E-mail: pensions0)sltnet.lk
Web site: www.pensions.gov.lk
Telephone2329580232043924344142431612
Amendment to the Circular dated25.09.2,009
PolicyForcesComputationPayments
Fax243221423323472342525
Telephone2332346232437523425252329178
W&OPP5PFL.G.U.Registration
~~)@ aogd G~a)t5e5)(~@e55~a~ tiJ61!,~tiJt6;;"~ 6lD6OOT8id>6TTLDDEPARTMENT OF PENSIONS
UlIr61~ffirr6lJIii6<ll1bGIfW6\Ja;W, UlIT~a;rT6lJIii6<llIb,Ga;[email protected] 10. Maligawatte Secretariat, Maligawatte, Colombo 10.
Fax2342078234207823914032329634
Telephone2431647243200824349742329634
Pension Circular 16/2009 (Amendment)
Heads of Overseas Missions,
District Secretaries,
Divisional Secretaries,
Bank Managers,
Pension Circular 16/ 2009 dated 25.09.2009 issued under above heading is repealed and this
circular is substituted.
(a) Background to the payment of overseas pension
PAYMENT OF PENSION TO SRI LANKAN PENSIONERS RESIDENT ABROAD
Nearly 25,000 Sri Lankan pensioners are living in foreign countries and most of them are in
Australia (including New Zealand) India, Canada, United Kingdom and United States of
America. Also a considerable number of pensioners are living in Middle East Countries and
Western Countries.
Several reasons have been caused for Sri Lankan pensioners to reside in foreign countries, such as
return of English officers to their homeland after serving in Sri Lanka, migration of Sri Lankan
officers to foreign countries after retirement on official language policy, ethnic crisis and
migration of pensioners to foreign countries to live with their children.
Various methods during recent past were followed by the Department of Pensions in order to pay
pension to Sri Lankan pensioners resident abroad. Payment methods such as through Crown
Agent Pension Units in United Kingdom, Pay & Accounts Office in India and Sri Lanka overseas
Missions were adhered while considerable number of pensioners reside abroad were used to draw
pension through bank accounts maintain in Sri Lanka.
Director GeneralDirectorDirector (F)
Internal Auditor
- ....
-........•
Nevertheless the fact that many pensioners live abroad the Department of Pensions had
no details of most of them. Furthermore the payments have been made during past
without any due method or management. Number of cases such a.s pensions of overseas
pensioners had been drawn by other persons through joint accounts was revealed. Having
considered these matters the Department of Pensions has decided to reorganize pension
payment methods of Sri Lankan pensioners resident abroad.
(b) New method of payment of pension to Sri Lankan pensioners resident
abroad
Decision was taken to cancel payment of pension through Crown Agent Pension Unit in
United Kingdom and Pay & Accounts Office in India. The method of crediting pension to
a local bank account in respect of pensioners living abroad will be further formalized.
Decision has been taken to pay Civil Pension or Widows' & Orphans' Pension to
pensioners resident abroad in accordance with following procedures under new method;
viz. through Sri Lanka overseas Missions or through a special bank account in a local
bank. Further, facility will be available to draw pension via Divisional Secretariats
subject to certain conditions.
01. Payment of pension through Embassies/ High Commissions of Sri Lanka
This payment method will be restricted for 5 countries such as Untied States of America,
United Kingdom, Canada, India and Australia. Pension will be made only through a
selected Sri Lanka Mission in those countries. Accordingly, these payments will proceed
through Embassy of Sri Lanka in Washington DC, High Commission of Sri Lanka in
London - United Kingdom, High Commission of Sri Lanka in Ottawa and Deputy High
Commission in Toronto - Canada, High Commission of Sri Lanka in Canberra -
Australia and Deputy High Commission of Sri Lanka in Chennai - India. Payment of
pension through Consulate General Offices in those countries will be cancelled.
Pensioners in New Zealand will be paid through High Commission of Sri Lanka in
Canberra - Australia. Pension will be paid in compliance to the following instructions.
2
1. Pension file for each country will be created and maintained by this department.
Said payment files will be dispatched to above paying Missions monthly. Embassy/
High Commission should pay pension refer to the file.
11. Pension will be paid by the Mission subject to the verification of pensioner's
survival and receipt of life certificate. These payments can credit to the bank
account of respective pensioner. Payments through cheques will be further
permitted only if there any issues of crediting pension to bank accounts.
111. Instead of providing allocations to each Mission the whole amount required for
pension payments will be released to the Ministry of Foreign Affairs monthly. The
ministry will take action to send the required money to the relevant Embassy/ High
Commission monthly. Accordingly it is possible to pay pension to overseas
pensioners at the same date when the pension paid to pensioners in Sri Lanka.
IV. Each Mission should send respective monthly payment details to the Department of
Pensions.
v. Pension payments maintained by Embassies/ High Commissions/ Deputy High
Commissions are cancelled and payments should be done only in compliance to the
monthly payment file created by this department.
VI. It is compulsory to send duly completed Data Entry Forms (through the Mission) by
all pensioners and entering Sort-code of the bank account would be more helpful for
prompt payment.
3
F---General instructions to Missions to making payments
1. Monthly pension file will create by the Department of Pensions and will dispatch to
Missions from January 2010. Said data will be available on official website
www.pensions.gov.lk.
11. Pension should be paid in compliance to the monthly pension file created monthly
by the Department of Pensions.
lll. Information provided by pensioners via Data Entry Forms will be used to create
monthly pension file. Pension of the pensioners who had not submitted information
will be temporarily nullified. Those pensions will be paid together with arrears from
the immediate month after receipt of information. Action will be taken to inform
relevant changes to the Mission. Therefore, all pensioners resident abroad should
compulsorily submit their information to this department via Data Entry Forms.
IV. Pension should be paid subject to the satisfactory of pensioner's survival. Life
certificate should be collected at least quarterly to get verification of pensioner's
survival. If there is any obstacle to collect life certificates quarterly should be
collected at least once in year.
v. Payment of penSIOn shall nullify in terms of Minutes on Pensions due to
imprisonment of a pensioner. This condition is applicable even to overseas
pensioners and pension of such pensioners should be nullified accordingly.
VI. Heads of Missions are free to create Life Certificate in compliance to Annexure 2 or
as they preferred. However the Life Certificate should be certified by a suitable
officer. Accordingly an officer in Mission, Chief Incumbent or a Priest of a religion,
officer in Army, Navy and Air Forces migrated from Sri Lanka or any other
government officer, Doctor, Engineer, Accountant or Notary Publici Justice of
Peace or a person accepts by the Mission are eligible to certify the life certificate.
Ratification by a pensioner himself is adequate, if the pensioner personally call over
the Mission to submit the life certificate.
4
vii. Verification such as the pensioner has not remarried is required to the payment of
widows' pension. An affidavit should be collected from the widow/ widower once
in each year together with life certificate to verify whether not remarried.
(02) Payment of pension through approved special bank account
All pensioners resident abroad are given opportunity under this method to open a special
bank account at a bank in Sri Lanka and to get credited monthly pension to the account.
i. This special account can open at People's Bank - Queen's Branch where the
Department of Pensions maintained its main account. Facilities are available for
pensioner to open this bank account having arrived in Sri Lanka or while in
overseas. This facility will be available at the BOC - Metropolitan Branch from
March 2010.
ii. Pensioners are required to submit duly filled Mandate form, Affidavit, Letter of
Consent in order to open this account. Documents submitted by pensioners while in
overseas countries should be ratified by Ambassador/ High commissioner or an
assigned officer at the Mission. The application will be certified by the Department
of Pensions, if the pensioner arrived in Sri Lanka. (application forms to open bank
accounts can download from the websites of the People's Bank and Bank of
Ceylon)
iii. Conditions are applicable to these overseas accounts.
Maintaining joint accounts or ATM cards are not allowed. Money of those accounts
can withdraw by pensioners themselves after arrived in Sri Lanka.
iv. Money in these accounts can transfer to other accounts. Accordingly the relevant
request should be forwarded to People's Bank (Manager, Quean's Branch) / Bank
of Ceylon (Manager - Metropolitan Branch) as per the specimen.
5
- .. ,,-
IV. Pension will be directly credited to pensioner's bank account and pensioners are
required to submit life certificates to this department once in each quarter. Life
certificate in each month should be submitted to the bank branch if the money
transferred to other accounts.
v. This department will take action to instruct bank officials regarding payment of
arrears to heirs after the death of pensioner.
(03) Payments through Divisional Secretariats
Pensioners visiting foreign countries for a short period should inform the Divisional
Secretariats. Those pensioners will be given opportunity to temporary nullifying their
pension until they are arrived in Sri Lanka or to draw pension through Divisional
Secretariat. When the pension paid through Divisional Secretariats for pensioners
resident abroad it is required to identify whether pension is paid to correct pensioner. All
pensioners are required to submit life certificates to the bank where they draw pension
and the Divisional Secretariat. Payment of pension shall nullify if the life certificate has
not submitted. All pensioners resident abroad are compulsorily required to submit duly
filled Data Entry Forms. Persons visited abroad for employment and attached to overseas
armed forces, pensioners hold dual citizenship and pensioners with Sri Lanka citizenship
are further paid pension through Divisional Secretariats. Approval from this department
should be availed for such payments.
In terms of the Minutes on Pensions and Widows' and Orphans' Pensions Act, the
pension cannot entrust to any other person. Therefore pensioners cannot open accounts to
credit pension to the names of persons hold their power of attorney or any other.
6
Fore:gn pension branch of this department can contact through following m~ans.
l
Address : Assistant Director, Foreign Pension Division,Department of Per ISions, Colombo 10, Sri Lanka.
Tel. ~:-.Jo. :+94 11 3 0305111 3 030512Fax No. :+94 11 2 342078e-mail address:[email protected]
foreignpensions@gmai!.comSkype addresS: fpensions .
04 Payment of pension to IOi:algovernment pensioners resident abroad!
(Thi~;is an substitute to the Pensicn Circular 16/2009 (3)- Local Government)
Payment of local government peLsion and widows' & orphans' p(msion is centralized tothe Department of Pensions. Thc:efon~ local government pensioners resident abroad arenot paid pension through Divisiolal Secretariats in future. Accordingly th,~pension willbe paid through,
4-1 Embassies / High Commissions of Sri Lanka
4-11 Crediting pension to specill bank account.Previously mentioned instructions should be followed for the paym ent of pensionunder these methods. Accordingly the data entry forms should be fo::warded to thefollowing address.
Chief AccountantLocal Government Pension Division.Department of PensionsColombo 10Sri Lanka.
Tel: +94 11 2 342525/ +94 1I:2 342526Fax': +94 11 2 342078 i
K A ThilakaratneDirectclr General of Pensions
Copies to
1. Secretary to the President
~:. Secretary to the Prime Minister
.3. Secretary to the Cabinet o::Ministers
4. Secretary - Ministry ofPuJlic Administration and Home AlTairs
5. Secretary - Ministry of Fillance
6. Secretary- Ministry of Fcreign Affairs
7. Auditor General
7
2 CertifiedPassport sizePhotograph
Data Entry Form of Pensioners Resident Abroad(FiH this Form using with only Block Capitals)
I Resident Country:
Fill in where Applicable
01. Personal Details of the Pensioner
i) Pension Type
ii) Pension Number:
CivilW&OP
ForcesLocal Government
iii) W&OP Registration Number
iv) Widows'IOrphans Pension Number: crrrTTTI(Only if drawing W&OP at present)
v) Last Name with initials:
vi) Name using for pension purposes
vi) Names denoted by Initials
Country
I
viii) Details of Permanent Resident:
a) Permanent Resident Card No :
b) Foreign Passport No :c) The Date received of Permanent Resident: D DIM M I Y Y Y Y
d) Whether have dual Citizenship: DYes 1__ INod) If so Address in Sri Lanka:
1own! Llty
Post Code I Telephone:
ix) Sex: Male: Female:
x) Date of Birth: D D 1M M I Y Y Y Y
xi) National 10 No (Sri Lanka):
xii) Civil Status: MarriedBachelor
WidowDivorced
xiii) The Period Resident abroad: Years Months Days
xiv) E-mail:
xv) Web Address:
xvi) Telephone No :
xvii) Fax No:
II
I) Is Spouse Living Yes No
II) Full Name of the Spouse:
III) NIC Number of Spouse :
IV)
V)
Permanent Resident Card No :
Date of Birth of Spouse: DD/MM/YYYY
VI) If Spouse is living in another place or in another country ( Give Details)
03. Details of Dependents.
Name Date of Birth Sex Civil EUDDDIMMIYYYY (M/F) Status (MIS)
Last Name First NameI2345
Sex:Civil Status:
M -MaleM - MarriedE - Employed
F- FemaleS - SingleU - Unemployed D-Disable
04. Pension Payment Details - Procedure of drawing pension at present
I. Present method of drawing pension
High Commissioner
Embassy
Consulate General
Sri Lanka
DDDD Bank & Account No. If a joint account, name &
address of the account partner I~ _
III
F:------
.. II. The address of High Commission or Sri Lanka Embassy which preferred to draw pension.
•
05. Particulars of Banks which pension is to be paid abroad.(for pensioners draw pension throughforeign missions)
CountryBankBank BranchAddress
Account No.(overseas)E-mail Address of Bank BranchWeb AddressFaxNoTele hone No.
06. If a special account at People's Bank - Queen's Branch or Bank of Ceylon - Metropolitan Branch was
opened,Account No .(Facility to open an account is available for pensioners who have not opened above account)
07. Month and Year of which the pension drew for last .
N.B. Please read updated Pension Circular 16/2009 (Amendment)
09. Data Entry Form should be supported with following attachments1. 02 photographs in passport size2. Photocopies of passport (photograph affixed page and visa approved page)3. Certified copy of citizenship or permanent resident card4. If prefer to draw pension by bank account at People's Bank - Queen's Branch or Bank of
Ceylon - Metropolitan BranchAccount Opening Information FormKYC (Know Your Customer) Profile FormLetter of Consent
5. Ifa widows'/ widowers' & orphans' pension, Widows'/ Widowers' Declaration Form
Signature of the Pensioner.
(Pensioners resident abroad should furnish this form through Sri Lanka Mission abroad)
IV
I declare that Mr/Mrs ................................................................ placed his/her signature before me this. . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . day 0f at
Name
Signature of Attester(Authorized officer of the Mission)
Designation
Address
Please send above details to reach below address.
Assistant DirectorDepm1ment of pensions,Foreign pension Branch,Colombo 10,Sri Lanka
TelEmailFaxWebSkype Address
: :+94 11 3 030511/ 3 030512: [email protected]; [email protected]: +94 11 2 342078: www.pensions.gov.lk: fpensions
•Duly filled forms of Local Government pensions should forward to reach at:
Chief AccountantLocal Government Pension DivisionDepm1ment of PensionsColombo 10.Sri Lanka
•
TelFax
: +94 11 2 320439: +94 11 2 342078
K A ThilakaratneDirector General of pensi ons
1) Please logon to www.pensions.gov.lk for downloading this form.
2) If both widow and widower are pensioner should fill two copies of this
form.
3) Not sending of this form shall liable temporary discontinuation of
payment of pension .
v
•
•
•
IN CASE OF WIDOW/ WIDOWERS PENSIONPART 1
AFFIDAVIT
Mrs/Mr. .
HEREBY SOLOMNLY, SINCERELY AND TRULY MAKE OATH and state as follows:
1. My maiden name as per my birth certificate.
2. After my marriage I use my name as.
3. My other names.
I confirm and declare that the statement contained in this affidavit is true to the bestof my knowledge and belief.
Signature.
Sworn at '" .On this .
Before me,
VI
."
., PART IIWIDOWS / WIDOWERS DECLARAION
I, .(Full name)
of .(Address)
do solemnly and sincerely declare that I was born on .(Date of Birth)
that I married the late ,(Full name &designation of husband/wife)
................................................... on and I remained his legal wife/husband(Date of marriage)
until his/her death on at and have not since legally or customary married(Date of death) (place of death)
and that my deceased husband /wife has left the following .(Number of Children)
children, the issue of this marriage
Name of child Sex Date of Birth Date of If dead,marriage * # Date of Death
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
....................................... ............... ................ .................. ....................
* If exact date is not known give year in which event occurred.# To be filled in only child is a female .• 2. Whether had any previous marriages, if so,
i. Marriages .ii. Children .
iii. Guardians .A report should be attached
3. I make this solemn declaration conscientiously believing the same to be true.
Date: .(Signature of widow/widower)
•
Witness:-( I ) Signature .
Designation .
(2) Signature .
Designation .
+ Delete which is not applicable.
Name & Address .
Name & Address .
VII
." .
•
•
•
LIFE CERTIFICATE
To Whom It May Concern:
Full name of Pensioner: .
••• ••••••••••• •••••• ••• •••• ••••• ••••••• ••••••••••• •••••• I ••••••••••• "" ••••••••••••••••••••
Pension No.: .
Signature of pensioner: .
I .(Please print name)
Of .(Please print address)
••• I •••••••••••••••••••••••••••••••••••••••••• 1 ••••••••••••• 1 ••• I ••••••••••••••••••••••••••••
(Please state profession)
Hereby certify that .(Please state pensioner's name)
•••••••••••••••••••••••••••••••••••••••••••••••••••• I •••••••••••••• II ••••• I ••••••••••••••••••
Of .
•• 1 •••••••••••• 1. I ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• I' ••••••••••
Whose signature is affixed above was alive on the day of 2009 .
•
Date . signature .
VIII
..Letter of Consent
This letter of consent is to be submitted by pensioners resident abroad regarding methodof drawing pension.
1.1 Full Name1.2 Neme used for pension
2
3
4
Pension or W&OP No.
3.1 Resident country &Address of pensioner
3.2 Telephone Number3.3 e-mail address
Address in Sri Lanka(if any)
5 Bank Account Number .(Account number at People's Bank - Quean's Branch/Bank of Ceylon - Metropolitan Branch)
Conditions
1. Savings account should be maintained as a single account.2. ATM cards should not be used.3. Subject to the conditions of Director General of Pensions.4. Consent of the Director General of Pensions should be availed to release money
in the account at a situation of paying money to heirs after death of pensioner.5. This account will be used only for crediting pension. Other deposits to this
account will not be accepted.6. Instructions of Pension Circular 16/2009 should be followed to transfer money of
this account to another account.
I declare consent with subject to above conditions to open a savings account at People'sBank, Quean's Branch or Bank of Ceylon, Metropolitan Branch, for pension purposes.
SignatureWitness
1.2.
Recommendations of the Director General of Pensions:-
Signature & Official Stamp
IX
j
Transfer of pension of overseas pensioners to another account
Manager, People's Bank, Quean's Branch, Colombo, Sri Lanka.
Manager, Bank of Ceylon, Metropolitan Branch, Colombo, Sri Lanka.
1. Name of Accountholder:-
2. Foreign Address:-
3. Telephone No.:-
4. e-mail address:-
5. Pension No.:-
6. Bank branch:-
7. Account No.:-
Kindly requested to transfer an amount of Rs. . (by number),
Rupees (in words)
from the special account No which I maintained
to draw the pension to the account No at
................................................. . A duly filled Life Certificate is submitted
herewith.
• Date: .
Signature
x
esJ!;@Je5JJesJo~ecs5eesJut::le5JMANAGER'S INTL
6l!;C;:))O eE:l~J {foesJr:JOFFICER'S SINo
1;.5)~/Date
@~@ {fof:S)r:J/A/C No.
(S,l)(i) {fof:S)r:J/BRANCH No.
I :. ".'~- - -,.~,_.-~::~~~~ - - - - - ;o~:~~o-~:-:~;~~-i:-~~m;-i5)(-~-~-c-)):~~m~;~~::~~:al~~m~)- . PEOPLE'S BANK (2006 {f!ot:5J 6 e6dxJ @@ZJ (5)(2J@jegj] tJJbt:5JJ 638@j@ CH5Jt:5J{f!gj]tJ (f!tJ(5;}ZJt:5JJtJC563)'It (Requirement in terms of Financial Transaction Reporting Act NO.6 of 2006)
PF 0300A S/E Rev. Dec. 2007.e
ee
•
(cr) GeiJJum - crwrnoS3 lil@Gl ~6ml5)m crL(!2~eJ 15lS3g~G.l@GlmGro ~@eiJ GI5lJ6(!26LSection (A) - Basic information of the individual including of those with Power of Attorney
ttt;J(J @CJ)JytJ@ ( "') @&pmJ @c:JJt;eDeD ( "') Tick the appropriate boxes
I. Cll~e~~esJo~ecs5 t::lw~bill:J e5J@JFull Name of the Customer
Cll~e~~esJo~ecs5 @8e5Jc.:lAddress of the Customer
2. ~ZlJeJOec,; E:l~e5JJ~c.:l({f~ernJrn) 3. ~arnffic.:l/cx.ISJc.:lJ~/rnrnrn~c.:l ; INature of business (if any) Occu pation/EmploymenVStatus
4. ~0ill:J rne5Jqjo 5. eE:l~J ec.:lloesJc.:lJecs5e5J@JIPosition held Name of employer
6. ~O~~Se5JJ~c.:l O@@Jo6esJ I 0 t;Elrn~ ~O~~Se5JJ~c.:l t::l6\rn @@JolSJesJI 0 Clet;Cll ~O~~Se5JJ~c.:l t::l6\rn @@Jo6esJ o Elet;iilesJec.:l1:1lCitizenship Sri Lankan Sri Lankan with dual citizenship Sri Lankan with foreign citizenship Foreign national
OJffic.:l 1~t::lJ ~bCllc.:l I IesJ<9@l:1lrn~e5J~e5Jc.:lNationality Type of Visa Expiry date
7. Elet;Cll @8e5Jc.:l({f~ernlrn) IForeign Address (if any)
(qJ) GeiJJum - q'S3eJJOGlOOenlZJeJ/Section (B) - Mandatory Checks(ft;Jt; et:J)}yCJ@( ,;) @~2l'J e"'}t;~ (,;) Tick the appropriate boxes
1. [email protected]~e5Jc.:lt::lC5lOJffic.:l rn~o~ esJO Cll~Si@J/Name, Date of birth and Nationality verification
~ell ~ell ElbCllc.:l t::l~C5lJ(eC5lrn 1 t::lC5l2) eC5lrn ~elleEle5J 8GCllrn @8 e<9liJe5J~esJell @JCSle55rn~o~ Elc.:l gqjc.:lTo be supported by one of the following accepted documents for each category (1 & 2 below)
0 OJffiesJ C5l~~~@ern 0 C5l@~) Si!; eE:lEl) esJJwrnNational Identity Card Official Armed Forces Service Card 0 eEle5Jrn (ElE:lrno l;.ellEle55e5J)
0 IiJJ@Elc.:lQesJo~Ele55Cl~C5l) coe~e55e5JClC5lffiesJc.:l 0 El\!lt;Cll (l)@Je55liJ@e~c.:l Others (specify)Birth Certificate for minor Passport
2 . @8e5Jc.:laJC5l~O~ esJO Cll~Si@J/Address verification
e~oEl @8e5Jc.:leC5lrn ~elleEle5J 8GCllrn @8 e<9liJe5J~esJell @JCSle55eoell~J esJO aJC5l~O~ esJOCllrngC1)c.:lResidential address verified and supported by one of the following accepted documentso OJffiesJ C5l~~~@eaJ o OOI!lc,; {fwesJJOc.:lISJe55@8c.:lell o eEle5Jrn lll~01:1l(;;lesJJClle5J
National Identity Card Letter from a public authority Statement of other Bankso eJoeC5llCSlesJ~~O05 o {fJ<;)c.:l@1iJ~ @~ern/aJelleE:lo~ ~e55~i o Elet;Cll Cll@Je55liJ@e~c.:l o @lEJe5Jo\(&fulo ~tl"flelle5J)(ElclaJo ~ellEl e5J)Utility Bill (specify) Income Tax ReceipVAssessment Notice Passport Others (Specify)o Oc.:l~O~ lll@~c.:l o I!IE:lElJSigellrn CSl~g@J o 1:1l@CSlElg@JDriving License Employment Contract Tenancy Agreement
* mL@mlCl!1l(!2~. 1 ml5l 2. q'~I5l@ Gluo!ll 8uo!ll "~(ijOI5l sgeJJ" ~~f) m6)l5lf) 6~eJJG.l15l!1l(!2Gl* N.B. Under Item 1 & 2, a copy should be held & stamped "Original Seen"
(!olD@'Ot:D"lD ~(j(J(Jj fI))OID/fJ(JlD)(juJ~/No Mobile phone bills are accepted
3. e~oEl @8e5J\!Ic.:lffiaJ0505Elc.:l: OO~c.:l Status of the Residential Address: Premises
0 6\@esJo~ (1:1) 0 el;.@JJ8c.:le55l!1cs5({fl) 0 lll~/I:1l@ (ff~) 0 Si@ (fft)Owner (A) Parent's (B) Lease/Rent (C) Official (D)
0 @Q)C3e55/e5J~~tC3e55(@) 0 <illiJlaJ@J/e5JElJaJ~e55<ileJ@(0)Friends/Relatives (E) Board/Lodging (F)
elM @8e5Jc.:l/Permanent Address ({f~-O Qillle55(;)ec.:le55/lnthe case of C-F)
4. (;)e5J~ Q~C5l) ffc.:l~@esJo~ec.ll8l@esJ@I/Applicants' ownership of wealtho eeiEJJSesJet;e!; 0 @@Zl El05esJ@ 0 ElZlJeJoesJeO~c.:le55 0 ffJ<ilc.:l\Oe5J 0 <il@\Db 00 o~ (&fulo ~tl"flelle5J)Residential property Financial assets Business premises Investments Motor vehicles Others (Specify)
(<il~e@ f:iJ@/IJJ~ @l0l e5J@esJo,ill:JJeEJe55Q~C5le55esJoe55e5J/ifproperty is on rent/lease, please indicate)
,5. Qell(.') @teQlell @@lQl : Oell(.') @teQlell @lbCSle@lellElII;.? Source of wealth: Wealth generated from
0 El13lelOI:ll B3wl:ll@ 0 CQt@(.') .0 erle(.')!Oell 0 Ela05fD(.')/QU~j(.')lEl 0 eElell05 (~e5OlQ I;.l:lIE>05ell)Business ownership Inheritance Investments Profession/employment Other (Specify)
6. QwQl05(JOl @Elell05El13lelo/Ela05fD(.')I:llDgq)/ Other connected Business/Professional activities
.
erll;.l(.')@Ql!;, @SeCSlI~ erol:ll(.')I [ )Income Tax File No.
7. ~05ElI el;.ell @~e!Vlntroduced by
ell@/Name I@Sell(.')/Address
OlfDl:ll eDt~~@e05 erol:ll(.')/NIC No.
<il~w erol:ll(.')/Account No.
(OoCSl@<il~@ Clf;.eDll;. erElI;.)el)@el;.ell@ I:110CSl05~e~Cll(.')l:lI @Ol ClllQlI 1:ll@@elllI:llQteCllereo@Ol(.')eo~ eElell05 S(.')~@ <il~@ Clf;.eDll;.@@(.')er&lb(.')(.').Mandatory for Current Accounts for all other accounts at the discretion of the Branch Manager on a risk based Approach)
............................................................. .............................................................CSl~el;.~I:llQteCll er05Qell l:,ell(.')Customer Signature Date
Qlt0l:ll i5l@OIOOltelleCll ell@ IName of Bank Officer
............................................................. .............................................................Qlt0l:ll i5l@OlOOltelleCll er05= ~ell(.')Signature of Bank Officer Date
8. I;.el!elll Qtl:ll I:llDgq) I:lle5OlE>l~@tC3e5q)E>1:lleeD! ereJO)el)(.')D@l:lI~ eeJell05@tC3e5q)ElI:llCSl~el;.~I:llQteCll 0 ooeJ 0 elltOlell@ Q~eDel! eJel!eel!l;.?I Does the client appear in the known suspected terrorist list or any other alert list? Yes No
9. CSl~el;.~I:llQt eeD! lil~eCll e~e@ fSlS(.')@Qwe Ql@181:ll(.')1:lle~Cllel@/5) eJClle(.')el!erellleJaOl~ g~CSl@(.')el!I;.? 0 lil~ 0 elltOlIs the client or any member of his immediate family is a Politically Exposed Persons (PEP)? Yes No
lil~ ell@ I:llQt0JlI:llQ ~e50l0 I;.l:lIeJel!ell/lf "YES" - Please Specify
10. eeJell05 ~e5OlQ/erl;.eDe5/QDeDel!(erteOll05) lather Details/Remarks/Notes (if any)
Designed & Printed at People's Bank Printing Section
•..
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..•... {5jS]&J !>e>am msOo5' «Jm~5'em ~ffiet»O~~ (5liZ:l~- dtn g~(5)@ CD) Ql~G) GjPEDPLE'S... - lriBIDIllillllri ~JJJiIlJ1uU!liliJlrinlll UIJ&uJiI CIJ'u9itll~ lIi!llll'~~ - 1/iGlJi1lJjWT lDiI~ID <In.L$ · BANKACCOUNT OPENING FORM Savings Accounts - Individual & Joint . ,. ,.
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~= 0 0 M M V V V V lj)totllCil~ g<!lQIOellQ Qt;./S»)/"'"",J;J~ozir LuSw.,.,i~"@i Ul.,i,tluui/Bank Use Only
iCI"iCI Account I I I IDate Number
l:Dt;@/SJ)l:D6t/(y',. • ..,UlUJ••• 1r/The Manager elF Number
@evo/SJ IiJtotll~/u>';'q,6ir "Jf,;,,J;J/People's Bank 1.
I I....................................................................................................... 2.,&>6li3t'ffiOe~ffi~&D @CilGi/~oeGi ~elI/~~@elI ~elaCl 0000IbW"l Go",~ ,,,,,r.'!>I/6rlD~ ramn",/Q.,wirq,6fiI", SifL/lU4i, ,....,8iQq,.ozir"'jD ~uUil';'''''I';' 3. Manager's IntI.Please open a SAVINGS account in my/our name/ s.
0 QJ@lellI:l/"Ib'u_/Normal 0 Sg ~/5Je; •...Ib••• /Sisu Udana 0 o.lelleQldeiJ@~"/(!J>Ib~ lMo1llI D~(SJ@'Ib<lnj6UiJ 0 O!QeoltD/"''''lAJiJ 4i>1b"';'.Investment savings Individual . Pass Book
0 ~c/~ mwnan~aya 0 QJ@k lj)~/"Ib" UfIIJIlUJUl'I'lWUIb0 Yes ~/Yes,._i.@/YesAcc. o ~Q/e..L.(r;noint 0Normal Minor ~ Cr3JXS>ell/o/Juqi,I1ft$JmJ0 eJ8ItDl !:JlC>eDl/",.IfiIb'<>II'''''' 0 ~~/tiJ"r!!>""Ib"" 0 e&DdJ/GrumJ/Other.................. ;......Vanitha Vasana IsuruUdana (~ ~/~J •••••••/Specify) Statement
(1) !WlC1l0t Q(i)£l) ell@ (@/S)tDl/@/S)~/f!@/S)~/ ..•.............) / (!J>1b'"6T~~" Q.JW'r (~/fJ<!!,tofi/Ge.u.fJ/ •..•••......•..•) / Name with Initials (Mr/Mrs./Miss/ •....._ ....•.)
@@C1lOtEl@elI~elIe&5J ~/CSPIb" 6T~i,e;","", ~~ Q.JW'r,. •• /Names Denoted by Initials
i~ Elbcs:>c/~ ~ ....."./IDType ~ qor=/.-:uw6IT ~ tiJou./ID No. ~O.tll. ~/ •. MI tiJ•• /Tel.No.c0a5 ~6lQ/~1b ,1Je;~/DateofBirth
I I I I I I I I I II IITIITIIIJII~0&=1- _/P_~'Add~
E~~[o<) I I I I I I
0Ul\Q~ <3<Sll~<ll&:> D~ -llj (~h ~ &lU>,!PI ~Initial Deposit ( .) Occupation or Profession
IJ(GJ t!lJi!/lJllfJdl82d86Sf: DtJJf1)d/~,s~ -J#<'5tiuGNfflitHu,mgi/Jolnt Account Holder's Details(2) ~","""l5l(!) (!!JfsxD)/~/~/ __ I/C!P".,~GWr(~IA!!PIJIfd.o.iIl __ ) (3) ~"'""" l5l(!)(!!JfsxD>/~/e&lfu/ __ )/~~~ GWr(~IA!!PIJIfd.o.ti/__ )Name with Initials (Mr/Mrs./Miss/ ...............) Name with Initials (Mr/Mrs.fMiss/ ...............)
j~@'llO' eJ@ffi ~~ ~/c!p~ "~, ••••",,i> ~~ ~/Names Denoted by Initials !il@tllO' ~ ~~ ~/c!p~;" "~I"'''''';''Ibfl~;, GWr •.•• /Names Denoted by Initials
r j~~~ ~~~
I~SlnLtW6l'l' ~ ~".,. &l6nJUT61T ~ ~"""10 Type IDType
•~~ ~/.-um"' •••:.<L ~"" lID No. eoell e.ellCl/~!VJi;1b~,.~/DateofBirth ~~ ~/.-um'" ...:-- ~"" lID No . eoell e.ma>/ 61!VJi;1b~,.~/Date of Birth
1111111= I I I I I I I =JcXlO @&lc/Jf'JJj;Ib~ (!J>"'l.OI/PermanentAddress cXlO @&lc/~iElbu (!J>"'l.Il/PermanentAddress
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IClttiic>lO••••1 ~.alffico Clttiic>lO••••1 ~.alffico~~.:!J'l.J.'i611 ~' ..••....~ .,..nOccupation or Profession .Occupation or Profession
£:lIllOcDOIll !j)llt6tl Iti'!!l' Cl'l:,lll) Cll!lIJ!l/@i5aiL~ 'nl'uqi 5IUi~~i~ II)LI5Ii>/Only for Investment Savings Account
",telIoo> ~@ (Ot')/"''''lAJi> Glib'''''' (~)/DepositAmount(Rs.)= ........ _-- ...._--_ ......_ .................... __ .........•.....................•.•.................... _-_ ........ _ ...................................................... _ .........._ ............(t:r~/G<>.ti>,..mtMin words)
IllU5Ioo\ tll@9t1l t:rlt:lllOC ~~0
eeQll!llS~
0~ (coc;,«>e\ ",C<ll<o lil~(lj~t:llm@ coa5 e.6lQ/~lDIi>1b~,.~/Date of Birth
m5lJU4i. ",rrrow 1DrJ~lT,r6,.tb 8>lT6lJIJ15'lm1@ GrumJ ~J!JlmfJi.&. 1..J]lItW)6lf)L"61ir.lh6lllIr~ ".•..• ]Deposit Frequency Monthly Quarterly Other ....................... Specify) If Minor Account
• eo~"'@clO ""1ft" ~~"'>S/ft" ~~~ __ /'10 ~ SS!!l ~c! ....................................................................................................................• !lSelI @t;.@ (lJ<'~ @Cill Cll,""'~l (I'''' .oDeodi CD@gq)Q./Q..n(!!'.J:f,f>tO/Jw lffl!>~{)Al ",,11flla..LL (yl~ ntlxtmfQ,"/"~6ir ~61&mr6il""Ji.;7j06m@ U6lIlJribG?:i1Tm",~tO lifo t.MnU taJ;nUuLMlbj"rnlM,6Tr f;;(!?su?6i1 5I~oSl:II}lfAJ" it&~. ~Ii. Guoir6IT6lIw.
Insert "Me persona Iy" /"Both of us" /"Either of us" /" All of us" as appropriately Withdrawals will be made by' .....................................................................................................................
I.1. r::'*otD/ me;Qrnlui>/Signature 2. r::'*otD/ me;Qrnlui>/Signature 3. r::'*otD/ me;Qrnlui>/Signature
I)~ dll/llH IllO4'011llOOdCOGl.!lalalO ~ ~ lll6llllll./utnJ)liIUI~,* &"156 qgfQj DI~f"'a>toi ill'UI'''&-.8lI'tB~U.,; _OIlL ""lIlil5".
If it isa minor Account Guardian's details should be mentionedfoverleaf.Form 506CB EISIT Rev. July 2004
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• ,..Ill;!! g~Cl)l!l dl~8m1 llllJ,~ ~e. l!lJ !l&! S!l@ ~ !l/;l!lOlJell Qo\l)(Sll!al 544 ~tS\ ~tilClU fI~ eoJ@~ Oa5croflttlleOOl. 5l1t;!le@e<ll1leQ 6J@/fltClU Bl@~!:!l fltQl, ~c! eoJ@t=Cll otliCllO eeo)l!)t&D5l~ e<llaec l!lJeGl BlQl2Sl!:!l~ COtl!)CllOt~ ~ fltQl.&l~Gl dl~@)mI mil, .flo fllllOe5 ~ fl'I!QClJ @Qffi~Cl rn~ e<Il~ &Jlll~ rn~ Bl@OOtCl ee<ll rnlt;!l~ Bl@OO~Cl Bl@ ~eoEJl fltQl.Glm ocmC1m !i11110~O(l8 dl~@)mI mil.OleOl!Q!deo ~6i06\Oe@ rnlt;!ll!l @cllllll!ll:ll ~l!l ClCllleIlOll!=! flt6\ liltoClJBl6l 06\ e:J@ClfI@Cl1@~Cllll 8>6\ 06\ ~@e5 liltt;. S<lW05, ~ Qlte5c:llll ~~@ l!l)Q 60 en enl@QQ Cl)@CDtello05
~. l!ll!l/fl8 l:lltl!lt05eDCellXSl ~/~.iliQl/'liuLL . 1Ji0000aia;rllf''*.jliU'" UlU""Ul"'Ll6lbU"', 6J6U1",jli""L<Y''"'!D';; ~",u.,,,ru Ulm,,! 544 1iiJ'" l'lu"'lI()w @<'!>tflwUl6IlTlbuU"I£iWUl6llTWGl.uiWUuL'-I-Q7l6lbU"'"''''',;;@> tfl!)1!""'" ~"'<,!>';;@> Lmj,lbu@>w. ~oiJ",uiJ)J @<'!>tflwUl6IlTlbUU[r£lWUl6llTWG/QWuJUULrrA!9tf.J>rr5iJ ,f,6llm"8;@}JOiVlffi5lJ 6f6lJr~ "L.L MJrul.tJ/15ar 5Urlfilj.fbrrl]7rl£~i,@, Lfilj,"IT@!D.IJi,.Ll!)ai lJiomai 1JiIiJ; $,"~ililQ;.tiTlDtBdJ 5>(!!J6tlIT ltlI}mTlD6G">Lth;rrsU d>61mf.£@.l J€l2V1m61JLtnir 6lJ1TQ:9w 8>6"mIi@j 61J)511thA!!;UU5lJ(!!Jli.@J ~ruro~ IJimTU,@J 6IJl61Jj,I)(!!;uuruir(f,@!J&@ Lfilj,fb"@}w.l!PiIi.vLI!) CiTul'liljai lJiomailJilllf''*.(!P~~L.@6 ~iEJu4i ih6/JlSli.@J Gl~rrLirurr6ll1 5llP.d~6lir gimL(!pffiW QL.L tfJL.LlliIa;66lriMu~ fDLUUiL!O~. &/mI.fl[i;Gg'"<!£f!fJ6U:'brD@JlD Gwif,@)a5!uliuiuL.L m6lJu4/' Gfbrrma;6IJ)UJ 60 lDllfb g,rr6t)j,~~ 6lJ)5lJlll.,i G<'IW5UfbtD@)W
ID"'"/ 1D"",,,,oirliiJ""ffiI@>Al~!D'"/ 1iiJ""",@>dl\l)lJUw.If an individual Account, .In case of my death, if a nominee has .been appointed by me in accordance with the section 544, of the Civil Procedure Code, he/she will be entitled to the balance in the Account.lfno such nominee is appointed, my legal heirs will be entitled to the balance in the Account.If it's a Joint Account,In the event of death of anyone of us, the surviving account holder/holders will be entitled to the balance.If it's a Investment Savings Account,I/We agree to deposit above amount for sixty (60)months and comply with and to be bound by the Bank's rules for the conductoflnvestment Savings Account.el!)l!) rnlt;!ll!l ~lll~l<!= Qll!l CleJlile5Ol1!Jc.>e5lilt,ClJ eml~eDtrn@e@ Q~b(S)l!llQ tllO flt6\ =/ee<ll e:ncleoJ<3111~mle>l flttil e>"e>c!Cll e<ll eO~@lS l!l1!l/fl8 l!ilClCllI!tI!Ot@mll! lil~ eWe5 Cle<l6\l:ilenOeo flQlO, ~ l!l:ille5e<::S 8smt8>l!lc) 1!ll!l/flO ~Clleil ~@/e~. 'Clo-UJiJ4,;;"''''',;;@> GllbudUl6llT<>'>dJiJ;""6lIUjW,tflu!i;1b"""''''''''6lIUjWjliU"'/jliUw",u6Ji>.tf>JU41i\6.tf>JGl"'u••••.LlbU"'''IW. "''''',;;''''''' ~rnMj,lb,u ~iJ)Jw jli"'L<Y''"')lJiJu(&i>Ib"'Gllbudur'" U>i",oir"""AlI1l", tflUJi;~6Ill•• "'e,;;@>,;;"'L@Uu@"'~!i>@>,IOU"'/jliUW 1iiJ""",@>Al~"'/fiiJ-",@>Al",~w ""'LJ6ll)lblljWliiJi>lbU"' ~16~UI~/~t6~,;;I€1",~uw.1/We hereby certify that 1/We have read & understood the Rules & Regulations of the Bank for the conduct of such Accounts displayed in the Bank Premises and/or included inthe pass book agree to abide by them.
0lBl e<::m@eQClJ !lSe5@6\o l!iloeD/OleoolQldeD rnlt;!ll!lml!lEJaQl l!iloo@l:, Qll!l fl'Bl@QlG:l00t;. eol~enl!QClJ eoll!leoQ Cro@ @tllb e<ltl!ilQ.~I!c! eoJ@tllIIJc.>tlleoll!leoQ tllOell!le5 ~ fll. o. 1510 Cl~bilJ ell@ 9Cl)Cl.I!lil~Ol Blml!l~Cl eo~CllI!Jc.>tlleoll!leDClell@ eeo~tell.~061 jliU[ @<,!>","u,u~UJU4 / <Y'lbIJL(!JiI\':.u'JU4 "'''''',;;@> ~utiJ{j,;;",uu(!JW\':uu$l ~"'[ 1b6llT$l iJ;w6U1(f!>iJUI","'u"'uuw tflwUl6lIllbll()[@<,!>"''''u Glu••• @>£6Ij,,;oJI£IwUJ,;;",,,,mi>.~1li1",uiJ)J j/lUJUlOlrWGl'OOMI1l",~.,.;, 1iiJ"" 1510 III tfluuu ~ ••••.(!Jw.@<'!>Glu"'i>1bUI,;;@>""",Glu!riJ)Ji>Ib"'''''Uu'i,u~"'[ tflWUl6IlT~UU[@<'!>"'''''u tflUJUl"'WGl.uiw <Y'tq.UIT,;oJ.WHEN A SAVINGS ACCOUNT/INVESTMENT SAVINGS ACCOUNT IS OPENED BY AN INDIVIDUAL HE/SHE MAY APPOINT A NOMINEE ON HIS OR HER OWN ACCORD.IN SUCH EVENT HE/SHE SHOULD FILL FORM NO. 1510IN CASE OF A BUDDHIST BIKKHU HE IS NOT ENTITLED TO NOMINATE A PERSONAS HIS NOMINEE.
1. . .m~~CllOt<3csl flo5c:>eo/",rrtq.';;"""'IlJlf",m",",,,,GlIlJlfUuW
Customer's Signature
2 .m~~t:nO<ecsl qo5c:>eo/ "'U'4-';;"""'IlJlf",m","" ••GlUJllUuW
Customer's Signature
3 .mlt;!le~~t:nO<ecsl flo5c:>eo/",utq.';;"''''UIT",ffl", "" ••GlwouuW
Customer's Signature
lil)~eGlm dllil1l!l Q":I5) O€)",m5 o€)lll OllllJDQ Ql!l~~", 1l!l6mm/llrrJ~IIlIDQIlUJrrCili~Ji $ClIl!!iib qgJl'il. jliu(bt'Jllll um;D'$,;' Qnilll6ljIDFill this Section only for the Minor Account
\il(!;)eDClc:.15lI>leo@e5 lill@ e>c>cl (Sg ~, \!)gOI: ~, Clll!lleD!l, O)eDeQ!deo) rnlt;!ll!l1lll~aeD CllOel5eD.(lj~ ISl@ClJecsl ~ c:>&lat>!W!lel!le5 fleoCl)Ot~ lil~ecsl/fI~csl \!)OOl!l 00t;.lil~l!csl/fltQ<llcsl fleDeD"QllEJc.oQl~Ot IIltlllCll!J= Clti?ll!l<J o~ {feoCl)Ote>em!l •• el106leD. ~ e~ rn~~l e>tMCl flEJc!DJ&) ~&l@>C) eoo/og lk:>rnCl ee<ll05 rnlt;!leOl e<ll~rnlt;!ltl ~Jecsl BleD"l@Cl1@COtl!lmlCllO~ ee>eD eCSlllW CllClgCl)CllOel5eD.l!)eodeD liltoClJe!l [email protected];!ll!l1lllc:>Ol~c.>e5 8>til e<ll eo"J@lS fI@fl @Cll /ffiO(Wlll ~JeG08l lilt(. S<ll!lClll! l!)l!) ~ClJC) ~.
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Please open a Minors Account (Sisu Udana, lsuru Udana, Normal, Investment) in the name of the above mentioned. Payment should be made to the Account Holder at his/herrequest on his/her attaining majority after satisfying yourselves as to the identity of the account holder. In the event of the Account Holder's demise prior to/after attainingmajority the balance in the account should be paid to the legal heirs of the Account Holder.I agree to comply and be bound by the operating rules & regulations of the People's Bank Minor's Account.IISS dll@lS oe>rn~Je= ""S .,@ID/llQeoo ID"tll IICllll5l""dl@,"@ (l<;,t>GlIlrXo "'0 1:I'1i'i .,,,,/ ••,,,1 o)cleol ••rn <;,ml~l fltli'i ~"e>clD) (!;)l eOCil@lS SOl/fiB 6cXll erno,!:lCllol IDE> IIS6rnClISJIi'i", ",0", 1:1"'0, l!l@ e",,/lle<::S BGCllt6'iSCl SOl/fiB ~"'''' ,"~@/,"~@.(;;QuS!U4i <!>6tlllli@ "G,f.iIJ!-J1UIJ&:JJ. 6lfltJ"-'6lO/ilflLjW. ifJutf,fb6!fHlJI&6IfJ/ilflLjtD t&IJ6lIiIfblJW 6lfll!lj,$IU 4filtf,:t>l GlJofT6lllJi-L~1f1Jo6llm. 1f,6llOl'&m", ~!]mU1j,.iJ UlrfJJJJl~ t&mLQP6IfJ!Duu(&~fboU QfbfTLITUIJ6lll wi;w,dr 6lJtt;;,&hUlw!fJurtfbQf'JSSfW,@i.@6; 09iL@UU@6lJ,f,!D@. !6fT0r/tDIJUJ j)6Wl"~@<€IwG!D~/j16Wl"l!il@i1~(;;!DlJm 6TllUiu6ll")fb~tD .@:ifbfTfiJ ~~61'i1&£I51irG:!DIIlir/<9Ir6l6'l'il&&lQjjCi!DfTLO.IIWe hereby certify that IIWe have read & understood the Rules & Regulations of the Bank for the conduct of such Accounts displayed in the Bank Premises and/or included inthe pass book agree to abide by them.
1!Jf!jifu>/ ~uw/Grade
[OJfI:»t;:,/~/Year
ITIJJ
~~w:,~O\ tllC<!!le<::~ } .~E~;;Bt~} .CDI'i\egIlI Clo<!lCll"""~,-j.~ •• @>5'1ItllProduct Code
Designed& Printed at People's BankPrintingSection
For Existing Customers
1. Account No:
2. Name of the Account :
3. Residential/RegisteredStatus of the Residential! Registered Address
Address D Owner D Rent! Lease
D Official D Board! Lodging(Please attach a copy of the recent utility bill D Parents D Others .................
certified by you to prove the residential address.)
4. Correspondence Address(if different to the item No.3)
5. Foreign Address (If any)
6. Nature of the Business /Profession / Vocation
7. Business / office AddressResidence Omce Mobile Fax E-Mail
8. Telephone Number(s)
DD I MM I yyyy9. Date of Birth / Registration
I I Place of Birth
10. NIC No. / Pass Port No.1 Date oflssue
Registration No. (Please attach a coP)' of the NIC / Registration Date of Expirydocument certified by you.)
D Sri Lankan Nationality
11. Citizenship D Sri Lankan with the dual citizenship Type of VisaD Sri Lankan with foreign citizenship
D Foreign national Expiry date
D Business transactions D Savings
12. Purpose oftheAC Opened D Employment! Professional income D Loan repayment
(Tick all relevant boxes) D Inward remittances D Share transactions
D Upkeep offamily / person D Investment purposes
D Domestic necessities D Others (Specify)
Expected source and nature of credits into the accountD Contract! Investment proceeds
13. Source of funds D Sales and business turnover(Tick all relevant boxes) D Family remittances
D Donations/ Charities (Local/ International)
D Commission income D Salary
D Export proceedsD Others (Specify)
14. Tax File No.
15. Anticipated Volumes: D Less than 100,000!~(US$ 1,000) D 2,000,000 to 3,000,000 (US$ 20,000 to 30,000)
Expected / Usual Volumes of D 100,000 to 500,000 (US$ 1,000 to 5,000) D 3,000,000 to 4,000,000 (US$ 30,000 to 40,000)
deposits in rupees / US$ per D 500,000 to 1,000,000 (US$ 5,000 to 10,000) D 4,000,000 to 5,000,000 (US$ 40,000 to 50,000)month: D 1,000,000 to 2,000,000 (US$ 10,000 to 20,000) DOver 5,000,000 - (US$ 50000 - )
16. Spouses Name
• Signature of the Customer
• Date:
l
Bank use OnlyDate:Branch Code:Officer's Sigilature with Sig No :
Kno",YourCustomer (KYC) Profile(Requirement in terms of Financial Transaction Reporting Act No 6 of 2006 )
The ManagerBank of Ceylon
[{] Please Tick the appropriate box / boxes
GRAPHIC SYSTEMS 5333371 - 4
••...•
Dear Customer,
Declaration to be made by customers under the Financial Transaction
Reporting Act. No. 06 of 2006 (FTRA)
Under the provisions of the FTRA No. 06 of 2006 and the rules and regulations
issued by Financial Intelligence Unit (FlU) of the Central Bank of Sri Lanka (CBSL)
Anti money laundering and combating terrorist financing, all banks are required to •
obtain and update the Information of the existing Customers.
In order to comply with this requirement, all banks agreed for a common document
to be forwarded to the Customers. Therefore we are sending herewith Know Your
Customer (KYC) Profile, which is designed to obtain and update the information of
your account.Kindly make arrangements to complete and forward the overleaf format
to your branch accordingly.
•Thank you.
LaUth Fernando
Compliance Officer
Anti Money Laundering
Bank of Ceylon
•
..-.-.•
-IThe ManagerBank of Ceylon
APPLICATIONFor Office Use Only
Branch Code .A/CNo .
ClF NO.1 .
ClF NO.2 .Input by .
Authorized by : .
Pleaseopen an Individual/Joint Account as per details provided below.Please tick 0 the appropriate cage
Manager's Signature Date
•
DOMESTIC CURRENCY ACCOUNTS ""F.OREIGN CURRENCY ACCOUNTS
D Current D Savings D KRG D Savings Specify Currency ...........................................
D Boc Prestige Plus D 18+ D Fixed Deposit D Fixed Deposit *NRFC/RFC/RNNFC/..........................................
D 7 - Day Call Deposit Others ......................................................... Others ......................................... (* Delete whichever is inapplicable)
THE ACCOUNT tSNO.tS, MAINTAINED PRESENTLY OR PREVIOUSLY AT BANK OF CEYLON
D Current D Savings A/C No.' ,(~)................................................................. (ii) ..............................................................
PERSONAL INFORMATION - APPLICANT 1 APPLICANT 2
Title: Mr.lMrs.lMiss/Dr/RevName in Full
Name with Initials
Any other Names(maiden name/others)
Permanent Addressin Sri Lanka with Postal Code
Date Moved to Present Address
Foreign Address(for foreign currency accounts)
Occupation and Start Date
Employer's Name
Official Address with Postal Code
Official Tele.No.Monthly IncomePrevious Employment, if any.
*NIC No.Tax Payer /Tax File No. Yes/No Yes/NoTel No. (Res.)
Tel No. (Overseas)
Fax No.E-mail Address
Nationality
Mailing Address D Permanent D Official D Foreign D Permanent D Official D Foreign
Date of BirthMarital Status
*Passport No.Mobile No.
Signature/s
*photocopy to be attachedD.RANASINGHE & SONS - BOC/SUPP/S 800653
I am well acquai nted with .
whose signature/s appear overleaf and his/her/their signature/s was/were affixed in my presence. I certify that he/she/they is a fare suitable
person/s to open and maintain a Current/Savings Account with Bank of Ceylon.
NCNo. :
Tele No.:
Signature .
Name & Desig nation: .
•
.-For Office Use Address : .
Verified by : .
Signature of the Officer Date .
TIME DEPOSITS Currency
• Cash / Cheque / Draft No .
• Amount (figures) .
In words .
• Term days / months / years
Period From to .
• Rate of Interest % p. a. to be payable
*Monthly / at maturity / at the time of withdrawal
AUTOMATED BANKING SERVICES
• Subject to automatic renewal conditions *with/without interest at the
prevailing rate.• All interest accruing due from time to time should be credited to
*Current / Savings / NRFC Account No of Mr.lMrs.lMiss
.............................................................................at.. Bra nch . (or)
• Mailing address to dispatch the bank cheque for the interest
For Office Use• Receipt No .
(* Delete whichever is inapplicable) •*For Current/NRFC Accounts only(For Automated Banking Services complete relevant application forms)
i*NOMINATION (EXCEPT CURRENT ACCOUNT)
I II I
(1) to .
(2) to .
II
BOC Credit Card ( if any) No. IMobile No. for SMS Banking I
BOC accounts to be linked
-t Bill Nos.
No
NoNo
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Visa Electron (Debit)Card
BOC Net
Internet Banking
*Email Statement
SMS Banking
Utility Payment
(*You may omit if you do not wish to nominate.)
Full Name of Nominee
Address of Nominee
ID Card No. / Passport No.If available.
2 3
•Payment %
1/ We do hereby nominate, the abovenamed as my/our nominee/s to receive all monies lying in the account on my/our death subject tothe provisions of Section 14 of Bank of Ceylon Ordinance. We are aware in the event of t,he death of anyone of joint account holders thenomination becomes invalid. Witness:
Name & Address: .
Signature 1 Date: .
Signature 2 Date: Signature
!OPERATING INSTRUCTIONS
• 1/ We agree to comply with and to be bound by the rules of the bank governing the conduct of this account which IlWe have read andunderstood and acknowledge the receipt of a copy of the rules and conditions of the personal/joint accounts.
• For joint accounts - Cheques / Withdrawals will be signed by * 1/ We hereby authorize you to act on instruction givenby * relating to this account (*/nsert both/either of us/anyone/all)
- In the event of the death of anyone of us the balance at credit of the account will be payable to the survivorwithout reference to the representatives of the deceased.
• For foreign currency accounts 1/ We agree to comply with and to be bound by the Exchange Control Regulations & Rules of the Bankgoverning the conduct of this account. •Signature 1 Signature 2
Date Date
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