individual aof

8/2/2019 Individual AOF

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SECONDAPPLICANT

Title Mr/Mrs/Miss/Ms

First NameSecond NameSurnameAddress

Post Code

Country

Date Moved In

National Insurance No.Passport No.CitizenshipMarital StatusPrevious Address if period of stay below 36 months

Address

Post Code

CountryDate of Birth

Home Tel.FaxE-mailMailing Address if different from above

Mother's Maiden Name

No. of Dependents

Receive Salary/Pension CreditsInvest in Term Deposits

Fixed Deposits Money Transfers

Self employed Employed full time Employed part time

Home maker Pensioner StudentOther (specify)Details of Employment/ BusinessJob TitleNature of Business

Section A

APPLICANT


First Name

Second Name

Surname

Address

Post Code

Country

Date Moved In

National Insurance No.

Passport No.

Citizenship

Marital Status

Previous Address if period of stay below 36 months

Address

Post Code

Country

Date of Birth

Home Tel.

Fax

E-mail

Mailing Address if different from above

Mother's Maiden Name

No. of Dependents

Operate personal A/C and SavingsOperate Business Account

Other Please Specify

Savings A/C Current A/C

Self employed Employed full time Employed part time

Home maker Pensioner Student

Other (specify)

Details of Employment/ Business

Job Title

Nature of Business

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21 Knightsbridge London SW1X 7LY

Application for Individuals

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mployers Name / Business Name

ddress

Work Telephone

ax

-mail

urrent Employment Start Date

alary / Income

ther Source(s) of Income

otal Income

xpected Account Turnover

escribe Major Sources of Credits

escribe Major Debits flowing through the Account

ame of the Bank

ccount No.

ranch Name

ort Code

ddress

stimated Value of Residence

utstanding Mortgage

alue of Other Property Held

ssets (in Thousands)

abilites (in Thousands)

usiness Interests

et Worth

lease issue me/us with a cheque book for use on the above account.

lease arrange to send a statement of account:-

nce a week Fortnight Month Half year

ection B

eclaration in case of Joint Accounts

the account a joint account? Yes / No

yes, Can any of the above operate the account singly? Yes /No

yes, review and sign the following section.We, the undersigned, request you to open an account or accounts in our joint names, or to continue the joint account already opened.We authorise you, until you receive notice in written form from any of us to the contrary:

) To pay and debit to any such account all cheques, orders to pay, bills of exchange, and promissory notes drawn, signed and accepted ormade by anyone of us, whether the account(s) be in credit or overdrawn or shall become overdrawn by reason of such debiting.2) To grant at the request of anyone of us, overdraft, loan or other credit facilities or accommodation to us or to any third person and by wayf security therefor, to accept as duly signed or executed on behalf of all of us any document creating or evidencing anyharge, mortgage or pledge over or in respect of any securities, deeds or other articles in our joint names.3) To pay against the signature of anyone of us, any moneys held in credit of any deposit account in our joint names.4) To deliver against the signature of anyone of us, any securities, deeds or other articles held in our joint names by way of security or forafe custody or otherwise. We agree that, in the event of the death of any of us, you are to pay or deliver to or to the order of the survivor orurvivors of us, all moneys, securities, deeds and other articles standing to the credit of or held for any account in our joint names. We herebygree that we shall be jointly and severally responsible for any overdraft, loan or other credit facilities or accommodation which shall beranted in our joint names or for our joint account, together with all interest, commission and other banking charges and expenses.5) To open any new account in the above names in which case all instructions contained in this application form will apply for the newccounts to be opened.

Employers Name / Business NameAddressWork TelephoneFaxE-mailCurrent Employment Start DateSalary / Income

Other Source(s) of IncomeTotal Income

Name of the BankAccount No.Branch NameSort CodeAddress

Estimated Value of Residence

Outstanding MortgageOther Property Held

Assets (in Thousands)Liabilites (in Thousands)

Business InterestsNet Worth

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Signature Second Applicant

Signature Fourth Applicant



Date Signed



Date Signed

Financial ReviewReview DateNext Due

Rev. Frequency (months)

Date of opening the Account

Date of opening in the System

Language

Tax Information Code

Signature of the Officer

Signature First Applicant

Signature Third Applicant

Date Signed

Section C

Declaration of Residence

s the account holder not ordinarily resident in the UK Yes/ NoName/s of the account holder/s not ordinarily resident ..............................................................................................................................................f yes please complete the following declaration/We declare that I/We are permanent residents of ........................Country for UK Exchange Control purpose and that my/our permanentddress is provided in Section A above./We undertake to inform the Bank immediately in the event of my/our taking up permanent residence in the UK or any change in ouresidence status by our acquiring residence of any other country./We are also aware of the fact that the UK Tax authority namely, the Inland Revenue has arrangement with specified countries to exchangenformation on our accounts details including my/our name and address, amount of deposit, amount of interest paid, date of birth and othereference on the account. Currently we are/we are not resident of one of these countries. I/We are also aware that the list of reportable

countries may change as and when the Inland Revenue add/delete new countries to the list.he

Signature First Applicant


Date Signed

Section D

/We hereby request the Bank to open the account in the above names and information. I/We hereby declare that the above information isrue and correct to the best of my/our knowledge. We understand that the account will be opened on the basis of the information provided

by me/us. I/We hereby agree that any new account opened immediately or on a future date will be subject to the same terms andconditions as contained in this application form./We undertake that I/we will not claim any interest on any of our Term deposit/s made from time to time after the maturity date unless anduntil we made specific request to renew the deposit. Notwithstanding this I/we here by authorise ICICI Bank UK Ltd to renew the termdeposit/s made from time to time, on maturity for an identical period in the absence of any specific notice to the contrary./We agree to comply with the Banks rules in regard to conduct of the accounts. I/We understand that the information I/we have given, maybe used to offer other services from the ICICI Bank UK Ltd. In this connection contact may be made to me/us Personally, or by direct

marketing means./We resolve to provide to the Bank in writing any changes in personal details or circumstances that may change from time to time./We hereby request ICICI Bank UK Ltd to issue a debit cum ATM Card. I/We acknowledge that the issue and usage of the card is governedby the terms and conditions as in force from time to time and agree to be bound by the same. I/We accept that the terms and conditions areable to be amended by ICICI Bank UK ltd from time to time. In case we do not agree to any of the modified terms and conditions we willurrender the debit cum ATM card to ICICI Bank UK Ltd. I/We further unconditionally and irrevocably authorize ICICI Bank UK Ltd to debit

my/our account to the amount drawn under the card and for the fees and charges for the use of the card. I/We here by confirm that thisccount will be operated singly and in case of joint account by either or survivor. I/We hereby request to provide me/us Internet Banking and

Telephone Banking facilities along with issuance of Debit cum ATM Cards. I/We undertake to abide by the rules governing the usage of theseacilities and also undertake to ratify and confirm all that the user/s do/es or cause/s to do through these facilities. This undertaking should

continue to be valid until and unless I/We revoke it by written notice to you.

/We choose NOT to be contacted by ICICI Bank for marketing purposes by ticking this box.

nformation may also be used for financial statistical analysis (for example credit scoring). I/We also understand that no information will bedisclosed outside ICICI Bank UK Ltd unless for fraud prevention purposes as required by law and unless I am/we are in default under an

greement in which case the Bank may disclose the fact to licensed credit agencies/other banks/building societies.Signature First Applicant


Date Signed

For Office use only

Primary Officer

Source of Data

Member Type

Date Added

Account Number Allotted

Branch Number

Customer Status

Name of the person authorising opening of the account:-

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FOURTHAPPLICANT


First NameSecond NameSurnameAddress

Post Code CountryDate Moved In

National Insurance No.Passport No.CitizenshipMarital StatusPrevious Address if period of stay below 36 months

Post Code

CountryDate of Birth

Home Tel.FaxE-mailGross Annual IncomeIncome

Name of the BankAccount No.Branch NameSort CodeAddress


Self employed Employed full time Employed part timeHome maker Pensioner StudentOther (specify)Details of Employment/ BusinessJob Title

Nature of Business

Employers Name / Business NameAddress

Work TelephoneFaxE-mailCurrent Employment Start DateSalary / Income

Other Source(s) of Income

Total Income

Annexure

HIRD APPLICANT

itle Mr/Mrs/Miss/Ms

irst Name

econd Name

urname

Address

ost Code CountryDate Moved In


assport No.

itizenship

Marital Status

revious Address if period of stay below 36 months

ost Code

ountry

Date of Birth

Home Tel.

ax

-mail

Gross Annual Income

ncome

Name of the Bank

Account No.

ranch Name

ort Code

Address


elf employed Employed full time Employed part time

Home maker Pensioner Student

Other (specify)

Details of Employment/ Business

ob Title

Nature of Business

mployers Name / Business Name

Address

Work Telephone

ax

-mail

urrent Employment Start Date

alary / Income

Other Source(s) of Income

otal Income

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individual aof

Documents