Account Opening

Form:

Southeast Bank Limited

Personal
Banking

A Bank with vision

Date:

Account Number:
Day

Month

Year

Customer ID:
Customer Group
ID:

The Manager
Southeast Bank Limited
.. Branch
Dear Sir,
I/We request you to open an account in my/our name with your Branch. The detailed information is
given below:

1.

Name of the Account

Holder:
Individual
Joint

1)

..
2)

..
3)

..

2.

Type of Account ():

Conventional Banking:

SB

CD

STD

FDR

Special Scheme

FC

RFCD

NFCD

Others (Please Specify):

.
Islamic Banking:

Mudaraba
SB
FC

Al-Wadiah
CD
RFCD

Mudaraba
STD

NFCD

MTDR

Mudaraba Special
Scheme

Others (Please Specify):

.
3.

Currency ():

Taka

Dollar

Euro

Pound
Page 1 of 7

Southeast Bank Limited

A Bank with vision

Account Opening
Form:

Personal
Banking

Others (Please Specify):

...

4.

Mode of Operations ():

Singly

Jointly

Any one

Others (Please Specify):

.

Page 2 of 7

Account Opening
Form:

Southeast Bank Limited

Personal
Banking

A Bank with vision

5.

Other Bank A/C(s) of the client (if any):

Name of the Bank

6.

Branch

Type of Account ()

A.

A.

Deposit

Loan

Others..
...

B.

B.

Deposit

Loan

Others.
.

C.

C.

Deposit

Loan

Others.
.

Introducers Information:
A. Name:
B. Account No.:
C. Name of the Branch:
I declare that, I know the applicant(s) and confirm the occupation and address of the applicant(s)
Introducers Signature Verified by:
Name:

Introducers
Signature:
Date:

7.

Signature:

Initial Deposit ():

Cash

Amount:

Cheque

Bank:

8.

Branch: ..

Information about FDR/MTDR :

Cheque No.:
.

Amount:
Currency:

Taka

Dollar

Euro

Pound

Others (Please Specify):

..
Period:

.. Month .... Year.

Day

Maturity Date: /. /..

.

Page 3 of 7

Account Opening
Form:

Southeast Bank Limited

Personal
Banking

A Bank with vision

For Renewal ():

Principal with Interest/Profit

Principal only and pay interest / profit in

cash

Principal only and credit Interest / Profit to A/c No: ..

..
Not Applicable

9.

Information about Special Scheme Deposit Account:

Name of the Scheme: ()
Conventional
Banking:

MSS

PSS

MIS

DBS

WEPSS

Others (Please Specify): ....

...
Islamic Banking:

Mudaraba MSS

Mudaraba PSS

Mudaraba MIS

Mudaraba WEPSS

Mudaraba DBS

Mudaraba Hajj Scheme

Others (Please Specify):

..
Period of the
Scheme:

Deposit at a time/
Installment
Amount:

Payable at maturity:

Tk.

No. of
Installment
(Yearly):

Tk.

Monthly Payable:

Tk.

Please credit Interest / Profit amount to A/c No: ....

10. Nominees Information:

I/We have nominated the following person in the event of my/our death to
receive/draw the amount of deposits held by you in my/our account. I/We
reserve the right to cancel or amend the mentioned nomination at any time.
I/We also agree that, the bank will not be liable for any transaction made as per
my/our instruction.
Name of the
Nominee:

..
.

Date
Birth/Age:

of

Photograph of the
Nominee
duly attested by the
A/C Holder

Page 4 of 7

Account Opening
Form:

Southeast Bank Limited

Personal
Banking

A Bank with vision

Fathers Name:

.
..

Spouse Name:

.
..

Permanent Address of the

Nominee:

Mothers Name:

....

....

Occupation:

National I.D. Card Number:

Relation
Holder:

with

the

A/C

..
..
Signature of the Nominee

(In case, a non-resident nominee is eligible to receive deposits, all the rules and regulations of existing
Foreign Exchange Regulation Act shall be applicable for remitting the said deposits abroad.)
11.

If one or more Account Holder(s) is/are Minor:

I declare as a legal guardian of the following Account holder(s) that the account holder(s) is/are minor.
His/her/their detailed information is furnished in the attached form. Until the account holder(s)
become(s) adult or any further declaration comes from me, the account will be operated under my
signature as legal guardian.
A. Name of the (Minor) Account
holder(s):
B. Name of the
Guardian:

C. Relationship with the

Minor:

..
..

(Personal Information Form in the names of the Minor and Legal Guardian must be filled in and both
the forms must be signed by the legal guardian.)
12.

Source of Fund:

.
13.

Statement Frequency
():

Monthly

Quarterly

Half Yearly

14.

Statement Delivery (): (Please choose only one option only)

Yearly

Page 5 of 7

Southeast Bank Limited

A Bank with vision

Collection from Branch

By Mail

15.

ATM Transaction:

Yes

16.

Declaration & Signature:

Account Opening
Form:

Personal
Banking

By E-mail
No

I / We have read, understood and hereby agree to abide by all the terms and conditions related to the
account.
I / We do hereby consciously declare that all the information provided herein above is
correct. I/We also confirm that we will provide further information/documents in addition to the
supplied information/documents as per your requirements.
Yours faithfully,

Name of the Account

holder:

1)

2)

3)

Signature:

1)
.

2)

3) .

Date:

1)
.

2) ..
.

3)

Page 6 of 7

Account Opening
Form:

Southeast Bank Limited

Personal
Banking

A Bank with vision

For Banks use only

SBS Codes

CIB Codes

Sector Code:

Borrower Code:

Economic Purpose Code:

Borrower Type:

Deposit Advance Code:

Sector Type:

Security Code:

Sector Code:

Privilege Code:

Type of Institution:

Remarks:
...
...............................
A/C opened by:

Approved by:

Data captured by:

Name:

Name:

Name:

Designation:

Designation:

Designation:

Signature with Seal:

Signature with Seal:

Signature with Seal:

Date:

Date:

Date:

Page 7 of 7