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IOPAO01(01July17)

D D M M Y Y Y Y

No YesI am a tax resident of another country(s) outside Malaysia :

PART D - DECLARATION BY APPLICANT

No Yes:

No Yes:(if yes, please specify)

(if yes, please specify)

1 .2.3.

DECLARATION OF POLITICALLY EXPOSED PERSONS (PEPs)

DECLARATION PURSUANT TO COMMON REPORTING STANDARD (CRS) ON TAX RESIDENCY

DECLARATION PURSUANT TO RULE 5.15(9) OF THE BURSA MALAYSIA SECURITIES BHD.

DECLARATION PURSUANT TO TERMS AND CONDITION FOR THE OPERATION OF SECURITIES TRADING ACCOUNT(s) IN ISLAMIC STOCKBROKING WINDOW OF MSSB

YOU ARE REQUIRED TO DECLARE WHETHER YOU / FAMILY MEMBER* / CLOSE ASSOCIATE** ARE CURRENTLY ENTRUSTED WITH A PROMINENT PUBLIC FUNCTION*** IN MALAYSIA OR A FOREIGN COUNTRY?

No, I am / My family member(s) / close associate(s) are not

Yes, I am / My family member(s) / close associate(s) are

YOU ARE REQUIRED TO DISCLOSE WHETHER ANY DEALING IN SECURITIES IN RESPECT OF YOUR TRADING ACCOUNT(S) IS CONDUCTED FOR YOURSELF OR ON BEHALF OF ANOTHER PERSON

for me as principal

for and on behalf of the party set out below, from whom, through whom or on whose behalf the securities are to be dealt with. I shall however remain liable for the dealings without prejudice to your right against the said party:-

i)Online Client

Non-Online Client

SUBSCRIBED AND SOLEMNLYdeclared by the account holder

PLEASE PRINT THE COMPLETED FORM AND PHYSICALLY SIGN WITHIN THE BOX

D D MM Y Y Y Y

lacca ecurities dn articipating Organisation Of rs sia ecuritie erha

Before me,

D D MM Y Y Y YPage 2 of 2

(16121-H)

IOPAO01BFeb20

ISLAMIC STOCKBROKING WINDOWINDIVIDUAL TRADING ACCOUNT APPLICATION FORMPRODUCT DETAILS

PART ONE - ACCOUNT DETAILS

(As per NRIC/Passport/ Authority

PART TWO - ACCOUNT TYPE

Islamic Trading - Cash Upfront Account

PART THREE - ONLINE TRADING FACILITYWe would like to apply for online trading :

FOR INTERNAL USE ONLY

Others, please specify :

I am NOT a Resident of MalaysiaI am a Resident of Malaysia

and I undertake to inform MSSB immediately should I subsequently obtain

PART FIVE- DECLARATION BY APPLICANT

Signature of Applicant

Applicant Name :

D D M M Y Y Y Y

PART SIX - TO BE COMPLETED BY DEALER’S REPRESENTATIVE

How do I know the applicant

Cash -

Applicant knowledge of trading rules

Intra day Trade

Proposed trading limit recommended

Name of broker :RM

Yes No

Excellent

Shares -

(16121-H)

DECLARATION BY DEALER’S REPRESENTATIVE

D D M M Y Y Y Y

FOR INTERNAL USE ONLY - DOCUMENT CHECKLIST

Account type

Country Code

Intraday

Trading Limit Keyed-in by

Checked by

0 1 2 0 0 1

A V G 0 0 1 K

If YES, Account No :

Correspondence Address : NoYes

Low Risk High RiskMedium Risk

RECOMMENDED BY CREDIT CONTROL

Remarks

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