g 8'l.~~'l.o~~ · 2018-03-07 · including Bangladesh Krishi Bank to report to Internal Revenue...

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Transcript of g 8'l.~~'l.o~~ · 2018-03-07 · including Bangladesh Krishi Bank to report to Internal Revenue...

/ ~~~~~~~ ~JICi'jiSlCW'G ~

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(End of theYear)

(Annexure-I)

Bangladesh Krishi Bank.................... Branch

Ref No.: Date: .

ToMrlMrs .

Subject: Update Information for compliance with Foreign Account Tax Compliance Act(FATCA) 2010 of USA.

Dear Valued Client,We would like to inform you that US Government enacted a Federal Law, commonly known as ForeignAccount Tax Compliance Act (FACTA) 20 IO. This Law requires that all Foreign Financial Institutions (FFls)including Bangladesh Krishi Bank to report to Internal Revenue Service (IRS) of USA regarding Accountsmaintained with Bangladesh Krishi Bank by US Person or Entity: I) US Citizen, 2) US Resident, 3) GreenCard Holder, 4) US Entity or Foreign Entity (Hold a substantial ownership interest 10% or more).

Indications of potentials "US person" Status:I. Are you a US Citizen I Resident! Entity?2. Are you a Green Card Holder of US?3. Do you use any US Address?4. Have you born in USA?5. Do you use "in care of' or "mail address" of "P.O. Box address" of USA?6. Do you use any US Telephone number?7. Have you granted Power of Attorney to a person with US address?8. Have you offered Standing instruction to transfer to an account maintained in the USA?9. Are you holding a substantial ownership interest 10% or more US Entity?10. Do you receive payments source from USA (interest, Dividend, Rent, Salaries or other Annual

Periodical Income)?

You are requested to provide us information as per above data within 15.03.2016.The bank will consider youas non US Person or entity if we do not receive any response from you. If you come out as US person or entityin future, you will be liable for any financial loss incur on our part due to your non response to this letterwithin the stipulated time. If you are a US Person or entity you will have to submit W8/W9 form of IRS to ourbranch and you also need to submit written consent to us for submission of required information regardingyour account as per FA TCA to IRS. If you do not agree with as per FA TCA requirement, your account will beclosed. For further information about FA TCA you may also visit www.irs.gov

With regards

Manager

(Annexure-2)

ToThe ManagerBangladesh Krishi Bank................... Branch

Subject: Submission of update account information as a US Person for compliance with ForeignAccount Tax Compliance Act (FATCA) 2010 of USA

Dear SirIn compliance with the above Law of USA, I do hereby authorize Bangladesh Krishi Bank or any of

its branch to share my following information with domestic/overseas regulators where applicable as per USGovernment's enacted Law.

KYC as a personlUS Entity of Foreign Entity:

SL Particulars as US person/EntityI Name of Entity2 Country of Incorporation3 Country of Registration4 Name of Individual5 Father's Name6 Mother's Name7 Spouse Name8 Date of birth9 Country of birth10 Country of Living/ResidenceII Nationality12 NIDNo14 E-TIN No15 Religion

Permanent Address16

Telephone NoMobile NoE-mailPost/Zip Code

18 Address in USA/Abroad

Telephone NoMobile NoE-mailPost/ZIP Code

19 US TIN20 Social security No/Green Card No

21. Answer as per your quarries:

a Are you a US CitizenlResidentiGreen Card HolderlEntity? Yes Nob Have you granted power of Attorney to a person with US address Yes Noc Do you use any US address "in care of' or "mail address" or "PO Box Yes No

address", Telephone Number?d Have you born in USA or Offer any standing instruction to transfer to an Yes No

account maintained in the USA?e Are you holding a substantial ownership interest 10% or more US Entity? Yes Nof Do you receive payments source from USA (Interest, Dividend, Rent, Yes No

Salaries or other Annual Periodical Income)?If yes, please provide us IRS Form:W-9!W8-BEN E(Form may be collectedfrom website.www.irs.zov)

I1We hereby acknowledge that the statement given above is true and correct. If this statement is identified asfalse, l!We hereby consent Bangladesh Krishi Bank to treat the account as per the direction of FATCA.I1wealso agree to undertake to notify Bangladesh Krishi Bank within 2 months if there are any changes in theabove.

Signature of AIC holder:Name:A/CNo:Address:Date: