Malacca Securities Sdn Bhd (16121-H)

(A Participating Organisation Of Bursa Malaysia Securities Berhad)

M alacca Sec urities Sdn Bhd ( 1 6 1 2 1 - H )
(A Participating Organisation Of Bursa Malaysia Securities Berhad)

I N D IVI
INDIVIDUAL TRADING ACCOUNT APPLICATION D UAL
FORM TR AD I N G AC C O UNT
CLIENT DETAILS OPAO01A(11April16)
OPAO01A(01July17)

PART A - APPLICANT
NAME OF APPLICANT:
(As per NRIC / Passport / Authority
Card / Registration Document)
OLD NRIC / PASSPORT /
- -
NEW NRIC NO.: AUTHORITY CARD / REG. NO :
DATE OF BIRTH: D D - M M - Y Y Y Y GENDER: Male Female

RACE: ✔ Bumiputra Chinese Indian Other:

(please specify)
NATIONALITY: ✔ Malaysian Other:
(please specify)

MARITAL STATUS: Single Married Other:

(please specify)
REGISTERED ADDRESS:
(As per NRIC / Passport / Authority
Card / Registration Document)

POSTCODE: TOWN:
STATE: COUNTRY:

CORRESPONDENCE
ADDRESS:

POSTCODE: TOWN:
STATE: COUNTRY:

HOME PHONE NO.: MOBILE PHONE NO.:

EMAIL ADDRESS:
EMPLOYMENT DETAILS
EMPLOYMENT STATUS: Employed Self-employed Other:
(please specify) YEARS IN
OCCUPATION: EMPLOYMENT : Y Y
NAME OF COMPANY: / BUSINESS
NATURE OF
EMPLOYMENT/ BUSINESS:
OFFICE PHONE NO.:
GROSS ANNUAL INCOME: RM ESTIMATED NET WORTH: RM
SPOUSE DETAILS
FULL NAME OF SPOUSE:
(As per NRIC / Passport / Authority
Card / Registration Document)
OLD NRIC / PASSPORT /
NEW NRIC NO.:
AUTHORITY CARD / REG. NO :
- -

OCCUPATION: YEARS IN
EMPLOYMENT : Y Y
NAME OF COMPANY: / BUSINESS
MOBILE / HOME PHONE NO.: GROSS ANNUAL INCOME: RM

PART B - FINANCIAL PARTICULARS

BANK NAME: JOINT ACCOUNT: Yes No
BANK ACCOUNT NO.:

PART C - INVESTMENT RISK PROFILE

1) What is your investment term? .................................................... Short Term ✔ Mid Term Long Term
2) What is your investment objective? ............................................ ✔ Capital Growth Savings Dividend
3) What is your risk tolerance level? ................................................. Conservative ✔ Moderate Aggressive
4) What is your main source of funds for investment?.................. Savings ✔ Salary Business Income Other:
5) How long have you been trading in the Malaysia market? ..... 0 year < 1 year 1-5 years 6-10 years > 10 years

6) Do you have Trading Accounts with other brokers? ................. No Yes:

(if yes, please specify)

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 lacca ecurities dn
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PART D - DECLARATION BY APPLICANT

1) Do you have any spouse / rela�ves working in Malacca Securi�es Sdn Bhd? ✔ No Yes:
(if yes, please specify)
2) Is / Are there any account(s) holder(s) of Malacca Securi�es Sdn Bhd ✔ No Yes: 1.
which is / are related to you?
(if yes, please specify) 2.
3.
(please state the Name, Relationship and Trading Account No. of Account Holder(s))
DECLARATION OF POLITICALLY EXPOSED PERSONS (PEPs)
YOU ARE REQUIRED TO DECLARE WHETHER YOU / FAMILY MEMBER* / CLOSE ASSOCIATE** ARE CURRENTLY ENTRUSTED WITH
A PROMINENT PUBLIC FUNCTION*** IN MALAYSIA OR A FOREIGN COUNTRY?
*"Family Member" includes parent, spouse, siblings, children and financial dependents
**"Close Associate" includes person(s) who are socially and/or professionally closely connected to a Poli�cally Exposed Person
*** "Prominent Public Func�on" includes the roles held by a head of state, a head of government, government ministers, senior civil servants, senior judicial or
military officials, senior execu�ves of state owned corpora�ons, senior poli�cal party officials, NGO, na�onal and interna�onal sport bodies.

✔ No, I am / My family member(s) / close associate(s) are not entrusted with a prominent public func�on
Yes, I am / My family member(s) / close associate(s) are entrusted with a prominent public func�on, these are detailed in the table below:

Name of person entrusted with Prominent Public Func�on Your Rela�onship to person Person’s Role / Occupa�on Person’s Employer / Organiza�on

DECLARATION PURSUANT TO COMMON REPORTING STANDARD (CRS) ON TAX RESIDENCY

I am a tax resident of another country(s) outside Malaysia : ✔ No Yes
If yes, please complete the CRS Tax-Residency Self-Cer�fica�on form (Individual), which can be found at the following link:
h�p://www.mplusonline.com.my/macsecos/openacc.asp
DECLARATION PURSUANT TO RULE 5.15(9) OF THE BURSA MALAYSIA SECURITIES BHD.
YOU ARE REQUIRED TO DISCLOSE WHETHER ANY DEALING IN SECURITIES IN RESPECT OF YOUR TRADING ACCOUNT(S)
IS CONDUCTED FOR YOURSELF OR ON BEHALF OF ANOTHER PERSON
I do solemnly declare that the dealings in securi�es in respect of my trading account(s) shall be conducted:
✔ for me as principal
for and on behalf of the party set out below, from whom, through whom or on whose behalf the securities are to be dealt with. I shall however remain
liable for the dealings without prejudice to your right against the said party:-
NAME OF PARTY CONCERNED :
COMPANY / NRIC / PASSPORT NO. :
CORRESPONDENCE / REGISTERED ADDRESS :

and I make this solemn declara�on conscien�ously believing the same to be true
DECLARATION PURSUANT TO TERMS AND CONDITION FOR THE OPERATION OF SECURITIES TRADING ACCOUNT(s) IN MSSB
I hereby declare/agree/undertake that:
a) I have a�ained the age of eighteen (18) years and all par�culars and informa�on furnished by me in this Trading Account Applica�on Form (“TAAF”) is true and correct and I have not
withheld any material fact or informa�on from Malacca Securi�es Sdn Bhd ('the Company')
b) I have not be en adjudicated or declared a bankrupt and have not commi�ed an act of bankruptcy and have no knowledge of any bankruptcy pe��on presented against me in any court
of competent jurisdic�on and I have not been listed as a defaulter by Bursa Malaysia Securi�es Berhad.
i) Upon the occurrence of any of the events rendering the above declara�on in Clauses(a) and (b) becoming inaccurate or untrue, I agree and undertake to immediately cease trading
and cease u�lizing the services of the Company and shall forthwith no�fy the Company in wri�ng of the occurrence of such event(s). Without prejudice to the aforemen�oned,
upon the Company having knowledge of the occurrence of any of the such events, the Company shall have the right and discre�on to immediately cease my trading and the
Company shall have the right to cease the provision of all its/their services or any part thereof. However, all orde rs carried out for me under any of the Client’s Securi�es Account(s)
(hereina�er defined) and all orders, instruc�ons and communica�ons carried out by the Company prior to the aforesaid cessa�on shall be valid and enforceable against me.
c) I understand and acknowledge that the Company do not provide any investment advice, sugges�ons or recommenda�ons;
d) I understand that my applica�on to open any account and any other services and facili�es are subject to the Company's approval as the case may be and the Company is absolutely
en�tled at it/ their respec�ve discre�on to reject my applica�on or impose such condi�ons and/or restric�ons as it / they may deem fit without giving any reasons thereof.
e) I undertake to furnish the Company with such addi�onal par�culars, informa�on and declara�on as the Company may require at any �me and from �me to �me. I further undertake to
promptly no�fy the Company should there be any changes to the par�culars, informa�on or the declara�on given to the Company as the case may be.
f) I also authorise the Company to verify the par�culars and informa�on provided from any source and in such manner as it/they shall deem fit.
g) I consent to the Company to conduct any check on the credit standing / financial status with any person or ins�tu�on or credit repor�ng agency that it/ they may de em necessary at any
point of �me.
h) I have been advised to seek independent legal advice on the effects and consequences of the terms and condi�ons of this TAAF Form and the Terms and Condi�ons for the Opera�on of
Securi�es Trading Accounts in MSSB (“ Terms “) and any failure to do so shall be at my risk.
i) I enclose herewith one (1) copy of my New NRIC/Passport/Authority Card duly cer�fied as the true copy
j) Online Client: I have read and understood the full contents of this TAAF and the Terms posted at the Company website www.mplusonline.com.my. I fully accept and agree to be
bound by the said TAAF and Terms and agree that the said Terms may be varied and/or supplemented by the Company from �me to �me. (Please refer to the Company website
www.mplusonline.com.my for the Terms and the updated version of the Terms)
Non-Online Client: I acknowledge that I have received a copy of the Terms. I have read and understood the full contents of this TAAF and the Terms. I fully accept and agree to be
bound by the said TAAF and Terms and agree that the said Terms may be varied and/or supplemented by the Company from �me to �me. (Please refer to the Company website
www.mplusonline.com.my for the Terms and the updated version of the Terms)

SUBSCRIBED AND SOLEMNLY Before me,

declared by the account holder
PLEASE PRINT THE COMPLETED FORM
AND PHYSICALLY SIGN WITHIN THE BOX

DIGITAL SIGNATURE IS NOT ACCEPTED Signature of Applicant Signature of Witness

Applicant Name : Witness Name : MOHD SHAQIL HAZIQ BIN MOHD ZUBIL
Witness NRIC : 9 2 0 5 0 9 1 4 6 4 1 9
Date : D D MM Y Y Y Y Date : D D MM Y Y Y Y
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 Malacca Securities Sdn Bhd (16121-H)
(A Participating Organisation Of Bursa Malaysia Securities Berhad)
M alacca Sec urities Sdn Bhd ( 1 6 1 2 1 - H )
(A Participating Organisation Of Bursa Malaysia Securities Berhad)

I ND IVI
INDIVIDUAL TRADING ACCOUNT APPLICATION D UAL
FORM TR AD I N G AC C O UNT
PRODUCT DETAILS OPAO01B(11April16)

PART ONE - ACCOUNT DETAILS

NAME OF APPLICANT:
(As per NRIC / Passport / Authority
Card / Registration Document)
OLD NRIC / PASSPORT /
NEW NRIC NO.: - - AUTHORITY CARD / REG. NO.:
CLIENT CODE:
(existing client only) FOR INTERNAL USE ONLY
PART TWO - ACCOUNT TYPE To be completed by dealer's representative To be completed by Operations
Account Description: (please select one) ACCOUNT CODE: CLIENT CODE:
A
✔ M+ Silver - Cash Upfront Account C NFTFV:
M+ Gold - Flexi-rate Collateralised T+3 Account L U No Yes
M+ T7 - Discretionary Financing Account Z
Verification Form Submitted:
X No Yes
Other, please specify:

PART THREE - ONLINE TRADING FACILITY DEALER / REMISER CODE:

I would like to apply for online trading: ✔ Yes No

If Yes, please provide your preferred first and second choice user ID preferences
(alphanumeric, min 6 characters, maximum 10 characters)
ONLINE TRADING:
User ID first preference: If both User ID preferences are not available, we will default
User ID second preference: the User ID to your Client Code assigned by the company:

PART FOUR - FOR DISCRETIONARY FINANCING ACCOUNT

1. I wish to apply for the Discretionary Financing (DF) account maintained with MSSB and agree to be bound by the terms and conditions for DF.
2. I understand and agree that, all terms and conditions and agreements in respect of trading/collateralized accounts remain applicable and binding and that MSSB may make such amendments or variations thereto in
its sole and absolute discretion.
3. I confirm that I have the financial ability to settle any amounts due or owing from me whether arising from or in respect of purchases of securities by me and/or contra losses incurred by me in this account.
4. I hereby irrevocably authorize MSSB to utilize/drawdown my DF for my outstanding purchases contract after T+3 and under such circumstance, I shall be deemed to have given my instruction/notification/application
to MSSB for utilization of DF facility and MSSB may at its absolute discretion approve/reject such instruction/notification/application in respect of any securities or group of securities which I have purchased under the
aforementioned account.
5. I further confirmed and affirmed that MSSB has a lien either directly, indirectly, constructively and in whatsoever form on any of my shares, cash and otherwise, within the control of MSSB.

PART FIVE - DECLARATIONS BY APPLICANT

I hereby solemnly, voluntarily, conscientiously, irrevocably and unconditionally declare (conscientiously believing the same to be true), that I have read and fully understood the full contents of the following:
1. I acknowledge and agree to abide by all the terms in the Trading Account Application “Client Details” Form , Trading Account Application “Product Details” Form (collectively referred to as “Application
Forms”) and Terms and Conditions for the Operation of Securities Trading Account(s) in MSSB.
2. The particulars and information given in the Application Forms are true and correct and I have not withheld any materials facts or information from Malacca Securities Sdn Bhd (“MSSB”). I undertake to
furnish MSSB with such additional particulars as MSSB may require from time to time. I further authorize MSSB to verify the information given by me from any source (including third parties) and in such
manner as MSSB shall deem fit. I undertake to inform MSSB in writing should there be any change(s) to my particulars declared in the Application Forms.
3. I hereby agree that all payments (including but not limited to sales proceeds, contra gain and credits) due to me shall be auto credited to my trust account maintained with MSSB.
4. I have read and understood the risks in investing in structured warrants.

PLEASE PRINT THE COMPLETED FORM

AND PHYSICALLY SIGN WITHIN THE BOX F Applicant Name:

Digital signature is not accepted

Date: D D - M M - Y Y Y Y

Signature of Applicant
PART SIX - TO BE COMPLETED BY DEALER'S REPRESENTATIVE
How do I know the applicant: REFERAL FROM CLIENT No. of years I have known the applicant: years

Existing trading limit with other broker: RM Name of broker:

Applicant knowledge of trading rules: Poor ✔ Average Above Average Excellent
Cash / Shares to be deposited: Cash - RM Shares - Please provide counters:
Intra Day Trade: ✔ Yes No
Proposed Trading Limit Recommended: Trading Account: (A) RM Collaterized Account: RM
(L)/(U)/(Z)
Other relevant information to justify the recommendation:
CASH ACCOUNT

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 Malacca Securities Sdn Bhd (16121-H)
(A Participating Organisation Of Bursa Malaysia Securities Berhad)

Declaration by Dealer's Representative

I hereby:
1. Submit this application to open trading account(s) with Malacca Securities Sdn Bhd and request you to approve this application and allow me to act as the Dealer’s Representative for the said applicant.
2. Confirm that the information given by me above is true and I have not withheld any information which might prejudice this application ; where the Applicant is unable to read and understand the
provisions (including the rights, covenants, undertakings and obligations of the Applicant) as contained in the application form, I have distinctly, clearly and audibly translated the same for the Applicant
into the .............................................
MALAY language / dialect which is the language / dialect understood by the Applicant, and the Applicant has appeared to clearly understand the same.
3. Undertake to indemnify Malacca Securities Sdn Bhd against any losses, damages, debts, charges and all other costs and expenses whatsoever incurred or suffered or which Malacca Securities Sdn Bhd
may incur or suffer in relation to or arising from Malacca Securities Sdn Bhd opening the account of this Applicant and the subsequent operation thereof.

PLEASE PRINT THE COMPLETED FORM

AND PHYSICALLY SIGN WITHIN THE BOX F Dealer Name: MOHD SHAQIL HAZIQ BIN MOHD ZUBIL

DR Code:
Digital signature is not accepted
Date: D D - M M - Y Y Y Y
Signature of Dealer's Representative

FOR INTERNAL USE ONLY - DOCUMENT CHECKLIST Customer ID

NRIC / Passport Enclosed: Yes No Existing Account : Yes No

Correspondence Address: Yes No CDS ACCOUNT:

If YES, Account No:
0 1 2 - 0 0 1 -
Signature Verified: Yes No

ML/TF Client Profiling: Low Risk Medium Risk High Risk

Intermediate A/c Code
Verified By: Date: A V G 0 0 1 K

RECOMMENDED BY CREDIT CONTROL DR Code:

Remarks
Account Type: /
Credit Search Done:
Yes No
Country Code:
Bankruptcy / Summons: Yes No
Intraday:
Other Related Accounts(s): Yes No Account(s)/Relationship:
Data Entry by :
BMSB Defaulter (Reference Only)
Recommended Limit: (A) RM - 0 0 Checked by :

(C) RM - 0 0
Date:
(L)/(U)/(Z) RM - 0 0
(X) RM - 0 0
Justification:

Recommended By:
Operations Date

Approved Limit: (A) RM - 0 0

(C) RM - 0 0
(L)/(U)/(Z) RM - 0 0
(X) RM - 0 0

Approved By :
Approving Authority Date

Trading Limit Keyed-in By :

Operations Date

Reviewed By:
Compliance Officer Date

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