Fcmb Client Ativation Form – Fill Out and Use This PDF

WHOLESALE INTERNET BANKING SERVICE

CLIENT ACTIVATION FORM

SECTION 3: BILLING INFORMATION (Please indicate account number(s) & currency as appropriate)

SECTION 4: ACCOUNT NUMBERS

*Please state the default Collections Pool Account________________________________________________________

WHOLESALE INTERNET BANKING SERVICE

CLIENT ACTIVATION FORM

SECTION 6: CUSTOMER ADMINISTRATION (for User ID & Password Reset with your Organisation)

Please indicate the number of pages of addendums completed (if any) __________________________

Virtual Card Number________________________________Expiry Date_______________________

I/WE acknowledge that my/our use of the service(s) required will be governed by the relevant terms and conditions applicable to such service(s) as indicated in this form. I/WE hereby certify that the information provided above is true and accurate at all times and, that we will notify you of the inaccuracy of such information and forthwith provide to you the up-to-date information. I/WE acknowledge that my/our use of the MyBank@net service(s) will be governed by the terms and conditions of the Master Client Access Agreement and other related documentation. I/WE confirm that we have read, understood and agree to be bound by the Master Client Access Agreement including, without limitation, the various indemnities provided thereunder. I/WE hereby acknowledge that you reserve the sole right to vary or modify the terms, conditions and content of this form at anytime with or without notice to us/me and we agree to be bound by such amendments(s) and / or modification(s) to this form.

SECTION 7: CONTACT REPRESENTATIVE DETAILS

Cash Management - Contact Person

___________________________________________________________________________________________________

WHOLESALE INTERNET BANKING SERVICE

CLIENT ACTIVATION FORM

SECTION 8: AUTHORIZERED SIGNATURE SPECIMENS FOR CORPORATE CHEQUES (Please print in black ink)

SECTION 8: FOR BANK USE ONLY

SIGNATURE VERIFIED BY:

*CSO NAME____________________________STAFF ID_______________________ DATE_______________________

*ACCOUNT OFFICER CODE______________________

INFORMTION VERIFIED:

BDM / RM SIGNATURE / DATE ______________________ PRODUCT & CHANNELS SIGN-OFF __________________

DATE RECEIVED _________________________________ DATE SENT TO AMU _______________________________

BUSINESS DEV.MANAGER _________________________ CONTACT NUMBER _______________________________

RELATIONSHIP MANAGER _________________________ CONTACT NUMBER_________________________________

CLIENT ACCESS MANAGER _______________________ CONTACT NUMBER _______________________________

CLIENT TYPE ____________________________________ CLIENT SEGMENT _________________________________

MyBank@Net GROUP ID __________________________ TRADE SET-UP ID _________________________________