የኢትዮጵያንግድባንክ ለድርጅትአዲስሂሳብመክፈቻቅጽ

Commercial Bank of Ethiopia New Account Opening Form for Company

entities

ቅርንጫፍ/Branch___________________

Saving Accounts/የቁጠባሂሳቦች Current FCY Accounts/ Fixed Time

Accounts/ተንቀሳቃሽሂሳቦች በዉጭአገርገንዘብየሚከፈቱሂሳቦች Deposit
Contracts/የግዜገ
ደብተቀማጭሂሳብ
Ordinary/መደበኛ Ordinary/መደበኛ NRT FCY/ ኤንአርቲሂሳብ Birr/
የብርሂሳብ
Womens/የሴቶች Special /ልዩ NRT Birr/ኤንአርቲየብርሂሳብ FCY/
የውጭገንዘ
NRNT//ኤንአርኤንቲየብርሂሳብ ብሂሳብ
Youth/የወጣቶች Other/ሌላ__________ Retention A & B/ሪቴንሽን
Teen-Youth/የታዳጊወጣቶች Diaspora/ዲያስፖራ
Educational /የትምህርት Other/ሌላ_____________
Minor/ለአቅመአዳም/ሄዋንያልደረሰ/ች

Mortgage/የቤቶችቁጠባ
Pension/የጡረታ Currency Type
Other/ሌላ_____________________ USD GBP EURO

በኢትዮይንግድባንክቅርንጫፎችሌላሂሳብአሎዎት?
Do you have any account with any branch of CBE? አዎ/Yes የለኝም/No

መልስዎአዎከሆነየሂሳብቁጥሮትንይዘርዝሩ
IF Yes, Please list the account(s)

1._________________________________________ 4. ________________________________________
2._________________________________________ 5.________________________________________
3._________________________________________ 6. ________________________________________

የደንበኛመለያቁጥር/Customer ID No. የሂሳብቁጥር/Account

No.

1.የድርጅቱመረጃ/Company Information
1.1. የድርጅቱስምእናአድራሻ/ Name and address of the company
የድርጅቱስም/
Company Name
ክልል/ከተማአስተዳደር/Region/City ተንቀሳቃሽስልክቁጥር/Mobile
Administration number
ዞን/Zone ስልክቁጥርየቢሮ/Telephone
Number-Office
ክፍለከተማ/Sub-City ኢሜልአድራሻ (ካለ) /e-mail
address(If any)(Optional)
ወረዳ/ቀበሌ/Woreda/kebele ፋክስቁጥር (ካለ)/Fax
Number(If any)(Optional)
የቤትቁጥር/House Number

1.2. የድርጅቱተጨማሪመረጃ/Additional Information of the Company

ድርጅቱየተቋቋመበትአገር/Country of ድርጅቱየተቋቋመበትቀን/Date of
Incorporation Incorporation

የግብርከፋይመለያቁጥር/TIN Number የንግድፈቃድቁጥር/trade licence

number
የንግድፈቃዱየተሰጠበትቀን/Trade የንግድፈቃዱየሚያበቃበትቀን/
licence issued date Expiry date of Trade licence
ድርጅቱቅርንጫፍካለውይዘርዝሩ የድርጅቱቅርንጫፍብዛት/Number of
(ተጨማሪገጽያያይዙ) /Please provide branches
list of branches/subsidiaries if any

ድርጅትዎ(ከባንክውጪ)የፋይናንስተቋምከሆነለቀጣዩጥያቄመልስይስጡ
If Your Organization is a financial institution (Other than banks), Please the below inquiry.

ድርጅትዎየ FATCA ህግንይተገብራል?

Are you FATCA Compliant? አዎ/Yes አይደለም/ No
መልስዎአዎከሆነእባክዎ GIIN ይሙሉ/If
Yes, please fill your GIIN
2.የድርጅቱዋናሥራአስፈፃሚ/ሥራአስኪያጅመረጃ/CEO or General Manager Information
ስም/Name የአባትስም የአያትስም
Father’s name Grand Father
Name
ክልል/ከተማአስተዳደር/Region/City ስልክቁጥርየመኖርያ (ካለ)/Telephone
Administration Number-Residence (If any)(Optional)
ዞን/Zone ተንቀሳቃሽስልክቁጥር/Mobile number

ክፍለከተማ/Sub-City ስልክቁጥርየቢሮ/Telephone Number-

Office

ወረዳ/ቀበሌ/Woreda/kebele ኢሜልአድራሻ/e-mail address

የቤትቁጥር/House Number ፋክስቁጥር (ካለ) /Fax Number (If any)

(Optional)
መታወቂያ /ፓስፖርትቁጥር/ID or የመታወቂያአይነት/ID Card type
Passport Number
መታወቂያየሰጠውአካል/Issued By መታወቂያየተሰጠበትቀን/Issued Date

አገልግሎትየሚያበቃበትቀን/Expiry
date
3. የድርጅቱባለቤትመረጃ/Beneficial Owners
Information( 10%እናከዛበላይድርሻያላቸውባለቤቶችበስምዝርዝርተጨማሪገፅያያይዙ/Declare listof beneficial owners with 10% and
above share holding)
4. የቦርድሰብሳቢእናአባላትዝርዝር/Board chair person and members
list(አባክዎንከታችበተያያዘውሰንጠረዝመሰረትበዝርዝርያቅርቡ/Please attach list according to the below format)
ተራ ሙሉስም/ ዜግነት/ አገር/ ክልል/ Sub City Woreda/ ID/Passport Educational
ቁጥር Full Name Nationality Country ከተማአስተዳደር/R Kebele Number Qualification
No. including egion/City
Grand Administration
Father’s
1. name

5. ሌሎችመረጃዎች/Other details
5.1.የፖለቲካሥልጣንላላቸውደንበኞች /Politically Exposed Person
ከዋናስራአስፈፃሚከድርጅቱባለቤትእናከቦርዱውስጥየፖለቲካሥልጣንያ አዎ/ የለም/No
ለውአለ? /Is there PEP from the CEO, Beneficial owners and Yes
board members?
መልስዎአዎከሆነአባክዎቀጥሎያሉትንይሙሉ/If your answer is Yes, please fill the following

የግለሰቡስም/Name of the exposed

person (Please use additional form for
morethan one PEP)
የሚሰሩበትመ/ቤት/Name of Employer
በመ/ቤቱያሎትየስራሃላፊነት/Position
የተዳርጓደኛሙሉስም/Name of spouse
የአናትሙሉስም/Mother’s full name
የልጆችስምዝርዝር/Name of Children 1.
2.

3.
ሂሳቡእንዲከፈትያፀደቀውሃላፊስምእናፊርማ (የፖለቲካተጋላጭለሆኑደንበኞችብቻ)
Full name and signature of approver (For PEP customer only)

ስም/Name ____________________________ የስራሃላፊነት/Position ____________________ፊርማ/ Signature______________

5.2. ድርጅቱበአሜሪካህግየተቋቋመ (የሚመራ)ነው? / Is the company linked to US?

አዎ/Yes አይደለም/ No

መልስዎአዎከሆነእባክዎትንፎርም W9
ይሙሉ/If Your answer is Yes, Please
fill form W9
የግብርከፋይመለያቁጥር (የአሜሪካቲን)
/TIN Number (US TIN)

6. ሌሎችአማራጭየክፍያመንገዶች/Other alternative payment channels

ከታችከተጠቀሱትአማራጭየባንክአገልግሎቶችየሚፈልጉትንይምረጡናለአገልገሎቱየተዘጋጀዉንፎርምይሙሉ Put “X” in the box, if you need one or more

alternative payment channels.
 የክፍያካርድ/ Payment Card
ሞባይልባንኪንግ/Mobile Banking
ኢንተርኔትባንኪንግ/Internet Banking
የሲቢኢብርደንበኛ/CBE BIRR Customer
የቁጠባደብተርያስፈልግዎታል?አዎ/አያስፈልገኝም /Do you need a passbook? (YES/NO)

ቀን/Date: __________________ የአመልካች/ቾችፊርማ

Signature of Applicant(s):______________________________

የኢትዮጵያንግድባንክ የፊርማናሙናመቀበያ
Commercial Bank of Ethiopia Signatory Specimen

የሂሳብስም/Account Name
የሂሳብቁጥር/Account Number (s)

የፈራሚውስም/Name of the ስም/First Name: የአባትስም/Second Name፡ የአያትስም/Last Name:

signatory

ክልልወይምከተማአሰተዳደር/Region or የመታወቂያውአይነት/Document Type

City adminstration
ክ/ከተማ/Sub City መታወቂያቁጥር/ID/Passport No.

ወረዳ/ቀበሌ/Wereda የሰጠውአካል/Issued By
የቤትቁጥር/House No. የተሰጠበትቀን/Issued Date
ኢሜይል/e- mail የሚያበቃበትቀን/Expiry date
ፖ.ሣ.ቁ/P.O.Box
የተንቀሳቃሽስልክ/Mobile no.
የቢሮየመስመርስልክ/Office Telephone
አንድጉርድፎቶግራፍ/
የፊርማናሙና/Specimen Signature Passport size photo
(if any)
_____________________ _________________________ ____________________________

የፈራሚውስም/Name of the signatory ስም/First Name: የአባትስም/Second Name፡ የአያትስም/Last Name:

ክልልወይምከተማአሰተዳደር/Region or የመታወቂያውአይነት/Document Type

City adminstration
ክ/ከተማ/Sub City መታወቂያቁጥር/ID/Passport No.

ወረዳ/ቀበሌ/Wereda የሰጠውአካል/Issued By
የቤትቁጥር/House No. የተሰጠበትቀን/Issued Date
ኢሜይል/e- mail የሚያበቃበትቀን/Expiry date
ፖ.ሣ.ቁ/P.O.Box
የተንቀሳቃሽስልክ/Mobile no.
የቢሮየመስመርስልክ/Office Telephone
የፊርማናሙና/Specimen Signature አንድጉርድፎቶግራፍ/
Passport size photo
______________________ ________________________ ____________________________ (if any)