FOR BANK USE ONLY

Maldives Islamic Bank

CIF No:
INFORMATION FORM
INDIVIDUAL New Acc: Dormant Update

If you are submitting for an information update, please complete section A and relevant sections to be changed

SECTION A PERSONAL INFORMATION

Title Mr Ms Mrs Dr Other , Please specify

Full Name
(as in ID card/PP for foreigners)

ID Card Expiry Date D D M M Y Y Y Y

National ID Card No.
Passport No. Passport Expiry Date D D M M Y Y Y Y
(for foreigners) (for foreigners)

Work Permit/Visa No. Work Permit/Visa D D M M Y Y Y Y

(for foreigners) Expiry Date

Date of Birth D D M M Y Y Y Y Nationality

Gender Male Female Marital Status Single Married

No. of Dependants Passphrase

Educational Primary Secondary/ Degree

Basic Education Masters Professional
Qualification Higher Secondary

Other, specify

SECTION B CONTACT INFORMATION

Mobile Number Email Address

Home Number Office Number

(as in ID card/Passport) Present Address (if different from permanent)

House/Building Name House/Building Name

Flat No/Floor Flat No/Floor

Street Name Street Name

City/Island/Atoll City/Island/Atoll

Postal Code Postal Code

Preferred mailing
Permanent Present
address

Next of kin (Optional)

In case of my death or to ascertain my whereabouts, please enquire from /inform the status of my account to:

Name Relationship

Address Email Address

National ID Card No. Mobile/Telephone No.

 SECTION C

EMPLOYMENT DETAILS:

Employment Status Salaried Self employed Unemployed Student Retired

N/A (minor account)

Employment Sector Civil/State Private Public Military/Police Political

Volunteer Judiciary Other, please specify

Monthly Salary (in MVR)

(please specify including
allowances)
Less than 10,000 10,000 to 35,000 35,000 to 50,000 More than 50,000

Employer Name

Occupation/
Joined Date:
Designation

Address of Employer

House/Building Name City/Island/ Atoll

Flat No/Floor Postal Code

Street Name

Name of previous employer Length of Service

(if you have been in your current job for less than one year)

OTHER FINANCIAL DETAILS:

Other Income (in MVR)
(please specify the amount accordingly)

Profit Income Pension Gi /Donation Rent

Sale of property Family Remittance Other

Less than 10,000 10,000 to 35,000 35,000 to 50,000 More than 50,000

If Self Employed, please specify the details:

Since

Other businesses Involved

Name of business Designation

Name of business Designation

Name of business Designation

ASSETS:

Building Land Provident Fund Pension Fund

Fixed Deposit Shares Vehicles/ Vessels None

Others, please specify

Property, please list name and country of each property

Is your property
No Yes, list all the mortgaged property(s)
mortgaged?

Is your property
No Yes, list all insured property(s)
Insured?

Vehicle/Vessel Motorcycle Car Vessel Others, specify

Is your vehicle/
No Yes, list all insured vehicle(s)
vessel insured?

If you are operating accounts in other banks, please specify accordingly

HSBC SBI MCB BML CBM

BOC HBL Others, specify None

Loans or other facilities with other institutions

Description Repayment Amount Frequency Expiry Date

SECTION D ACCOUNT TRANSACTION INFORMATION )

Estimated monthly value of transactions ( in MVR)

Less than 15,000 15,000 to 30,000 30,000 to 50,000 50,000 to 200,000

200,000 to 500,000 500,000 to 1,000,000 More than 1,000,000, please specify a minimun amount

Estimated monthly volume of transactions

0 - 10 10 - 20 20 - 30 More than 30
 ADDITIONAL INFORMATION

[Link] tick the appropriate box if you are in any of the following positions:

Heads of State/Heads of Governments (example: President, Vice President, Prime Ministers)

Cabinet Ministers & State Ministers [includes Deputy or Assistant Ministers]

Members of Parliament [Any Similar Legislative Bodies]

Judges & Magistrates

Elected Council Members

Members & Senior Most Officials of a State Agency or Institution [like board members of central banks]

Senior Military Officials

Senior Officials appointed as per the provisions of a specific law (example: Head of FIU)

Senior Political Appointees of a Government (example: Coordinators at various Ministries)

Board Members of State-Owned Enterprises

Foreign and Local Diplomats [include ambassadors, chargés d'affaires etc.]

Senior Political Party Members [including members of the governing bodies of political parties]

OR

2. If none of the above is applicable, please tick any of the following:

I am actively seeking or being considered for above stated positions;

I have been retired for less than 12 months from the above mentioned positions;

My Close Family Members [Parents, Spouses, Children, sibling etc.] – are holding, OR actively seeking OR being considered OR retired for less than
12 months from the above stated positions. (Please Complete below)

Any individual holding any of the above stated position is associated party with my Business and holds more than 25% voting rights/share in your
Business/Company; (Please Complete below)
Any individual holding any of the above stated position has significant influence over the policy, business and strategy of my Business/Company
implying that the individual takes part in day to day management and the position is not an isolated consultative role or a non—executive role.
(Please Complete below)
I have a joint beneficial ownership of a legal entity or a legal arrangement (for example company or trust etc.) or any other close business
relationship with an individual holding any of the above stated positions;

I have a sole beneficial ownership of a legal entity or a legal arrangement (for example company or trust etc.) which is set up by a person holding
any of the above stated positions;

None of the above

3. If YES, please specify the details

Full Name

Occupation / Designation
 FATCA DECLARATION

Are you a citizen of

No Yes, name of the country
any other country?

Home Address

Do you hold a green Are you a work permit

Yes No Yes No
card of USA? holder of USA

I declare that I possess USA nationality/Lawful Permanent Residency/Passport and authorize Maldives Islamic Bank to disclose required
information to Inland Revenue Services of USA under FATCA.

I declare that I do not possess USA nationality/ Lawful Permanent Residency /passport as on date. I further undertake to inform the Bank
of obtaining USA Citizenship/Green card/Passport in future within material time and authorize Maldives Islamic Bank to disclose required
information to Inland Revenue Services in USA.

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If updating the specimen signature:

Signature New Signature

Date: D D M M Y Y Y Y

FOR BANK USE ONLY

(Please complete Annexure 1 - Customer Risk Rating sheet and attach with this form)

CRP Rating Risk Categorization Low High

Sanction List checked KYC update frequency Annually Once in 3 years

Forms and supporting documents Staff ID Signature Date

Received by

Checked by

Authorized by