Appendix 1

ACCOUNT APPLICATION FORM INDIVIDUAL

(Please read the terms and conditions attached to this application form before completing the form)

A. TYPE OF ACCOUNT/FACILITY
Please tick ( ) where applicable

FOR OFFICE USE ONLY

Account/Facility

Client A/c No :
1

Securities Trading

Online Trading:

Margin Trading

CDS A/c No: 0 7 3

Local

Global

Capital Markets Services Representatives

Licence Holder (CMSRL) Code :
Name of CMSRL :

Margin (T+10)
4

Global/Bursa Multi-Currency Equities Trading

E-Trade Trading
Cash Deposit: RM

Settlement Currency in Foreign Securities Trading:

Ringgit Malaysia
Non-Ringgit Malaysia
Contra in Foreign Securities:
Yes
No

Dividend Payment in Foreign Securities:

Ringgit Malaysia

Contract Notes

Monthly Statements

Margin Statements

Trust Account Statements

Intra-Day Trading:

Intra-Day Option
(FIFO)

Securitised Trading Account

Shares Deposited: As per list attached.

E-Statement

Non-Ringgit Malaysia

Trade in US securities? If yes, please execute the W-8Ben Form.

5

Shares Pledged: As per list attached

Cash Upfront Trading

Initial Deposit:

RM

Payment Mode

Cash

10

Custodial

11

3rd Party Pledge Trading

12

Trust

13

Others, please specify

(T+3)

No

Cheque

Others, please specify

B. PERSONAL DATA

Name (as per NRIC/Passport/Authority Card)

New NRIC No

Old NRIC No/Passport/Authority Card

(DD/MM/YYYY)

Date of Birth

U.S. Taxpayer Identification Number

(For U.S. Resident only)

Nationality

Malaysian

Non-Malaysian (please specify)

Race (for Malaysian only)

Bumiputra

Chinese

Gender

Male

Female

Marital Status

Single

Married

Residency

Resident

Non-Resident

Indian

Others (please specify)

Others (please specify)

Registered Address (as per NRIC/Passport/Authority Card)

Post Code
Correspondence Address (if different from above)

Post Code
Tel No.: Home

Office

Facsimile

Email

221211

Handphone

C. EMPLOYMENT INFORMATION
Employment Status

Employed

Self Employed

Others (please specify)

Name of Employer
Employer Nature of Business
Occupation/Designation
Office Address

Post Code
Years in Employment/Business

D. FINANCIAL INFORMATION
Gross Annual Income

Estimated Net Worth

Below RM50,000

RM50,001-RM100,000

RM100,001-RM200,000

RM200,001-RM300,000

RM300,001-RM500,000

Above RM500,000

RM

Bank/Branch
Type of Account

Account No.

E. DETAILS OF SPOUSE (if married)

Name (as per NRIC/Passport/Authority Card)

New NRIC No.

Employment Status

Old NRIC/Passport No.

Employed

Self-Employed

Others (please specify)

Name of Employer/Nature of Business

Occupation/Designation
Contact No

Office

Handphone

F. INVESTMENT OBJECTIVE AND EXPERIENCE

Investment Objective

Capital Growth

Dividend Income

Speculation

Others (please specify)

Investment Horizon

Short Term (<1 year)

Long Term (>1year)

Both

Investment Experience

Shares_____ Years

Derivatives_____Years

Others (please specify)

Source of Funds

Own Cash ___ Business

Investment Returns

Others (please specify)

G. OTHER INFORMATION
1

Existing account with Kenanga Investment Bank Berhad

Yes, Account No

Is the Applicant an employee or dealers representative of a participating organization of Bursa Malaysia Securities Berhad? (If yes, please state the name of
the participating organization)
Yes (Name Of PO)

No

No

Any trading account maintained with other participation organization of Bursa Malaysia Securities Berhad? (If yes, please specify name of
participating organization)

the

Is the Applicant related to any staff/director/capital markets services representatives licence holder of Kenanga Investment Bank Berhad or K&N Kenanga
Holdings Berhad Group? (If yes, please provide name and relationship)

Do any of the Applicants related persons have Trading Account(s) maintained with Kenanga Investment Bank Berhad? Related persons include the
applicants spouse and child
(If yes, please provide name, account number and relationship)
Name of Related Person

Trading Account No

Relationship

a
b
c
6

Is the Applicant a Director or a substantial shareholder of a company which has a Trading Account with Kenanga Investment Bank Berhad? (If yes, please
provide name and account number)
Name of Related Person

Trading Account No

a
b
c
(Please attach details in separate sheet if the space provided is insufficient)
7

Political Exposed Persons

Does the Applicant hold, or has previously held or is actively seeking a position or is being considered for a prominent public position? (If yes,
please provide details)
Position Held

No of Years

Does any of the Applicants immediate family member(s) hold, or has previously held or is actively seeking a position or is being considered for a prominent
public position? (If yes, please provide details)
Name of immediate family member(s)

Relationship

NRIC/Passport No

Position Held

No of Years

Is the Applicant a guarantor for any account holder in Kenanga Investment Bank Berhad or K&N Kenanga Holdings Berhad Group? (If yes, please provide
details)
Name of Guaranteed Person

Account Number

H. PAYMENT INSTRUCTION
I hereby agree to receive the share sales proceeds only via direct credit into my following bank account subject to the terms and conditions attached to this
application form.
Bank/Branch
Type of Account
Joint Account

Account No
Yes

No

(Please submit a photocopy of passbook/latest bank statement for verification purpose)

I. DECLARATION BY APPLICANT
I hereby declare as follows:1

I wish to open an account with Kenanga Investment Bank Berhad (the Bank) and understand that the Bank may at its absolute discretion approve the
opening of my account at any of the banks branches on such terms and conditions the Bank deems fit (which shall be communicated to me) or reject my
application without assigning any reason whatsoever.

I am at least eighteen (18) years old and am neither insolvent nor an undischarged bankrupt. I do not have any criminal record nor any litigation case
pending against me for any debt due and I have not been declared a defaulter by Bursa Malaysia Securities Berhad at any time to date.

The particulars and information given in this application form are true and correct and I have not withheld any material facts or information from the Bank. I
undertake to furnish the Bank with such additional particulars as the Bank may require from time to time. I further authorize the Bank to verify the
information given by me from any source (including third parties) and in such manner as the Bank shall deem fit. I undertake to inform the Bank in writing
should there be any change(s) to my particulars declared in this Account Application Form.

I have been advised to seek independent legal advice on the effects and consequences of the terms and conditions of this Account Application Form and the
Client Account Common Terms & Conditions (Terms) and any failure to do so shall be at my risk.

I have read and understood the risks in investing in structured warrants.

The dealings in securities in respect of my trading account shall be carried out in accordance with Rule 404.3(7)(a) of the Rules of Bursa Malaysia Securities
Berhad:
for me as principal
for and on behalf of the party(ies) set out below, from who, through whom or on whose behalf the securities are to be dealt with.

Particulars
Name of party(ies) concerned
NRIC No/Passport No.
Address/Registered Address

7 * Declaration of Domestic Ringgit Credit Facilities as at to-date

I do not have Domestic Ringgit Credit Facilities as defined under the Exchange Control Notices of BNM.
I have Domestic Ringgit Credit Facilities as defined under the Exchange Control Notices of BNM. I hereby acknowledge that I have read and understood
the Exchange Control Act 1953 and/or BNMs FEA policy and shall abide by the provisions at all material time.
8 * Declaration of Exposure in Foreign Securities for the current calendar year-to-date:
Currently invested

RM

Remaining balance for investment

RM

* To be completed by applicants who wish to trade in Global/Bursa Multi-Currency Equities (For Malaysia Residents Only)
9

I declare that I have read and fully understood the contents and terms and conditions of this Account Opening Form and the Client Account Common Terms
& Conditions (Terms) and acknowledge that I have received a copy of the Client Account Common Terms & Conditions. I fully accept and agree to be
bound by the said Terms and agree that the said Terms may be varied and/or supplemented by the Bank and/or any regulatory bodies from time to time.

Witnessed by Capital Markets Services Representatives License holder

or Authorised Officer of Kenanga Investment Bank Berhad or Notary Public

Signature of Applicant

Name:

Name:

NRIC No.:

Date:

Date:

J. TO BE COMPLETED BY CAPITAL MARKETS SERVICES REPRESENTATIVES LICENCE HOLDER

Recommended limit: Trading/Margin

RM_

No of years I have known the Applicant

How do I know the Applicant/relationship

Other background information

Brokerage Rate

I hereby declare that the information given by me is true and correct and I have not withheld any information which might prejudice this application. I further
declare that the Applicant/Applicants authorized personnel has met me in person and that all information given by the Applicant on this form has been verified
and is a correct record and reflection of the Applicant. I also confirm that the signature on page 4 is that of the Applicant and am aware that the Applicant is
required to comply with all the terms and conditions accompanying this application form which the Bank may vary from time to time at its absolute discretion.
I undertake to indemnify the Bank against any losses, damages, debts, charges and all other costs and expenses whatsoever incurred or suffered or which the Bank
may incur or suffer in relation to the Bank opening an account for this Applicant and the subsequent operation thereof.

Signature of Capital Markets Services Representatives Licence Holder

Name:
New NRIC No.:
Date:
DOCUMENTS TO BE SUBMITTED
* Photocopy of NRIC or passport (foreigner)
* Copy of latest Payslip/EA Form/Tax Return (Form BE)
* Any other documents required by the Bank

K. FOR OFFICE USE ONLY

1 Operations Department
Bursa Defaulter

No

Yes, Date Defaulted

Defaulter Uplifted

, Date Uplifted

Date Received
Checked By

Date

Approved By

Date

Data Entry By

Date

Date Account Opened

2 Credit Department Equity Broking

Credit Check

Yes

No

Recommendation

Yes

If yes, limit recommended

No

If no, please state reason

Yes

No

Recommended By
Approval

RM

Date
If yes, limit approved RM

Remarks
Approved By

Date

Date limit sent

By

Brokerage Code
Connected Party

Yes

No

Multiple Trading Account

Yes

No