ei Z_¨ (hw` _v‡K): Other Bank account's Information (If any)
11. e¨emv msµvšÍ Z_¨ (Business Infornation ) :
1)
2)
kvLv
Branche¨vs‡Ki bvg
Name of Bank
GKvD‡›Ui aiY (wUK w`b)
Nature of Account (Please Tick)
wW‡cvwRU GKvD›U
Deposit Account Bb‡f÷‡g›U GKvD›U
investment Account Ab¨vb¨
Others
wW‡cvwRU GKvD›U
Deposit Account Bb‡f÷‡g›U GKvD›U
investment Account Ab¨vb¨
Others
MÖvnK AvBwW bs :
Customer ID
3. gy`ªv (wUK w`b)
B›Uvi‡bU e¨vswKs (Internet Banking) E-mail :
UvKv (Taka) BD.Gm.wW Wjvi (USD) BD‡iv (EURO) cvDÛ (GBP) Ab¨vb¨ (Others)
7. GmGgGm e¨vswKs Gi Rb¨ (SMS Banking) †gvevBj b¤^i:
8. wb‡Pi AvKl©Yxq †mev¸‡jv wb‡Z wUK w`b [ ]
I/we hereby apply to open an account with your branch. My/our information details are given below :