ACCOUNT APPLICATION FORM

Account Application Form

MAIN ACCOUNT HOLDER ACCOUNT HOLDER 2

Account Type
Relationship to Main Account Holder
Individual Joint Account Holders
US Person Declaration Yes1 No2 US Person Declaration Yes1 No2
A. Personal Information A. Personal Information
New Client Existing Client New Client Existing Client

(Any new information provided in this application shall be taken as (Any new information provided in this application shall be taken as
a request to update your existing particulars in the Bank’s records) a request to update your existing particulars in the Bank’s records)

Salutation and Full Name (As in NRIC/Passport) Salutation and Full Name (As in NRIC/Passport)

NRIC/Passport Number Singapore PR NRIC/Passport Number Singapore PR

Yes No Yes No
Permanent Residential Address (Must not be a PO Box address) Permanent Residential Address (Must not be a PO Box address)

Country Postal Code Country Postal Code

Mailing Address (If different from residential address) Mailing Address (If different from residential address)

Country Postal Code Country Postal Code

Marital Status Single Married Others Marital Status Single Married Others
Mother’s Maiden Name Mother’s Maiden Name
Highest Education Received Highest Education Received
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 Yes No Self-employed Yes No
Name of Employer/Name of Business (For self-employed) Name of Employer/Name of Business (For self-employed)

Occupation Annual Income Occupation Annual Income

Nature of Business/Industry Nature of Business/Industry

Banking/F inance Retail/F&B Travel/Hospitality Banking/F inance Retail/F&B Travel/Hospitality
Government Manufacturing Building/Construction Government Manufacturing Building/Construction
IT/Communications Others, please specify IT/Communications Others, please specify
Source of Wealth Source of Wealth
Business Income Investment Returns Business Income Investment Returns
Inheritance/Gift Salary Inheritance/Gift Salary
Savings derived from Others, please specify Savings derived from Others, please specify

Planned transaction amount (Per month) Planned transaction amount (Per month)
S$10,000 & below S$10,001 to 50,000 S$10,000 & below S$10,001 to 50,000
S$50,001 to 100,000 S$100,001 to 200,000 S$50,001 to 100,000 S$100,001 to 200,000
Above S$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.
1
2
I acknowledge that I am aware that I need to notify the bank within 30 days of any change to my status.

1
 B. Accounts To Open
ATM/Phone Banking ATM/Phone Banking
Current Access Indicator3 Savings Access Indicator3
ANZ SGD Current Plus Account Primary Account ANZ SGD Statement Savings Account Primary Account
ANZ SGD Current Account Primary Account ANZ Australian Dollar Savings Plus Account Primary Account
ANZ Foreign Currency Current Account Primary Account ANZ Progress Saver Account Primary Account
(Select currency: AUD/CAD/CHF/EUR/GBP/USD) (Select currency: SGD/AUD/USD)

Others, please specify

Primary Account ANZ Foreign Currency Statement Savings Primary Account

HKD/JPY/NZD)
Account (Select currency: CAD/CHF/CNY/EUR/GBP/

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

Cheque Book 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 Phone call SMS/MMS, fax, email and postal mail
Account Holder 2 Phone call 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.

3
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.
4
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.
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
of such referral and that the referrer may be able to infer my/our
1. I/We hereby request and authorise Australia and New Zealand approximate account balance based on the amount of rewards
Banking Group Limited, Singapore Branch (the “Bank”), to open awarded to the referrer, and I/we hereby consent to the Bank
an ANZ Bank Account which includes one or more account(s) of informing the referrer of my/our account opening and of the
any kind as I/we may request the Bank in accordance with this amount of rewards awarded to the referrer.
Mandate and subsequently to open such further account(s) of any
11. I/We hereby warrant that all the information and documents
type in my/our joint names of whatever nature as I/we request (the
provided by me/us in relation to this application are true, complete
“Account(s)”) in accordance with and subject to the Bank’s Terms
and accurate in all respects.
and Conditions for ANZ Bank Account (the “Terms”), as amended
from time to time by the Bank. 12. I/We acknowledge that it is my/our responsibility to comply
with the tax obligations in the countries where I/we may have
2. The Bank is hereby authorised and instructed generally, to act on
or otherwise incur such obligations (whether due to my/our
instructions given by me/us in accordance with the Terms. The
nationality, tax domicile, incorporation, source of income, physical
Bank may, in its discretion and on such terms as the Bank may
presence or otherwise) (“Jurisdictions”).
impose, allow instructions to be given by phone, fax and other
form of communication and I/we shall bear the risks arising 13. I/We declare that I/we have not committed or been convicted of
therefrom, and indemnify the Bank, as set out in the Terms. any tax evasion or money laundering related offences in any court
of law or administrative proceedings in the Jurisdictions stated
3. In the absence of contrary written instructions which the Bank may
above and my/our source of funding is not the proceeds of any
agree to, the conditions set out in the Terms (including, but not
serious tax crime.
limited to, those set out in the Mandate) shall apply to each and
every Account, of whatever nature, now or hereafter opened by the 14. In the event that my/our particulars provided in this application
Bank or by me/us in our joint names. differ from my/our existing particulars in the Bank’s records, I/we
request that such existing particulars be updated and superseded
4. I/We have been supplied with a copy of the Terms, the Statement
accordingly.
of Disclosure for Joint Accounts, Risk Disclosure Statement for
Investments and Schedule of Charges and agree to abide thereby. Deposit Insurance Scheme: Singapore dollar deposits of non-
bank depositors are insured by the Singapore Deposit Insurance
5. Where I/we have requested for Phone Banking Services and ATM
Corporation, for up to S$50,000 in aggregate per depositor per Scheme
Services, I/we conf irm that I/we have read the Bank’s Terms and
member by law. Foreign currency deposits, dual currency investments,
Conditions for 24-hour Banking and agree to abide thereby.
structured deposits and other investment products are not insured.
6. I/We agree not to access Digital Banking unless I/we have read the
Custody Agreement: The Bank has arrangements with various
Bank’s Terms and Conditions for Personal Internet Banking - Digital
custodians to hold the assets (excluding cash) which you have
Banking and further agree to abide thereby.
delivered or transferred through the Bank for custody. A summary of
7. In the event of any discrepancy between this Mandate and the the key terms of the agreements entered into with each custodian,
terms and conditions indicated in points 4, 5 and 6, the express and/or the manner in which the custody accounts are maintained
terms of this Mandate shall prevail. and established has been made available for your easy reference.
8. I/We conf irm that I/we have been given the opportunity to consult This summary can be found on the Bank’s website at www.anz.com.
with my/our professional advisors before agreeing to the terms and sg (http://www.anz.com/singapore/en/signature-priority-banking/
conditions indicated in points 4, 5 and 6 and this Mandate. products-services/terms-conditions-products). A copy of the Summary
9. I/We agree that the Bank, its agents and service providers of Custody Agreements will be made available upon request at any of
(in Singapore or otherwise) may collect, use, disclose and/or the Bank’s branches.
process my/our personal data and any information relating to Notif ication on Outsourcing of our Banking Services: Australia
me/us (including but not limited to my/our Accounts, financial and New Zealand Banking Group Limited, Singapore branch (“ANZ”)
condition and/or transactions) in accordance with the Terms and may from time to time engage the services of our head off ice, its
for the purposes stipulated therein. Where personal data is to be branches, subsidiaries or aff iliates and third parties (collectively “service
transferred out of Singapore, I/we acknowledge and agree that providers”) for certain outsourced activities. Whether our service
the Bank will comply with the Personal Data Protection Act in providers are located in Singapore or elsewhere, they are strictly
doing so and take appropriate steps to ensure that the recipient required to maintain information security and customer conf identiality
of the personal data is bound by legally enforceable obligations to to the same standard as ANZ is responsible for.
provide to the transferred personal data a standard of protection The laws in Singapore and other countries may require ANZ and our
that is at least comparable to the protection under the Act, such service providers to disclose information relating to ANZ’s customers to
that the personal data is kept secure and confidential. relevant authorities from time to time. The circumstances under which
10. If I/we were referred to the Bank by any person, I/we acknowledge such disclosure may be required are limited and include compulsion
that the referrer may receive rewards from the Bank in respect 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

Date D D M M Y Y Y Y Date D D M M Y Y Y Y

Please tick if you are a staff of ANZ Please tick if you are a staff of ANZ

3
 D. ANZ Credit Card And MoneyLine Application
ANZ Optimum World MasterCard Credit Card Documents Required (Mandatory)
Principal : S$180 p.a. (1 Year Fee Waiver) 1. Please submit the following identif ication documents that are
Supplementary : S$90 p.a. (1 Year Fee Waiver) applicable to you and tick the relevant boxes below:
Minimum income : S$80,000 p.a.(Singapore Citizens, Permanent Residents & Foreigners) = Singapore Citizens and Permanent Residents
Select your preferred category: Photocopy of your Identification Card (Front and back)
Dining & Leisure Travel Shopping Groceries
= Foreigners
Selected category will be valid for the immediate calendar quarter Photocopy of your valid Employment Pass (Valid for at least 9 months)
(based on the date of application approval) and the next calendar AND
quarter. To continue enjoying 5% cash rebate7 in your preferred Photocopy of your Passport AND Proof of residence
category, please submit your selected category by 25th of the month 2. Please submit the following income documents that are applicable
before the start of a new calendar quarter. to you and tick the relevant boxes below:
ANZ Travel Visa Signature Credit Card = Salaried Employee
Principal : S$200 p.a. Latest computerised/electronic payslip OR
Supplementary : S$100 p.a. Latest Income Tax Notice of Assessment OR
Minimum income : S$60,000 p.a.(Singapore Citizens & Permanent Residents) CPF Statement for the last 6 months
S$90,000 p.a. (Foreigners) = Self-employed
ANZ Platinum MasterCard Credit Card Income Tax Notice of Assessment for the last 2 years
ANZ Platinum Visa Credit Card = Commission-based Earner
Principal : S$160 p.a. CPF Statement for the last 6 months OR
Supplementary : S$80 p.a. Income Tax Notice of Assessment for the last 2 years OR
Minimum income : S$30,000 p.a. (Singapore Citizens & Permanent Residents) Commission Statement from the company for the last 6 months
S$60,000 p.a. (Foreigners) You may also submit a copy of your income documents online using
SingPass at anz.com.sg.
ANZ Switch Platinum Credit Card
Principal : No Annual Fees8 Are you submitting your CPF Statement online? Yes No
Supplementary : No Annual Fees8 Additional documents required for Supplementary Card application
Minimum income : S$30,000 p.a. (Singapore Citizens & Permanent Residents) A photocopy of Supplementary Cardmember’s Identification Card
S$60,000 p.a. (Foreigners) (front and back)/Passport/Employment Pass (valid for at least 9 months)
I would like the above to be a secured credit card. is required. The Bank reserves the right to request for additional
(Please complete Credit Card Memorandum of Charge.) information and supporting documents (e.g. utility bill) from time to time
as required. Incomplete or unclear applications may delay processing.
ANZ MoneyLine9
Credit Card Information
Annual Fee : S$70 p.a. Approval of the Credit Limit is subject to the Bank’s discretion and
Minimum income : S$30,000 p.a. (Singapore Citizens & Permanent Residents) the Bank may grant the Credit Limit in whatever manner it deems
Effective interest rates are 25% p.a. for ANZ Optimum World MasterCard Credit Card, ANZ Travel Visa appropriate without giving any reason. For more information on
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.
qualifying criteria, credit card charges and fees, please refer to anz.com.sg.

Principal Card Applicant

Do you have an existing ANZ Credit Card? Yes No Name to appear on credit card (Please include surname)
Please select one only:
I am the Main Account Holder I am the Account Holder 2 (Maximum 18 characters)

Personal Information
Residential Status
Self-Owned Mortgaged Employer’s Parents’ Rented Others
Residential Type
HDB Condominium/Apartment Landed Others

Length of stay at address Years 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 Others
Address

Length of employment Years Months Job Title

7
Cash rebate will be awarded in the form of Optimum$ and can be redeemed under the ANZ Optimum Rebate Programme.
8
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.

4
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:- is bound by legally enforceable obligations to provide to the transferred personal data a
1. I/We ask that an ANZ Credit Card account be opened for me/us and that an ANZ Credit standard of protection that is at least comparable to the protection under the Act, such
Card be issued to me/us until I/we/the Bank terminate(s) the same. that the personal data is kept secure and confidential.
2. I/We hereby declare that the information given in this application and all the documents 7. If, for any reason whatsoever, the Card Account is closed (whether by me/us, the
submitted to the Bank are complete, true and accurate and belong to the Bank Bank or otherwise) within the period of nine (9) months from the date of opening of
absolutely and that I/we have not wilfully withheld any material fact. I/We undertake to the Card Account, I/we agree that the Bank shall be entitled to claim from me/us full
notify the Bank immediately of any change in such information. reimbursement of the cost of any welcome gift which the Bank may have given to me/
3. I/We hereby authorise and give the Bank consent to conduct credit checks on me/us us upon approval of my/our application and/or activation of my/our Card Account. I/
(including but not limited to checks with any credit bureau recognised as such by the We hereby authorise the Bank to debit the Card Account for the cost of such gift (as
Monetary Authority of Singapore) and to obtain and verify and/or to disclose or release determined by the Bank) prior to closure of the Card Account.
any information relating to me/us and/or any of my/our account(s) from or to any other 8. The preferred credit limit indicated is subject to the approval of the Bank at its
party or source as the Bank may from time to time deem f it at the Bank’s discretion for reasonable discretion. The Bank will assign a credit limit based on its discretion and MAS
the purpose of this application and without any liability or notice to me/us. guidelines when you select the option to allow the Bank to assign such credit limit for
4. I/We conf irm that at the time of the application, I am not/neither of us is an you.
undischarged bankrupt and no statutory demand or legal proceeding has been served 9. I/We as Supplementary Credit Card holder(s) agree to the credit limit that is assigned to
on or commenced against me/us. me/us to be the same as the Principal Card member.
5. I/We agree to be bound by the terms of the Mandate, the Cardmember’s Agreement, 10. If I/we have applied for Credit Card FlexiLoan, I/we agree to be bound by the Credit Card
the Terms and Conditions for 24-hour Banking, the Terms and Conditions for ANZ Debit FlexiLoan Terms and Conditions.
Card, the Terms and Conditions for Personal Internet Banking - Digital Banking, the 11. If I/we have applied for Credit Card Balance Transfer, I/we agree to be bound by the
Terms and Conditions Governing ANZ MoneyLine Accounts and such other terms and Credit Card Balance Transfer Terms and Conditions.
conditions as the Bank may prescribe from time to time, copies of which are available for 12. The Bank reserves the right to terminate my/our ANZ Signature Priority Banking Visa
my/our perusal at the Bank’s website, upon request at any of the Bank’s branches and/or Inf inite Credit Card(s) if I/we do not maintain the minimum Signature Priority Banking
which will be extended to me/us upon the Bank’s approval of my/our application herein total relationship balance. In the event of such termination, I/we also hereby request
together with my/our ATM Card and/or Customer Identification Number. and apply for an ANZ Platinum Credit Card to be issued to me/us at that point in time,
6. I/We agree that the Bank, its agents and service providers (in Singapore or otherwise) subject to the Bank’s approval then. I/We also agree to be bound by the Cardmember’s
may collect, use, disclose and/or process my/our personal data and any information Credit Card to be issued to me/us at that point in time, subject to the Bank’s approval
relating to me/us (including but not limited to my/our Card Account and/or Card then. I/We also agree to be bound by the Cardmember’s Agreement and such other
Transactions) in accordance with the Cardmember’s Agreement and for the purposes relevant and then prevailing terms and conditions which may govern the use of the ANZ
stipulated therein. Where personal data is to be transferred out of Singapore, I/we Platinum Credit Card. Agreement and such other relevant and then prevailing terms and
acknowledge and agree that the Bank will comply with the Personal Data Protection Act conditions which may govern the use of the ANZ Platinum Credit Card.
in doing so and take appropriate steps to ensure that the recipient of the personal data 13. 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

Date D D M M Y Y Y Y Date D D M M Y Y Y Y
10
Overall credit limit def ines as the combined credit limit that is assigned to your ANZ Credit Card and ANZ MoneyLine account(s)
11
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.
12
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 6. I/We hereby agree and undertake that, for so long as any part
provisions. These provisions and the security created herein shall also of the Liabilities remains outstanding or the Card Account is not
be binding on my/our personal representatives. terminated, I/we shall not close the Deposit account and shall not
2. I/We agree to place and maintain a minimum deposit (in the amount withdraw any sum from the Deposit, or assign, mortgage, charge,
indicated by me/us in this form) with Australia and New Zealand pledge, transfer, or create any security interest or encumbrance
Banking Group Limited (the “Bank”), which I/we warrant to be free or otherwise deal with the Deposit in any manner whatsoever
from any encumbrance, to be used as security for all outstandings, nor attempt or purport so to do and I/we shall not do or omit any
fees and charges which the Principal applicant may be liable for in act which may in any way delay or prejudice the Bank’s right to
respect of the Principal and the Supplementary applicant’s Card the Deposits. I/We acknowledge that the Card Account will be
Account(s) (the “Liabilities”). terminated if the Deposit account is closed or if the value of the
Deposit falls below the pledged amount for any reason whatsoever
3. I/We hereby charge for the settlement of the Liabilities all sums
without the Bank’s prior written consent. I/We understand that any
which have been or may from time to time hereafter be deposited
balance from the Deposit will only be returned 45 business days after
by me/us with the Bank whether in Singapore Dollars or other
closure of the Card Account.
permitted currency under the deposit indicated by me/us in this
form including any renewals thereof whether by way of extension 7. Any notice or demand for payment by you hereunder shall, without
or replacement (and even if bearing a different account number/ prejudice to any effective mode of making the same, be deemed to
currency type/amount) together with interest accrued or to be have been sufficiently made hereunder on me/us if sent by post to
accrued thereon and all additions thereto (the “Deposit”). I/We the Principal Applicant’s address stated below and shall be assumed
understand that the Credit Limit to be granted will be subject to the to have reached the Principal Applicant within 24 hours of posting,
Bank’s discretion as well as the amount deposited and will be fully and in proving such service it shall be sufficient to prove that the
secured against the Deposit. notice demand was properly addressed and posted.
4. I/We irrevocably authorise the Bank to, at any time and from time to 8. The Principal Applicant acknowledges that these provisions shall
time in its sole and absolute discretion and without notice to me/us, not prejudice but be in addition to the terms of the Cardmember’s
appropriate and apply the Deposit (whether it has matured or not) Agreement and the card application declaration.
or any part thereof in or towards the satisfaction and settlement of 9. This memorandum shall be construed in accordance with the laws
all or any of the Liabilities whether the same is due or contingent and of the Republic of Singapore and I/we submit to the non-exclusive
whether there has been a default or not. Any currency conversion jurisdiction of the Singapore Courts.
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
Witnessed by Bank Staff Signature of Principal Applicant/Joint Account Holder 1

Name Name

Address Address

NRIC/Passport Number NRIC/Passport Number

Occupation Occupation

Signature of Joint Account Holder 2 Signature of Joint Account Holder 3

Name Name

Address Address

NRIC/Passport Number NRIC/Passport Number

Occupation Occupation

Signature of Joint Account Holder 4 Signature of Joint Account Holder 5

Name Name

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 D D M M Y Y Y Y

Source of Account
0 – Self Solicitation 2 – Phone Banker Referral 5 – Credit Card Referral N – Mortgage Referral
1 – Client Referral (MGM) 3 – Overseas Branches Referral 6 – Commercial Banking Referral S – Staff Referral
CIF Number for Client Referral Others (Please specify)

Account Opening Check

Documents Submitted Name of Checker
Account Application Form (Fully completed and signed by customer)
Identity Card/Passport (Original sighted & copy made for file) Signature of Checker
Proof of Address (Original sighted & copy made for file)
OMLR (Duly signed by approvers)
Income Document
WC Result
SG Check Result Date D D M M Y Y Y Y

Market Segment Branch Code Primary Off icer Code Secondary Off icer Code

Account Creation (Branch Operations)

Main Account Holder Account Holder 2
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
If yes, please indicate If yes, please indicate

CIF Number of Main Account Holder CIF Number of Account Holder 2

Debit Card Issued No Yes Debit Card Issued No Yes

8
 ATM/Phone Banking Access Indicator
(Note: Please select only 1 account as Primary Account and the rest of the accounts
Current Account will be linked as secondary)

ANZ SGD Current Plus Account Number Primary Account

ANZ SGD Current Account Number Primary Account
ANZ Foreign Currency Current (Select currency: AUD/CAD/CHF/EUR/GBP/USD)
Account Number Primary Account
Others (Please specify)
Account Number Primary Account
Savings 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
GBP/HKD/JPY/NZD)

Others (Please specify) Account Number Primary Account

Input by Checked by
Name Name

Signature Signature

Date D D M M Y Y Y Y Date D D M M Y Y Y Y

Signature Scanning
Scanned by Checked by
Name Name

Signature Signature

Date D D M M Y Y Y Y Date D D M M Y Y Y Y

ANZ Credit Card Source Code ANZ MoneyLine Source Code

0 0 0 8 0 9 9 0 V B 0 3 B H 1 0 0 0 M T 5 8 8 0 G 0 B H

Follow up required for income documents Yes No

lnput Check WC Y/N EV Y/N

SA WC Y/N
EX ML CO1 AL CO2
EX CC
AM Input By/Date Checked By/Date
EBC

9
10
11
12
13
© Australia and New Zealand Banking Group Limited (ANZ) 2016 ABN 11 005 357 522 Item No. SGEGB210616

anz.com.sg