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CPR Form

This document is an account opening form and KYC for individuals, requiring personal and identification details, contact information, and employment status. It includes sections for account type, currency, purpose, and anticipated activities. The form also contains a customer declaration and is regulated by the Central Bank of UAE.

Uploaded by

Ajay Abhira
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© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
11 views3 pages

CPR Form

This document is an account opening form and KYC for individuals, requiring personal and identification details, contact information, and employment status. It includes sections for account type, currency, purpose, and anticipated activities. The form also contains a customer declaration and is regulated by the Central Bank of UAE.

Uploaded by

Ajay Abhira
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ACCOUNT OPENING FORM & KYC – Personal (For Individual)

Please use BLOCK LETTERS


Tick in the boxes as appropriate Date: 14 / 06 / 2024

Account Type: {SavingAccount} Saving {CurrentAccount} Current {CallAccount} Call {OthersAccount} Others (Specify)

Account Currency: {AEDCurrency} AED {USDCurrency} USD {GBPCurrency} GBP {EURCurrency} EUR

Purpose of opening the account: Savings Salary transfer Investment Loan payment Foreign remittance {othersPurpose} others (specify):

Bank Channel: Branch Digital

Applicant Details

Full Name: First: Middle: Surname:

Nationality: Secondary Nationality (If Any):

Date of Birth: 09/10/1982 Place of birth: Country of birth:

Residence Status: Resident Non-Resident Citizen Gender: Male Female

Marital Status: Single Married Divorced Widowed

Highest Education Qualification

Are you a Resident of UAE by Investment? Yes No


Do you have any other nationality or residency other than the above? No Yes (Complete the below table)

ID Correspondent Address (Zip Code/Postal


Country/Nationality ID Type Expiry Date Tax ID Number
Number Code)

{countryNationality_details} {idType} {idNumber} {expiryDate} {taxIdNumber} {postalCode}

Identification Details

Passport No: AB635654 Passport Expiry date: 2026-06-29T00:00:00

Residency visa No.: {residencyVisaNo_Identification} Visa Expiry date: {visaExpiryDate_Identification}

Emirates ID No.: Emirates ID Expiry date:

Contact Details

P.O. Box: {POBox_Contact} Office/Department Name: {officeDepartmentName_Contact}

Area/Landmark: {areaLandmark_Contact} Villa/Flat no: {villaFlatNo_Contact}

City: {city_Contact} Emirate: {emirate_Contact}

Country: {country_Contact} Mobile no: 971522233333

Email: apoel19@[Link]

Residential Address

Building name: test Street Name: test

Area/Landmark: {areaLandmark_Residential} Villa/Flat no: {villaFlatNo_Residential}

City: Umm Al Quwain Emirate: {emirate_Residential}

Country: United Arab Emirates P. O. Box: {POBox_Residential}

Overseas/Home Country Address

Address Line 1:

Address Line 2:

Emirate/City: {emirateCity} Country: {country_Overseas}

Telephone No. {telephoneNo}


Are you a PEP or an immediate family member, close friend or business relation in a politically exposed position (PEP) or any affiliation to any political or
past political party?

No If yes specify:

Customer Profile Individual

Employment Self- Others (Unemployed/


{EmploymentSalaried} Salaried {EmploymentSelfEmployed} {EmploymentOthers}
Status: Employed Retired/ Dependent)

Salaried Self employed

Employer Name & Country: 3I INFOTECH LIMITED - SHARJAH Industry:

Monthly salary: 10000 Monthly income from Business: 10000

Other source of income: {otherIncomeSource_Salaried} Other source of Income: {otherIncomeSource_SelfEmployed}

Profession: {profession_Salaried} Company Name & Country: {companyNameAndCountry_SelfEmployed}

Employment start date: {employmentStartDate_Salaried} Provide copy of trade license: {tradeLicenseCopy_SelfEmployed}

Source of fund for Unemployed/ Dependent:

Additional source of Income (if any): Source, Location Country & Value (AED): {additionalSourceOfIncome_Salaried}

Initial Deposit Amount (AED):

(Own account) Bank Name: bank Location:

If 3rd party, please provide below information:

Person/entity Name: Bank Name: Bank location:

Source of Wealth (If Any)

Anticipated Account Activities with Invest Bank

Estimated amount turnover in the account (Yearly AED) Credit: Debit:

Expected type of account activity yearly in AED (Credit): Cash: 12 Cheques: 12 Internal Transfers: 12 External Transfers: 0

Expected type of account activity yearly in AED (Debit): Cash: 12 Cheques: 12 Internal Transfers: 12 External Transfers: 0

If cross border please mention: Purpose: No. of transfers: Country:

Accounts with Other Banks (In and outside UAE)

Bank Name Location (Country)

1-

2-

Banking Facilities Required

E-Statement Yes No SMS Banking Yes No Cheque Book Yes No

Online Banking Yes No Debit Card Yes No

Name required on debit card:

Customer Declaration

I / We request you to open account pursuant to the above data. I/ We have read and understand the terms and conditions (which can be found at
[Link]) applicable to the accounts or the banking services which I/ We have selected on which I / We expressly agree and accept to abide by
whether in Arabic or English language.

Customer Signature:

FOR BANK USE ONLY

Name Signature
Signed in my presence
Designation Staff ID

All documents collected: Yes No If no specify

Name Signature
Reviewed / Approved By
Designation Staff ID
RM Name:

Additional Information from


RM (if Any)

al bank regulated and licensed by the Central Bank of UAE


P.O. Box -1885, Sharjah – U.A.E | [Link] | Tel. 600 544 404.

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