Are you looking for a new bank account? If so, you may be wondering if Form Pembukaan Rekening Bank Bni is the right choice for you. This article will provide an overview of the bank and its services, as well as details about the application process. So, whether you're just getting started or are considering switching banks, read on for all you need to know about opening a BNI account.
This figure has got specifics of form pembukaan rekening bank bni. This table provides information about the form's size, finalization time, and the fields you're required to fill.
Question | Answer |
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Form Name | Form Pembukaan Rekening Bank Bni |
Form Length | 6 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 1 min 30 sec |
Other names | cara mengisi formulir bni, contoh cara mengisi formulir pembukaan rekening bni online, formulir pembukaan rekening bni, cara mengisi formulir bank bni |
FORMULIR APLIKASI PEMBUKAAN REKENING INVESTOR (PERORANGAN)
INDIVIDUAL INVESTOR ACCOUNT OPENING APPLICATION FORM
Mohon diisi dengan huruf cetak dan beri tanda √ pada kotak pilihan
Please fill in with with block letters and mark √ in the box
Kode Nasabah
Client Code
CIF Baru /New CIF |
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CIF Lama / Existing CIF |
No Rekening di BNI / BNI Account Number *) |
Daftar Internet Banking? |
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Sign Up for Internet Banking? |
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No CIF *) |
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Baru / |
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Ya |
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Tidak |
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New |
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Yes |
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No |
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CIF Number |
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Rek. Yang ada |
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*) diisi oleh petugas |
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No SID *) |
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Filled by the officer |
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Existing Account |
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SID Number |
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No Sub Rekening Efek *) |
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Securities Account Number |
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Nama Depan
First Name : …………………………………………………………….................
Nama Belakang
Last Name : …………………………………………………………….................
(Isi Nama sesuai Kartu Identitas / Fill Name as stated in the ID)
Nama Alias (jika ada)
Alias Name (if any) : …………………………………………………………..................
Jenis Kelamin |
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Sex |
: |
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Laki0Laki |
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Perempuan |
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Status Pernikahan |
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Male |
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Female |
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Marital Status |
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Menikah |
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Lajang |
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Janda/Duda |
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Married |
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Single |
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Widow/Widower |
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Tempat/Tanggal Lahir |
: ………………………………………………................……. |
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Place/Date of Birth |
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tgl |
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bln |
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thn |
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Nama Gadis Ibu Kandung
Mother’s Maiden Name : …………………………………………...............………
Tanda pengenal |
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Identity |
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KTP |
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Paspor |
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ID Card |
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Passport |
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KITAS/KITAP |
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No: |
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Temporary Residence Visa |
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ID Number |
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Berlaku s/d |
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tgl |
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bln |
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Expiry Date |
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Seumur Hidup / Valid for life |
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Tempat Diterbitkan
Place of Issuance : …………………………………………….................………….. |
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Tanggal Diterbitkan |
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Date of Issuance |
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: tgl |
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bln |
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thn |
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Kewarganegaraan |
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*)dilampirkan Paspor & KITAS |
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Nationality |
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WNI |
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Passport & KITAS attached |
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WNA *), Negara Asal : .......………..…….......………. |
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Native Country |
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Agama |
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Islam |
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Kristen |
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Katolik |
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Religion : |
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Moslem |
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Christian |
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Catholic |
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Buddha |
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Hindu |
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Kong Hu Cu |
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Buddhist |
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Hindu |
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Kong Hu Cu |
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Lainnya / Others : ……………………………………………….. |
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NPWP |
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Ada |
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Tidak Ada |
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Tax ID Number |
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Possess |
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Not Possess |
No:
Tempat Diterbitkan
Place of Issuance : ………………………………………………………..…………......
Tanggal Diterbitkan |
: tgl |
bln |
thn |
Date of Issuance |
Alamat (sesuai tanda pengenal)
Address as stated in ID Card : (fotokopi terlampir / copy attached)
Alamat Tempat Tinggal Terkini
Present Residence Address : …………………….............……………………..
……………………………………………………………………......................……………..
……………………..........…………...…… RT / RW |
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Desa / Kelurahan |
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Village |
: ........…………………………………………………………… |
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Kecamatan |
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Sub0District |
: .......…………………………………………………………… |
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Kota |
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Kode Pos |
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City |
: ………………………........... Zip Code |
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Propinsi |
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Negara |
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Province |
: ………………........………… Country |
:.... …………………………… |
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Status Tempat Tinggal / Ownership of Residence : |
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Milik Sendiri |
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Milik Sendiri Dijaminkan |
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Own House |
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Own House Used as Collateral |
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Milik Keluarga |
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Sewa / Kontrak |
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Family Owned House |
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Rented House |
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Rumah Dinas |
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Official Residence |
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No. Telpon |
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Phone Number : |
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No. Fax |
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Fax Number |
: |
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No. HP |
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Cell Phone |
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: ……………………………………………………………… |
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SD |
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SMP |
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SMA / Sederajat |
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Elementary |
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Junior High |
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Senior High School |
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D10D2 |
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D3 |
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S1 |
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S2 |
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Diploma |
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Academy |
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Degree |
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Tandatangan / Signature
2011
1/3
Nama TempatBekerja
Name of Working Place : …………………………………………………............
Alamat Tempat Bekerja
Address of Working Place : …………………………………………................
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Province : …………………............……... |
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Jumlah Penghasilan Per Bulan / Monthly Income
Bidang Usaha
Line of Business : ………………..……………..............……………………………..
Jabatan Pekerjaan |
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< Rp. 5.000.000 |
Rp. 10.000.000 0 < Rp. 20.000.000 |
Rp. 5.000.000 0 < Rp 10.000.000 |
Rp. 20.000.000 0 < Rp 50.000.000 |
Frekuensi Penghasilan / Income Frequency |
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Harian / Daily |
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Jumlah Penghasilan Per Tahun / Annual Income
Rp. 50.000.000 0 < Rp. 100.000.000
≥Rp. 100.000.000
Bulanan / Monthly
< Rp. 50.000.000
Rp. 50.000.000 0 < Rp 100.000.000
Jumlah Kekayaan Bersih / Net Worth
< Rp. 500.000.000 Rp. 500.000.000 0 < Rp 1.000.000.000
Rp. 100.000.000 0 < Rp. 250.000.000 Rp. 250.000.000 0 < Rp. 500.000.000
Rp. 1.000.000.000 0 < Rp. 2.500.000.000 Rp. 2.500.000.000 0 < Rp. 5.000.000.000
Rp. 500.000.000 0 < Rp. 1.000.000.000 ≥ Rp. 1.000.000.000
Rp. 5.000.000.000 0 < Rp. 10.000.000.000 ≥ Rp. 10.000.000.000
Nama Suami atau Istri
Spouse Name : …………………………………………………………..............
Alamat Tempat Tinggal
Residence Address : ……………………………………………………..............
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Sub0District : ……………………………………………………………........................
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Identity |
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ID Card |
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Passport |
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Seumur Hidup / Valid for life |
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Place of Issuance : ……………………………………………………….................
DATA PEKERJAAN SUAMI ATAU ISTRI / SPOUSE OCCUPATION
Karyawan/Employee |
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Profesional/Professional |
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Lain0Lain/Others |
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Nama Perusahaan Tempat Bekerja / Company Working Place
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Bidang Usaha
Line of Business : ………………..…………………………………………....................
Alamat Perusahaan / Company / Institution Address
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Kota / City |
Kode Pos |
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Zip Code |
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Propinsi / ProvinceNegara / Country
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Jabatan Pekerjaan / Job Position
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Lama Bekerja |
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Length of Employment : |
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Fax Number |
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Tanggal Diterbitkan
Date of Issuance |
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No. Telp
Phone Number :
No. HP
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tgl |
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Jumlah Penghasilan Per Tahun / Annual Income
< Rp. 50.000.000
Rp. 50.000.000 0 < Rp. 100.000.000
Rp. 100.000.000 0 < Rp. 250.000.000
Rp. 250.000.000 0 < Rp. 500.000.000
Rp. 500.000.000 0 < Rp. 1.000.000.000
≥ Rp. 1.000.000.000
Email : ………………………………………………………………............
Tandatangan / Signature
2011
2/3
Gaji |
Hasil Usaha |
Bunga Bank |
Hasil Undian |
Hibah dari Orangtua atau Anak |
Hasil Investasi |
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Salary |
Business Profit |
Bank Interest |
Lottery |
Grant from Parent or children |
Proceed of investment |
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Warisan |
Uang Pensiun |
Deposito |
Pinjaman |
Hibah dari pasangan |
Lainnya / Others |
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HeritagePensiunFund |
Deposit |
Loan |
Grant from spouse |
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*) Nama pemilik rekening harus sama dengan nama nasabah |
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The beneficiary name shall be the Client’s name |
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Nama |
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Untuk Perhatian / For Attention |
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Name |
: …………………………………………………………………......................... DesignationUntuk :Perhatian……………………………………………………………................................/ For Attention |
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No. Telpon Seluler |
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No. Fax |
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Cell Phone Number : |
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Nama Pemilik Rekening / Beneficiary *) |
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Jenis Rekening / Type of Account |
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No. Rekening Pemohon di Bank Lain |
Nama Bank dan Cabang |
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Client’s Other Bank Account Number : |
Bank and Branch Name : …………..........……………. / ………..…………………………… |
Pengalaman Investasi / Investment Experience |
Maksud dan Tujuan Investasi / Investment Objectives |
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Saham / Equity |
Reksa Dana / Mutual Fund |
Apresiasi Harga/ Price Appreciation |
Spekulasi / Speculation |
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Obligasi / Bonds |
Derivatif / Derivatives |
Investasi / Investment |
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Pendapatan / Income |
Lainnya / Others |
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Lainnya / Others |
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Jangka Waktu Investasi / Investment Horizon |
Informasi Transaksi/ Trading Information |
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Jangka Pendek |
Jangka Panjang |
Jumlah Deposit Awal / Initial Deposit : ……………….............……………………… |
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Long Term |
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Batas Transaksi / Trading Limit : ……………………………….............…………….. |
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Korespondensi yang berhubungan dengan Rekening harap dikirim ke |
Pelayanan Konfirmasi Transaksi Efek |
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Please send all correspondence related to the Account to |
Securities Transaction Confirmation Service |
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Alamat Kantor |
Alamat Rumah Saat Ini |
No. Fax |
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Office Address |
Present Residence Address |
Fax Number |
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Others, jelaskan |
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Lainnya, please specify |
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............................................................
Untuk keadaan darurat, keluarga tidak serumah yang dapat dihubungi yaitu
For emergency situation, please specify a relative living on different address to be contacted
NamaHubungan
Name : …………………………………………………………………........................... Relation : ………………………………..……………………………..............................
Alamat Tempat Tinggal |
No. Telpon |
Residence Address |
: …………………………………………...............………… Phone Number : |
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No. Telpon Seluler
Cell Phone Number :
No. Fax
Fax Number :
Tandatangan / Signature
2011
3/3
Ketentuan dan prosedur pelaksanaan mengenai Rekening Investor selanjutnya, diatur dalam Syarat dan Ketentuan Pembukaan Rekening Investor yang menjadi lampiran dari Formulir Aplikasi Pembukaan Rekening Investor dan mengikat Pemohon.
Dengan ditandatanganinya Formulir Aplikasi Pembukaan Rekening Investor ini, maka Pemohon menyatakan dan memberi kuasa sebagai berikut :
1.Pemohon dengan ini menyatakan bahwa :
a.Seluruh data dan informasi yang dicantumkan dalam Formulir Aplikasi Pembukaan Rekening Investor adalah benar, lengkap, dan sah, dan Bank diberi hak untuk memeriksa dan melakukan verifikasi atas kebenaran, kelengkapan, dan keabsahan dari setiap data dan informasi dalam Formulir Aplikasi Pembukaan Rekening Investor ini.
b.Pemohon telah diberikan informasi yang cukup dan memadai perihal karakteristik produk Rekening Investor yang akan dimanfaatkan oleh Pemohon, dan Pemohon mengerti serta memahami segala konsekuensi pemanfaatan produk Rekening Investor, termasuk manfaat, risiko, dan biaya0biaya (bila ada) yang melekat pada produk Rekening Investor.
c.Pemohon telah menerima, membaca, mengerti dan menyetujui isi Ketentuan Umum dan Persyaratan Pembukaan Rekening Investor sebagaimana terlampir dari Formulir Aplikasi Pembukaan Rekening Investor, dengan ini Pemohon menyatakan tunduk dan terikat dengan ketentuan0ketentuan tersebut, serta ketentuan lain terkait produk/fasilitas Rekening Investor yang berlaku di Bank beserta segala bentuk perubahannya yang akan diberitahukan dengan sarana yang ditetapkan Bank.
2.Pemohon dengan ini memberi kuasa kepada pihak0pihak di bawah ini untuk melakukan tindakan0tindakan sebagai berikut :
a.Memberikan kuasa kepada Bank untuk melakukan pemblokiran dan atau penutupan rekening, apabila menurut pertimbangan Bank :
1)Pemohon tidak mematuhi ketentuan Prinsip Mengenal Nasabah (Knowing Your Customer);
2)Data yang Pemohon berikan kepada Bank tidak benar atau diragukan kebenarannya;
3)Pemohon menyalahgunakan rekening.
b.Memberikan kuasa kepada PT. BNI Securities (BNIS) untuk melakukan tindakan0tindakan sebagai berikut :
1)Memperoleh informasi tentang saldo dan mutasi rekening yang terdapat pada Rekening Investor sehubungan dengan kegiatan penyelesaian transaksi efek Pemohon pada BNIS melalui sarana perbankan yang disediakan Bank.
2)Melakukan segala tindakan0tindakan berkenaan dengan pengoperasian Rekening Investor, termasuk memberikan instruksi pemindahbukuan atau pendebitan seluruh dana atau sejumlah dana tertentu yang terdapat dalam Rekening Investor, untuk penyelesaian pembayaran dalam rangka penyelesaian transaksi efek Pemohon.
Contract conditions and implementation procedures regarding Investor Account will be arranged in the Investor Account Opening Terms and Conditions that will be the attachment of the Investor Account Opening Application Form and it will bind the Applicant.
By signing this Investor Account Opening Application Form, then the applicant states and authorizes the following:
1.The applicant hereby declares that:
a.All data and information set forth in the Investor Account Opening Application Form is true, complete, and valid, and the Bank was granted the right to inspect and verify the correctness, completeness, and validity of any data and information in this Investor Account Opening Application Form.
b.Applicant has been provided sufficient and adequate information concerning product characteristics of the Investor Account that will be utilized by the Applicant, and the applicant understands the consequences of Investor Account product utilization, including benefits, risks, and costs (if any) attached to the Investor Account product.
c.Applicant has received, read, understood and agreed to the contents of the General Terms and Conditions as attached in this Investor Account Opening Application Form, therefore the Applicant states to subject to and bound by such provisions, and other provisions related to Investor Account products / facilities applicable within the Bank and all forms of amendment which will be notified by means determined by Bank.
2.Applicant hereby authorizes the parties below to perform the following actions:
a.Authorize the Bank to suspend and or closing accounts, if in the opinion of the Bank:
1)The applicant does not comply with the Know Your Customer provision;
2)The data given to the Bank by the applicant is incorrect or doubtful;
3)The applicant misuses the account.
b.Authorize PT. BNI Securities (BNIS) to perform following actions:
1)Obtain information about account balances and transfer contained in the Investor Account in connection with the Applicant’s securities settlement activity in BNIS through banking facilities provided by the Bank.
2)Perform all actions with respect to the operation of the Investor Account, including sending debit or transfer instruction of the entire fund or a specific funds contained in the Investor Account, for the purpose of payment settlement in order to settle the Applicant’s securities transaction.
c.Memberikan kuasa kepada Bank untuk memberikan akses kepada PT. Kustodian Sentral Efek Indonesia (KSEI) melalui sarana elektronik perihal informasi mengenai saldo dan mutasi rekening yang terdapat pada Rekening Investor, sehubungan dengan kegiatan penyelesaian transaksi efek Investor melalui KSEI.
d.Memberikan kuasa kepada Bank untuk melakukan menutup rekening apabila Rekening Investor tidak aktif dan bersaldo nihil selama enam bulan berturut0turut serta berdasarkan data yang ada di PT. BNI Securities (BNIS) bahwa Pemohon/Nasabah tidak melakukan transaksi efek di BNIS.
c.Authorize the Bank to provide access to the Indonesian Central Securities Depository (KSEI) through electronic means, regarding information on account balances and mutation found in the Account Investor, in connection with Investor’s securities transaction settlement activities through KSEI.
d.Authorize the Bank to close the account if the Investor Account is not active and nil balance for six consecutive months, and also based on existing data in PT. BNI Securities (BNIS) that the Applicant / Customer does not conduct transactions in securities BNIS.
2011
(Lembaran Untuk BNI)
Tandatangan / Signature
3.Pemberian akses dan informasi mengenai saldo dan mutasi rekening yang terdapat pada Rekening Investor sebagaimana dimaksud angka 2 huruf b, c dan d di atas bukanlah merupakan pelanggaran atas ketentuan Rahasia Bank sebagaimana diatur dalam Undang0Undang Nomor 7 tahun 1992 tentang Perbankan sebagaimana telah diubah dengan Undang0Undang Nomor 10 tahun 1998, berikut segenap peraturan pelaksanaannya dan perubahan0perubahannya.
4.Pemohon menjamin serta membebaskan Bank dari segala kewajiban, tuntutan, gugatan dan klaim apapun serta dari pihak manapun, termasuk Pemohon sendiri, serta dari segala kerugian dan resiko yang mungkin timbul di kemudian hari sehubungan dengan pelaksanaan tindakan0tindakan sebagaimana dimaksud dalam pernyataan dan kuasa Pemohon ini.
3.Providing access and information regarding account balances and transfer found in the Investor Account referred to item 2 letter b and c above, is not a violation to the Bank Secrecy Provisions as stipulated by Act No. 7 Tahun 1992 regarding Banking, which was amended by Act No. 10 of 1998, following all implementing regulations.
4.Applicant guarantees as well as relieves the Bank from any liability, claims, lawsuits and claims of any kind and from any party, including the Applicant him/herself, and from all losses and risks that may arise later in connection with the implementation of measures referred to this Applicant’s statement and authorization.
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Pemohon / Applicant
Materai / Stamp
Rp. 6000
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Nama jelas, tanda tangan, dan materai
Name, Signature, and Stamp
VALIDASI PETUGAS *)
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_______________________ Tgl:…………………………….. |
_______________________ Tgl:…………………………….. |
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Nama : |
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NPP :
NPP :
Telp / HP :
Email :
Jabatan :
Unit :
Persetujuan Supervisor BNI Securities
Persetujuan Supervisor BNI **)
TTD
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Nama :
Jabatan :Tgl:……………………………..
TTD
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Nama :
Jabatan :Tgl:……………………………..
*) Diisi oleh petugas / Filled by the officer
**) Dibubuhi Stempel Cabang / Stamped by Branch seal
2011
(Lembaran Untuk BNI)
Apakah anda bekerja di PT BNI Securities ?/ Are you working for PT BNI Securities ?
Ya / Yes
Tidak / No
Jika Ya, sebutkan nama bagian / If Yes, please mention the department name
Apakah anda mempunyai saudara atau anggota keluarga (termasuk orang tua/saudara kandung) yang bekerja di PT BNI Securities ?
Do you have any relatives working for PT BNI Securities ?
Ya / Yes
Tidak / No
Jika Ya, sebutkan nama
If Yes, please mention the name(s)
Bagian/ Department
Apakah anda mempunyai saudara atau anggota keluarga (termasuk orang tua/saudara kandung) yang bekerja pada perusahaan efek lain, Bursa Efek, perusahaan yang diatur oleh Bursa Efek/Badan Pengawas Pasar Modal dan Lembaga Keuangan, Bank, Asuransi atau Lembaga keuangan sejenis ?
Do you have any relatives working in other securities company, Stock Exchange, other company under supervision of Indonesian Stock Exchange / Capital Market and Financial Institutions Supervisory Body, Bank, Insurance Company or other similar financial institution?
Ya / Yes
Tidak / No
Jika Ya, sebutkan nama dan jabatan
If Yes, please mention the name and position
Nama Perusahaan/ Company Name
Apakah anda mempunyai saudara atau anggota keluarga (termasuk orangtua/saudara kandung sampai dengan derajat ketiga) yang mempunyai status sebagai seorang karyawan dari perusahaan, direktur atau mempunyai pengendalian pada suatu perusahaan publik atau kepemilikan terhadap saham yang dilarang ?
Do you have any relatives being an employee of a company, Director or having control to any public company(ies) or having prohibited stocks ?
Ya / Yes
Tidak / No
Jika Ya, sebutkan nama dan jabatan
If Yes, please mention name and position
Nama Perusahaan / Company Name
Apakah anda sudah memiliki Rekening di PT BNI Securities ? / Do you have any Account in PT BNI Securities ?
Ya / Yes |
Tidak / No |
Jika Ya, sebutkan alasan pembukaan rekening baru
If Yes, please mention reason of opening the new account
No Rekening / Account Number
Mohon dilampirkan / please enclose a copy of :
1.KTP yang masih berlaku / copy of the valid ID card atau/or Paspor yang masih berlaku / copy of the valid Passport
2.KITAS (jika ada) / Residence Permitt (if any)
3.NPWP (jika ada) / Copy of the tax number (if any)
!"!#$%!&'##!( !!&'##!(
Dengan ini saya/kami menyatakan bahwa :
1.Semua informasi yang tercantum pada formulir ini adalah benar dan sah; bilamana di kemudian hari terdapat tuntutan dalam bentuk apapun dari pihak ketiga manapun atas transaksi dan/atau rekening (0 rekening) saya/kami terhadap PT BNI Securities, maka saya/kami bertanggung jawab penuh atas segala tuntutan pihak ketiga tersebut baik yang bersifat kasus perdata maupun pidana;
2.Semua penyetoran dana hanya ditujukan kepada rekening Bank atas nama dan yang telah ditunjuk oleh PT BNI Securities;
3.Semua penyetoran Efek hanya ditujukan kepada rekening Efek atas nama PT BNI Securities di Lembaga Penyimpanan dan Penyelesaian (LPP);
4.Saya/kami memberi wewenang penuh kepada PT BNI Securities untuk memeriksa kebenaran dan keabsahan semua informasi tersebut;
5.Saya/kami mengerti bahwa persetujuan pembukaan rekening dapat dipertimbangkan untuk diberikan berdasarkan informasi dalam formulir ini dan syarat0syarat perjanjian lainnya. Namun demikian PT BNI Securities mempunyai hak untuk menolak aplikasi ini tanpa adanya keharusan untuk memberikan alasan.
6.Semua sumber dana yang saya gunakan dalam transaksi pembelian efek bukan didapatkan atau berasal dari pencucian uang (Money Laundering) atau kegiatan lain yang melanggar hukum;
7.Tidak akan menggunakan rekening efek yang akan dibuka sebagai sarana untuk melakukan tindakan yang dapat dikategorikan melanggar hukum termasuk namun tidak terbatas pada tindakan pidana pencucian uang.
2011
(Lembaran Untuk
I / We hereby declare that :
1.All information stated in this form are true and valid; if subsequently there is any claims in any form whatsoever from any third party on transaction and/or my/our account(s) to PT BNI Securities, then I/we are fully liable on such claims of the third party, either in the nature of civil or criminal case;
2.All payments of fund may only be deposited to a bank account designated by and registered on behalf of PT BNI Securities;
3.All Securities deposit may only be addressed to the Securities account of PT BNI Securities in the Depository and Settlement Institution (LPP);
4.I/We granted full authority to PT BNI Securities to verify the correctness and validity of such all information;
5.I/We understood that the approval on opening account may be considered to be granted based on the information contained in this
form and the conditions of other agreement. However, PT BNI Securities is entitled to reject this application without any obligation to provide the reason.
6.All sources of fund used in the securities purchasing transactions are not obtained/originated from money laundering practices or any unlawful actions
7.I shall not use the securities account to be opened as the means of doing any unlawful actions, including but not limited to the criminal action considered as money laundering.
Tandatangan / Signature