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Organization Information

Name of Account Holder (name of organization)

1. Name

Name of Account Holder (name of organization): * Tên doanh nghiệp theo GCNĐKDN

Foreign language name (if any):

Abbreviated name:

2. Address

Headquarter address according to the DNR: *

Country: *

Province/City: *

District: *

Ward /Commune *

Number/ Street: *

Transaction address: *

Same address as head office

Other

Transaction address *

Country: *

Province/City: *

Quận/Huyện: *

Phường /Xã *

Number/ Street: *

3. Contact us

Phone: *

Fax:

Email: *
Lưu ý: đây là email nhận thông tin kích hoạt tài khoản

4. Tax number

Tax number: *

Residence:*

5. Operation License / Establishment Decision / Certificate of Business Registration

License Number: *

License type: *

Issuance date: *

Place of issue: *

6. Fields - activities

Business fields, main activities: *

7. Revenue

Revenue of the latest year:

8. Authorization:

Type of organization: *

Information of affliated organization

1. Name

Name of Affiliated Organization: *

Foreign language name (if any):

Abbreviated name:

2. Address

Headquarter address according to the DNR: *

Country: *

Province/City: *

District: *

Ward /Commune *

Number/ Street: *

Transaction address: *

Same address as head office

Other

Country: *

Province/City: *

District: *

Ward /Commune *

Number/ Street: *

3. Contact us

Phone: *

Fax:

Email: *
Lưu ý: đây là email nhận thông tin kích hoạt tài khoản

4. Tax number

Tax number: *

Residence : *

5. Operation License / Establishment Decision / Certificate of Business Registration

License Number : *

Issuance date : *

Place of issue : *

6. Lawful representative of the affiliated organization :

Full name: *

Date of birth: *

Mobile: *

ID number/Passport/ID Card: *

Issuance date: *

Place of issue: *

7. Revenue

Revenue of the latest year:

8. Authorization:

Authorization No.: *

Account Information

HDBank branch where the account is opened

Branch:

Address:

Account type:

Currency:

Account services resgistration

1. Account statement

1. Frequency of receiving:

Daily

Weekly

Monthly

Other frequency

2. Method:

At counter

Via post office:

Swift

Email

2. Registration for electronic transactions (Ebanking)

Service: *

Internet Banking/Mobile Banking

Account No: Current accounts is opened in this forms and Accounts No (any if ).

eBanking Limit + All current accounts and Users at the time of registration:

Per Account	Daily limit :
Per User	Transaction limit: Daily limit:

Approve menthods:

Single approve transactions: one initiator and one approver.

Multiple approve transactions – Full: one initiator and multiple hierarchical approvers.

Multiple approve transactions – Option: one initiator and multiple nonhierarchical approvers

SMS Banking (Account balance fluctuations)

Account	List of phone numbers
Current accounts is opened in this forms

HDBank+Misa e.Connect service

Limit: According to the current eBanking limit

User: EBanking Users at the time of registration

FATCA Information

Organizations incorporated in the United States / operating in the US or under US law / Organizations with at least 1 controlling person (*) who are US citizens or permanent residents / Financial institutions outside the US under FATCA regulations?

Yes

No

Confirmation of the United States signs under FATCA	Forms to fill out	Confirmation of providing information
Confirmation of the United States signs under FATCA	Forms to fill out	Yes No
Organization incorporated in the United States/operating in the United States or under U.S. law	Template W-9
Organization with at least 01 controlling person (*) who is a citizen or permanent resident of the United States	Template W -8BEN-E: Applies to organizations Template W-9: Applies to Controllers who are US citizens or permanent residents	Consent for HDBank to report information about our account opened at HDBank to the US Internal Revenue Service (IRS) and the State Bank
Financial institution outside the United States under FATCA regulations, please select one of the FATCA compliant statuses below:	Template W -8BEN-E
Customer GIIN issued by IRS:
Not registered for compliance
Not the three subjects mentioned above

(*) Controllers include: account holder; other individuals controlling the operation and beneficiaries of the account; individuals holding from 10% of the charter capital of the Customer; individuals holding 20% or more of the charter capital of organizations contributing capital of such Customer; other individuals actually controlling the Customer; individuals entrusting, authorizing the Customer; individuals have the right to control the individual entrusting/authorizing the Customer, individuals having the right to control the legal entity/organization entrusting or authorizing the Customer.

Beneficial owner information

1. Organization whose beneficial owner is an individual who directly or indirectly owns 25% or more of the charter capital?:

Yes

No

Individuals holding directly or indirectly from 25% of the charter capital of the organization

Personal Information

Full name: *

ID/Passport: *

Issuance date: *

Place of issue: *

Date of birth: *

Nationality: *

Permanent address: *

Contact address: *

Information related to Ownership

Mobile: *

Occupation:

Position:

Ownership ratio: *

Direct: *

Direct

Indirect

If indirectly owned, please enter relevant organization information:

Name of organization: *

ERC/Establishment Decision/Operating License Number:

Country where the Organization's headquarters is located:

2.Is there another individual controlling the account's operation or benefiting from the transaction?: *

Yes

No

The Controlling Personal information

Full name: *

ID/Passport: *

Issuance date: *

Place of issue: *

Date of birth: *

Nationality: *

Permanent address: *

Contact address: *

Mobile: *

Occupation: *

Position: *

Relationship: *

Information of entrusting and authorization agreement

Does the organization participate in receiving a trust or authorization for the management and use of money and assets ? *

Yes

No

1. Information of the entrusting/authorizing organization or individual

Organization/personal information

Full name: *

Foreign language name:

Abbreviated name:

ID number/Passport/ID card (if an individual): *

Number of Operation License/ Establishment Decision/ Branch operation registration certificate (if the organization) *

Permanent address *

2. The entrusting/authorizing assets

Property Information

Type of the entrusting/authorizing assets: *

Value of the entrusting/authorizing assets: *

Entrustment, authorization

Contents/ Scope of the entrusting/authorization: *

Date of the entrustment/ authorization document: *

Identification number of the entrustment/ authorization issued by the competent state agency (if any):

Beneficiary's name and ralated individual, organization (if any):

Information of the account holder’s lawful representative

Add Info

Infomation of the chief acountant/person in charge of accountings

Add Info