(PDF 340kB)
Account Application Form
Account Application Form
MAIN ACCOUNT HOLDER
Account Type
Individual
ACCOUNT HOLDER 2
Joint
US Person Declaration
Account Holders
Yes1
Relationship to Main Account Holder
US Person Declaration
No2
A. Personal Information
New Client
Existing Client
Yes1
No2
A. Personal Information
New Client
Existing Client
(Any new information provided in this application shall be taken as
Salutation and Full Name (As in NRIC/Passport)
Salutation and Full Name (As in NRIC/Passport)
a request to update your existing particulars in the Bank’s records)
NRIC/Passport Number
Yes
(Any new information provided in this application shall be taken as
a request to update your existing particulars in the Bank’s records)
NRIC/Passport Number
Singapore PR
No
Singapore PR
Yes
Permanent Residential Address (Must not be a PO Box address)
Permanent Residential Address (Must not be a PO Box address)
Country Country Postal Code
Postal Code
Mailing Address (If different from residential address)
Mailing Address (If different from residential address)
Country Country Postal Code
Single Marital Status
Married Others
Postal Code
Single Marital Status
Mother’s Maiden Name
Mother’s Maiden Name
Highest Education Received
Highest Education Received
Married Others
Primary
Secondary
A Level/Pre-University
Primary
Secondary
A Level/Pre-University
Diploma
Degree
Others, please specify
Diploma
Degree
Others, please specify
Contact Details (Please provide mobile number & 1 alternative number)
Contact Details (Please provide mobile number & 1 alternative number)
Home Mobile
Home Mobile
Off ice Fax
Off ice Fax
Email
Email
Self-employed
No
Yes
Self-employed
No
Yes
No
Name of Employer/Name of Business (For self-employed)
Name of Employer/Name of Business (For self-employed)
Occupation
Occupation
Annual Income
Annual Income
Nature of Business/Industry
Banking/F inance
Retail/F&B
Travel/Hospitality
Government
Manufacturing
Building/Construction
IT/Communications
Others, please specify
Source of Wealth
Business Income Investment Returns
Inheritance/Gift
Salary
Savings derived from
Others, please specify
Nature of Business/Industry
Banking/F inance
Retail/F&B
Travel/Hospitality
Government
Manufacturing
Building/Construction
IT/Communications
Others, please specify
Source of Wealth
Business Income Investment Returns
Inheritance/Gift
Salary
Savings derived from
Others, please specify
Planned transaction amount (Per month)
S$10,000 & below
S$10,001 to 50,000
S$50,001 to 100,000
S$100,001 to 200,000
Above S$200,000
Planned transaction amount (Per month)
S$10,000 & below
S$10,001 to 50,000
S$50,001 to 100,000
S$100,001 to 200,000
Above S$200,000
I am a U.S. citizen, resident, permanent resident, green card holder or U.S. tax payer by reason of having substantial physical presence in the U.S. or for any reason.
I acknowledge that I am aware that I need to notify the bank within 30 days of any change to my status.
1
2
1
B. Accounts To Open
Current
ATM/Phone Banking Savings
Access Indicator3
ATM/Phone Banking
Access Indicator3
ANZ SGD Current Plus Account
Primary Account
ANZ SGD Statement Savings Account
ANZ SGD Current Account
Primary Account ANZ Australian Dollar Savings Plus Account
ANZ Foreign Currency Current Account
Primary Account ANZ Progress Saver Account
(Select currency: SGD/AUD/USD)
(Select currency: AUD/CAD/CHF/EUR/GBP/USD)
Others, please specify
Primary Account
ANZ Foreign Currency Statement Savings Account (Select currency: CAD/CHF/CNY/EUR/GBP/
HKD/JPY/NZD)
Primary Account
Primary Account
Primary Account
Primary Account
Others, please specify
Primary Account
C. Banking Services
Debit Card3 (The Current and/or Savings Account selected comes equipped with an ANZ Visa Debit Card)
Name as it should appear on the ANZ Debit Card4 (Up to a maximum of 19 characters) Point of sale5 daily limit (Please select one6)
Main Account Holder
S$0
S$1,000
S$2,000
S$5,000
Account Holder 2
S$0
S$1,000
S$2,000
S$5,000
I/We do not wish to have the Debit Card
I would need a Cheque Book
I would need a Phone Banking3
Consent to Marketing Information and Personal Data Usage
I would like to receive marketing information and materials on products, services or events, provided by Australia and New Zealand
Banking Group Limited, Singapore Branch (“ANZ”) and its authorised merchants and agents, via (you may 3 one or both options):
Main Account Holder
Account Holder 2
Phone call
Phone call
SMS/MMS, fax, email and postal mail
SMS/MMS, fax, email and postal mail
By 3 this form, I consent to the chosen mode(s) of communication and agree to the Terms and Conditions stated below.
Terms and Conditions for Consent to Marketing Information and Personal Data Usage
1. My consent given here will override my registration on the Do Not Call Registry, if applicable.
2. I consent to ANZ, its agents and service providers (in Singapore or otherwise) collecting, using, disclosing and processing my
personal data, to provide me with marketing information and materials on products, services or events, provided by ANZ and its
authorised merchants and agents.
3. My consent applies to Singapore telephone numbers under my name in ANZ’s records including new telephone numbers that I may
provide or update ANZ with from time to time.
4. My consent given here shall be valid regardless of the success of my application.
I/We have read and understood the declaration and authorisation section set out in this form. I/We aff irm the said declaration and
agree and represent to the Bank to abide and be bound by the matters stated therein. By signing on this form, I consent to ANZ
contacting me via phone/SMS relating to my application notwithstanding any registration on the Do Not Call Registry.
Please specify ATM/Phone Banking access indicator for the account(s) opened under Section B.
Note : Please select only 1 account as Primary Account and the rest of the accounts will be linked as secondary.
If the embossed name for the card is not indicated in this form, the Bank shall use the account holder’s full name, subject to character limitation on card.
5
Point of sale refers to purchase of goods and services at retail merchants using the ANZ Visa Debit Card.
6
In the absence of any point of sale daily limit specif ied, a default limit of S$2,000 will be applicable.
3
4
Deposit Insurance Scheme: Singapore dollar deposits of non-bank depositors are insured by the Singapore Deposit Insurance Corporation, for up to S$50,000 in aggregate per depositor
per Scheme member by law. Foreign currency deposits, dual currency investments, structured deposits and other investment products are not insured.
2
Account Mandate
To: Australia and New Zealand Banking Group Limited, Singapore
1. I/We hereby request and authorise Australia and New Zealand
Banking Group Limited, Singapore Branch (the “Bank”), to open
an ANZ Bank Account which includes one or more account(s) of
any kind as I/we may request the Bank in accordance with this
Mandate and subsequently to open such further account(s) of any
type in my/our joint names of whatever nature as I/we request (the
“Account(s)”) in accordance with and subject to the Bank’s Terms
and Conditions for ANZ Bank Account (the “Terms”), as amended
from time to time by the Bank.
2. The Bank is hereby authorised and instructed generally, to act on
instructions given by me/us in accordance with the Terms. The
Bank may, in its discretion and on such terms as the Bank may
impose, allow instructions to be given by phone, fax and other
form of communication and I/we shall bear the risks arising
therefrom, and indemnify the Bank, as set out in the Terms.
3. In the absence of contrary written instructions which the Bank may
agree to, the conditions set out in the Terms (including, but not
limited to, those set out in the Mandate) shall apply to each and
every Account, of whatever nature, now or hereafter opened by the
Bank or by me/us in our joint names.
4. I/We have been supplied with a copy of the Terms, the Statement
of Disclosure for Joint Accounts, Risk Disclosure Statement for
Investments and Schedule of Charges and agree to abide thereby.
5. Where I/we have requested for Phone Banking Services and ATM
Services, I/we conf irm that I/we have read the Bank’s Terms and
Conditions for 24-hour Banking and agree to abide thereby.
6. I/We agree not to access Digital Banking unless I/we have read the
Bank’s Terms and Conditions for Personal Internet Banking - Digital
Banking and further agree to abide thereby.
7. In the event of any discrepancy between this Mandate and the
terms and conditions indicated in points 4, 5 and 6, the express
terms of this Mandate shall prevail.
8. I/We conf irm that I/we have been given the opportunity to consult
with my/our professional advisors before agreeing to the terms and
conditions indicated in points 4, 5 and 6 and this Mandate.
9. I/We agree that the Bank, its agents and service providers
(in Singapore or otherwise) may collect, use, disclose and/or
process my/our personal data and any information relating to
me/us (including but not limited to my/our Accounts, financial
condition and/or transactions) in accordance with the Terms and
for the purposes stipulated therein. Where personal data is to be
transferred out of Singapore, I/we acknowledge and agree that
the Bank will comply with the Personal Data Protection Act in
doing so and take appropriate steps to ensure that the recipient
of the personal data is bound by legally enforceable obligations to
provide to the transferred personal data a standard of protection
that is at least comparable to the protection under the Act, such
that the personal data is kept secure and confidential.
10. If I/we were referred to the Bank by any person, I/we acknowledge
that the referrer may receive rewards from the Bank in respect
of such referral and that the referrer may be able to infer my/our
approximate account balance based on the amount of rewards
awarded to the referrer, and I/we hereby consent to the Bank
informing the referrer of my/our account opening and of the
amount of rewards awarded to the referrer.
11. I/We hereby warrant that all the information and documents
provided by me/us in relation to this application are true, complete
and accurate in all respects.
12. I/We acknowledge that it is my/our responsibility to comply
with the tax obligations in the countries where I/we may have
or otherwise incur such obligations (whether due to my/our
nationality, tax domicile, incorporation, source of income, physical
presence or otherwise) (“Jurisdictions”).
13. I/We declare that I/we have not committed or been convicted of
any tax evasion or money laundering related offences in any court
of law or administrative proceedings in the Jurisdictions stated
above and my/our source of funding is not the proceeds of any
serious tax crime.
14. In the event that my/our particulars provided in this application
differ from my/our existing particulars in the Bank’s records, I/we
request that such existing particulars be updated and superseded
accordingly.
Deposit Insurance Scheme: Singapore dollar deposits of nonbank depositors are insured by the Singapore Deposit Insurance
Corporation, for up to S$50,000 in aggregate per depositor per Scheme
member by law. Foreign currency deposits, dual currency investments,
structured deposits and other investment products are not insured.
Custody Agreement: The Bank has arrangements with various
custodians to hold the assets (excluding cash) which you have
delivered or transferred through the Bank for custody. A summary of
the key terms of the agreements entered into with each custodian,
and/or the manner in which the custody accounts are maintained
and established has been made available for your easy reference.
This summary can be found on the Bank’s website at www.anz.com.
sg (http://www.anz.com/singapore/en/signature-priority-banking/
products-services/terms-conditions-products). A copy of the Summary
of Custody Agreements will be made available upon request at any of
the Bank’s branches.
Notif ication on Outsourcing of our Banking Services: Australia
and New Zealand Banking Group Limited, Singapore branch (“ANZ”)
may from time to time engage the services of our head off ice, its
branches, subsidiaries or aff iliates and third parties (collectively “service
providers”) for certain outsourced activities. Whether our service
providers are located in Singapore or elsewhere, they are strictly
required to maintain information security and customer conf identiality
to the same standard as ANZ is responsible for.
The laws in Singapore and other countries may require ANZ and our
service providers to disclose information relating to ANZ’s customers to
relevant authorities from time to time. The circumstances under which
such disclosure may be required are limited and include compulsion
under law, court order, police investigations or criminal prosecutions.
Signing Conditions for Joint Accounts
(Any change to the signing condition subsequently must be notif ied in writing to the Bank by all Account Holders)
Any one of us All of us
Others, please specify
Customer Acknowledgement
Signature of Main Account Holder
Signature of Account Holder 2
DD MM YYYY
DateDate
Please tick if you are a staff of ANZ
DD MM YYYY
Please tick if you are a staff of ANZ
3
D. ANZ Credit Card And MoneyLine Application
Documents Required (Mandatory)
1. Please submit the following identif ication documents that are
applicable to you and tick the relevant boxes below:
= Singapore Citizens and Permanent Residents
Photocopy of your Identif ication Card (Front and back)
= Foreigners
Photocopy of your valid Employment Pass (Valid for at least 9 months)
AND
Photocopy of your Passport AND Proof of residence
2. Please submit the following income documents that are applicable
to you and tick the relevant boxes below:
= Salaried Employee
Latest computerised/electronic payslip OR
Latest Income Tax Notice of Assessment OR
CPF Statement for the last 6 months
= Self-employed
Income Tax Notice of Assessment for the last 2 years
= Commission-based Earner
CPF Statement for the last 6 months OR
Income Tax Notice of Assessment for the last 2 years OR
Commission Statement from the company for the last 6 months
You may also submit a copy of your income documents online using
SingPass at anz.com.sg.
Are you submitting your CPF Statement online?
Yes
No
ANZ Optimum World MasterCard Credit Card
Principal : S$180 p.a. (1 Year Fee Waiver)
Supplementary : S$90 p.a. (1 Year Fee Waiver)
Minimum income : S$80,000 p.a.(Singapore Citizens, Permanent Residents & Foreigners)
Select your preferred category:
Dining & Leisure
Travel
Shopping
Groceries
Selected category will be valid for the immediate calendar quarter
(based on the date of application approval) and the next calendar
quarter. To continue enjoying 5% cash rebate7 in your preferred
category, please submit your selected category by 25th of the month
before the start of a new calendar quarter.
ANZ Travel Visa Signature Credit Card
Principal : S$200 p.a.
Supplementary : S$100 p.a.
Minimum income : S$60,000 p.a.(Singapore Citizens & Permanent Residents)
S$90,000 p.a. (Foreigners)
ANZ Platinum MasterCard Credit Card
ANZ Platinum Visa Credit Card
Principal : S$160 p.a.
Supplementary : S$80 p.a.
Minimum income : S$30,000 p.a. (Singapore Citizens & Permanent Residents)
S$60,000 p.a. (Foreigners)
ANZ Switch Platinum Credit Card
Principal : No Annual Fees8
Supplementary : No Annual Fees8
Minimum income : S$30,000 p.a. (Singapore Citizens & Permanent Residents)
S$60,000 p.a. (Foreigners)
I would like the above to be a secured credit card.
Additional documents required for Supplementary Card application
A photocopy of Supplementary Cardmember’s Identif ication Card
(front and back)/Passport/Employment Pass (valid for at least 9 months)
is required. The Bank reserves the right to request for additional
information and supporting documents (e.g. utility bill) from time to time
as required. Incomplete or unclear applications may delay processing.
Credit Card Information
Approval of the Credit Limit is subject to the Bank’s discretion and
the Bank may grant the Credit Limit in whatever manner it deems
appropriate without giving any reason. For more information on
qualifying criteria, credit card charges and fees, please refer to anz.com.sg.
(Please complete Credit Card Memorandum of Charge.)
ANZ MoneyLine9
Annual Fee : S$70 p.a.
Minimum income : S$30,000 p.a. (Singapore Citizens & Permanent Residents)
Effective interest rates are 25% p.a. for ANZ Optimum World MasterCard Credit Card, ANZ Travel Visa
Signature Credit Card and ANZ Platinum MasterCard Credit Card, and 23% p.a. for ANZ Switch Platinum
Credit Card, and interest is subject to compounding if the monthly interest charges are not repaid in full.
Principal Card Applicant
Do you have an existing ANZ Credit Card?
Please select one only:
I am the Main Account Holder
Yes
Name to appear on credit card (Please include surname)
No
I am the Account Holder 2
(Maximum 18 characters)
Personal Information
Residential Status
Self-Owned Mortgaged Residential Type
HDB
Condominium/Apartment Length of stay at address Employer’s
Years
Parents’
Rented Landed Others
Others
Months
(At permanent residential address)
Billing Address
Singapore Residential Off ice
Mailing (As indicated in earlier section)
Employment Details
Job Status
Employee
Sales/Commission-based Self-employed
Contractual
Years remaining
Address
Length of employment Years
Months
Job Title
Cash rebate will be awarded in the form of Optimum$ and can be redeemed under the ANZ Optimum Rebate Programme.
Your card remains valid as long as you make three (3) retail transactions every 12 months.
9
Prevailing interest rate: 17.88% p.a. Prevailing interest rate is the effective interest rate. A minimum interest amount of S$12 will apply.
7
8
4
Others
Basic Salary (Monthly)S$
Monthly Commission/Variable Income (Monthly) S$
Bonus/Other Income and Sources (Annual) S$
Rental Dividends Others
Name of Previous Employer (If your current employment is less than one year)
Previous Position
Length of Previous Employment
Years
Months
Credit Limit
You may choose to request for your overall preferred credit limit10 up to four times of your monthly income, or higher multiplier if your annual income is
S$120,000 and above. Existing ANZ Credit Card and/or ANZ MoneyLine account holders who are applying for an additional card will enjoy their existing
credit limit if they do not submit latest income documents.
My preferred credit limit11 (Minimum S$500, rounded to the nearest hundred)
For ANZ Credit Card S$
For ANZ MoneyLine S$
Please tick here if you would like the Bank to assign a credit limit12
Supplementary Card Applicant (Supplementary Cardmember must be 18 years old and above)
(Please select one only)
I am the Main Account Holder
I am the Account Holder 2 Name to appear on credit card (Please include surname)
(Maximum 18 characters)
ANZ Credit Card And MoneyLine Declaration And Authorisation
By signing this form, I/we hereby agree and represent to the Bank that:1. I/We ask that an ANZ Credit Card account be opened for me/us and that an ANZ Credit
Card be issued to me/us until I/we/the Bank terminate(s) the same.
2. I/We hereby declare that the information given in this application and all the documents
submitted to the Bank are complete, true and accurate and belong to the Bank
absolutely and that I/we have not wilfully withheld any material fact. I/We undertake to
notify the Bank immediately of any change in such information.
3. I/We hereby authorise and give the Bank consent to conduct credit checks on me/us
(including but not limited to checks with any credit bureau recognised as such by the
Monetary Authority of Singapore) and to obtain and verify and/or to disclose or release
any information relating to me/us and/or any of my/our account(s) from or to any other
party or source as the Bank may from time to time deem f it at the Bank’s discretion for
the purpose of this application and without any liability or notice to me/us.
4. I/We conf irm that at the time of the application, I am not/neither of us is an
undischarged bankrupt and no statutory demand or legal proceeding has been served
on or commenced against me/us.
5. I/We agree to be bound by the terms of the Mandate, the Cardmember’s Agreement,
the Terms and Conditions for 24-hour Banking, the Terms and Conditions for ANZ Debit
Card, the Terms and Conditions for Personal Internet Banking - Digital Banking, the
Terms and Conditions Governing ANZ MoneyLine Accounts and such other terms and
conditions as the Bank may prescribe from time to time, copies of which are available for
my/our perusal at the Bank’s website, upon request at any of the Bank’s branches and/or
which will be extended to me/us upon the Bank’s approval of my/our application herein
together with my/our ATM Card and/or Customer Identification Number.
6. I/We agree that the Bank, its agents and service providers (in Singapore or otherwise)
may collect, use, disclose and/or process my/our personal data and any information
relating to me/us (including but not limited to my/our Card Account and/or Card
Transactions) in accordance with the Cardmember’s Agreement and for the purposes
stipulated therein. Where personal data is to be transferred out of Singapore, I/we
acknowledge and agree that the Bank will comply with the Personal Data Protection Act
in doing so and take appropriate steps to ensure that the recipient of the personal data
7. 8. 9. 10. 11. 12. 13. is bound by legally enforceable obligations to provide to the transferred personal data a
standard of protection that is at least comparable to the protection under the Act, such
that the personal data is kept secure and confidential.
If, for any reason whatsoever, the Card Account is closed (whether by me/us, the
Bank or otherwise) within the period of nine (9) months from the date of opening of
the Card Account, I/we agree that the Bank shall be entitled to claim from me/us full
reimbursement of the cost of any welcome gift which the Bank may have given to me/
us upon approval of my/our application and/or activation of my/our Card Account. I/
We hereby authorise the Bank to debit the Card Account for the cost of such gift (as
determined by the Bank) prior to closure of the Card Account.
The preferred credit limit indicated is subject to the approval of the Bank at its
reasonable discretion. The Bank will assign a credit limit based on its discretion and MAS
guidelines when you select the option to allow the Bank to assign such credit limit for
you.
I/We as Supplementary Credit Card holder(s) agree to the credit limit that is assigned to
me/us to be the same as the Principal Card member.
If I/we have applied for Credit Card FlexiLoan, I/we agree to be bound by the Credit Card
FlexiLoan Terms and Conditions.
If I/we have applied for Credit Card Balance Transfer, I/we agree to be bound by the
Credit Card Balance Transfer Terms and Conditions.
The Bank reserves the right to terminate my/our ANZ Signature Priority Banking Visa
Inf inite Credit Card(s) if I/we do not maintain the minimum Signature Priority Banking
total relationship balance. In the event of such termination, I/we also hereby request
and apply for an ANZ Platinum Credit Card to be issued to me/us at that point in time,
subject to the Bank’s approval then. I/We also agree to be bound by the Cardmember’s
Credit Card to be issued to me/us at that point in time, subject to the Bank’s approval
then. I/We also agree to be bound by the Cardmember’s Agreement and such other
relevant and then prevailing terms and conditions which may govern the use of the ANZ
Platinum Credit Card. Agreement and such other relevant and then prevailing terms and
conditions which may govern the use of the ANZ Platinum Credit Card.
I/We agree that the approval of this application is subject to the Bank’s discretion and
that the Bank reserves the right to decline the application without giving any reason.
Disclaimer: No product or service referred to herein may be offered or sold within the United States or to or for the benef it of US Persons. Neither this
document, nor any copy thereof may be sent to or taken into the United States or distributed in the United States or to a US person. The full disclaimers
at our website at anz.com.sg are deemed to be incorporated herein.
Signature of Principal Card Applicant
Signature of Supplementary Card Applicant
DateDate
DD MM YYYY
10
11
12
DD MM YYYY
Overall credit limit def ines as the combined credit limit that is assigned to your ANZ Credit Card and ANZ MoneyLine account(s)
Please note that the credit limit assigned to you is subject to the Bank’s approval and discretion. The f inal approved credit limit may be lower than what you have indicated.
Please note that the Bank will assign a credit limit to you based on its discretion and Monetary Authority of Singapore (MAS) guidelines when you select the option to allow the Bank to assign such
credit limit for you.
5
Credit Card Memorandum Of Charge
Please complete this Memorandum of Charge form, which is supplemental to your Secured Credit Card application form.
Name of Principal Applicant/Joint Account Holder 1
Name of Joint Account Holder 2
Name of Joint Account Holder 3
Name of Joint Account Holder 4
Name of Joint Account Holder 5
Deposit Account Number
Deposit Amount (SGD/USD/GBP/EUR/AUD)
Declaration
1 By signing this form, I/we agree to be bound by the following
provisions. These provisions and the security created herein shall also
be binding on my/our personal representatives.
2. I/We agree to place and maintain a minimum deposit (in the amount
indicated by me/us in this form) with Australia and New Zealand
Banking Group Limited (the “Bank”), which I/we warrant to be free
from any encumbrance, to be used as security for all outstandings,
fees and charges which the Principal applicant may be liable for in
respect of the Principal and the Supplementary applicant’s Card
Account(s) (the “Liabilities”).
3. I/We hereby charge for the settlement of the Liabilities all sums
which have been or may from time to time hereafter be deposited
by me/us with the Bank whether in Singapore Dollars or other
permitted currency under the deposit indicated by me/us in this
form including any renewals thereof whether by way of extension
or replacement (and even if bearing a different account number/
currency type/amount) together with interest accrued or to be
accrued thereon and all additions thereto (the “Deposit”). I/We
understand that the Credit Limit to be granted will be subject to the
Bank’s discretion as well as the amount deposited and will be fully
secured against the Deposit.
4. I/We irrevocably authorise the Bank to, at any time and from time to
time in its sole and absolute discretion and without notice to me/us,
appropriate and apply the Deposit (whether it has matured or not)
or any part thereof in or towards the satisfaction and settlement of
all or any of the Liabilities whether the same is due or contingent and
whether there has been a default or not. Any currency conversion
that may be necessary will be effected at the Bank’s prevailing
exchange rate.
5. I/We agree that the Deposit is to be held by the Bank as a continuing
security notwithstanding my/our bankruptcy, insanity or death,
any intermediate payment or settlement of account or any other
matter whatsoever until such time as the Liabilities may be fully
paid and discharged and the Card Account closed. The Deposit is
in addition to and shall not prejudice any other security created
now or hereafter held by the Bank or any right or remedy the Bank
might have in respect of the same. Nothing herein shall restrict the
operation of any other rights or remedies whatsoever which the
Bank may have under law or otherwise.
6
6. I/We hereby agree and undertake that, for so long as any part
of the Liabilities remains outstanding or the Card Account is not
terminated, I/we shall not close the Deposit account and shall not
withdraw any sum from the Deposit, or assign, mortgage, charge,
pledge, transfer, or create any security interest or encumbrance
or otherwise deal with the Deposit in any manner whatsoever
nor attempt or purport so to do and I/we shall not do or omit any
act which may in any way delay or prejudice the Bank’s right to
the Deposits. I/We acknowledge that the Card Account will be
terminated if the Deposit account is closed or if the value of the
Deposit falls below the pledged amount for any reason whatsoever
without the Bank’s prior written consent. I/We understand that any
balance from the Deposit will only be returned 45 business days after
closure of the Card Account.
7. Any notice or demand for payment by you hereunder shall, without
prejudice to any effective mode of making the same, be deemed to
have been suff iciently made hereunder on me/us if sent by post to
the Principal Applicant’s address stated below and shall be assumed
to have reached the Principal Applicant within 24 hours of posting,
and in proving such service it shall be suff icient to prove that the
notice demand was properly addressed and posted.
8. The Principal Applicant acknowledges that these provisions shall
not prejudice but be in addition to the terms of the Cardmember’s
Agreement and the card application declaration.
9. This memorandum shall be construed in accordance with the laws
of the Republic of Singapore and I/we submit to the non-exclusive
jurisdiction of the Singapore Courts.
Witnessed by Bank Staff Signature of Principal Applicant/Joint Account Holder 1
NameName
Address Address
NRIC/Passport Number NRIC/Passport Number
Occupation Occupation
Signature of Joint Account Holder 2
Signature of Joint Account Holder 3
NameName
Address Address
NRIC/Passport Number NRIC/Passport Number
OccupationOccupation
Signature of Joint Account Holder 4 Signature of Joint Account Holder 5
NameName
Address Address
NRIC/Passport Number NRIC/Passport Number
Occupation Occupation
If there are more than 5 Joint Account Holders, please attach Annex 1 to this page before commencement of signing by any Joint Account Holder.
7
BANK USE ONLY
Bank Staff Conf irmation
Client signature is witnessed by/conf irmed by
Name of Bank Staff
Signature of Bank Staff
Date DD MM YYYY
Source of Account
0 – Self Solicitation
1 – Client Referral (MGM)
2 – Phone Banker Referral
3 – Overseas Branches Referral
5 – Credit Card Referral
6 – Commercial Banking Referral
CIF Number for Client Referral
N – Mortgage Referral
S – Staff Referral
Others (Please specify)
Account Opening Check
Name of Checker
Documents Submitted
Account Application Form (Fully completed and signed by customer)
Identity Card/Passport (Original sighted & copy made for f ile)
Proof of Address (Original sighted & copy made for f ile)
OMLR (Duly signed by approvers)
Income Document
WC Result
SG Check Result
Market Segment
Branch Code
Primary Off icer Code
Signature of Checker
Date
DD MM YYYY
Secondary Off icer Code
Account Creation (Branch Operations)
Main Account Holder
Are the documents completed? No
Yes
Are the documents completed? No
Yes
Is there any hit in checks?
No Yes
Is there any hit in checks?
No Yes
No
Yes
If yes, please indicate
If yes, please indicate
CIF Number of Main Account Holder
CIF Number of Account Holder 2
Debit Card Issued
8
Account Holder 2
No
Yes
Debit Card Issued
ATM/Phone Banking Access Indicator
(Note: Please select only 1 account as Primary Account and the rest of the accounts
will be linked as secondary)
Current Account
ANZ SGD Current Plus
Account Number
Primary Account
Account Number
Primary Account
Account Number
Primary Account
Account Number
Primary Account
ANZ SGD Statement Savings
Account Number Primary Account
ANZ Australian Dollar Savings Plus
Account Number Primary Account
ANZ Progress Saver (Select currency: SGD/AUD/USD )
Account Number
Primary Account
ANZ Foreign Currency Statement Savings (Select currency: CAD/CHF/CNY/EUR/
Account Number
Primary Account
ANZ SGD Current
ANZ Foreign Currency Current
(Select currency: AUD/CAD/CHF/EUR/GBP/USD)
Others (Please specify)
Savings Account
GBP/HKD/JPY/NZD)
Primary Account
Account Number
Others (Please specify)
Input by
Checked by
NameName
SignatureSignature
DateDate
DD MM YYYY
DD MM YYYY
Signature Scanning
Scanned by
Checked by
NameName
SignatureSignature
DD MM YYYY
DD MM YYYY
DateDate
ANZ Credit Card Source Code
ANZ MoneyLine Source Code
00080990VB03BH Follow up required for income documents lnput
Check
SA
No
WC Y/N
EV Y/N
WC Y/N
EX
ML
EX
CC
AM
Yes
1 000MT 5880G0BH
CO1
Input By/Date
AL
CO2
Checked By/Date
EBC
9
10
11
12
13
© Australia and New Zealand Banking Group Limited (ANZ) 2015 ABN 11 005 357 522 Item No. SGEGB080715
anz.com.sg
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