ACCOUNT OPENING FORM

For SME & Corporates

For Official Use Only

CIF Number
Corporate Account Number
Name of En ty/Firm
Branch (where applicable)

Part-1
Type of Product(s) requested (Tick as Appropriate)

Corporate Wakala Deposit Sharia Alternate for Bill Discoun ng

Business Finance Mortgage Finance
✔ Le er of Guarantee Fleet Finance
Labour Guarantee Equipment / Machinery Finance
Le er of Credit Other

Details of Credit Facili es Requested

Credit Amount Tenor Profit Security Offered/
Facility Type (AED in Millions) (In years) Rate/year Cash Margin

Business Profile/En ty Details:

Name of the En ty (Legal)
Registered Name and Address
Branches/Offices (Country and Address)
Business License Number
License Expiry Date
Building Name and Flat/Apt #
Street Name
Office Space Ownership (Rented/Owned)
P.O Box and Emirate
Nearest Landmark
Contact Number (Land and Mobile)
Email
Nature of Business

Page 1 of 8
Address of Parent Company (If Applicable)
Registered Office Address
PO Box Number and Emirate
Telephone Number
Facsimile Number
Mobile Number
Email
Website
Office Ownership
Related Party Informa on
Ul mate Business Details of the
Company Name Contact Person
Owners (UBOs) facili es outstanding

Type of Cons tu on (Tick as Appropriate)

Sole Proprietorship Partnership
Limited Liability Company Government En ty
Free Zone Establishment/company Foreign Company
Public Joint Stock Company Embassy/Consulates
Social or professional club /Society/Associa on / Escrow
Trust, Nominee Fiduciary / Co-opera ve Society/ Brokerage
Charity Organiza on
Others (Please specify)
Approximate Annual Turnover (AED)
Source of Funds (Please Specify)
Purpose for seeking the facility GUARANTEES
Mode of Payment Cash Cheque Funds Transfer
Amount of deposit expected per month (All Inclusive)
Purpose of high deposit amount
(In the above context High Volume Denotes > AED500K)
Other Account Details
1) Bank Name ____________________________________Account Type
Account Since ________________________________________________________________________
2) Bank Name ____________________________________Account Type
Account since ________________________________________________________________________
Facili es Availed from other Banks/Financial Ins tu ons (FI) Yes ✔ No
If Yes, please specify the below details:
Bank/FI Facility Type Facility Amount Outstanding Amount Facility End Date

Company Staff Details

Total Number of Employees __________________________________________________________
Are Salaries paid in cash to Employees Yes ✔ No
If not, kindly state the Mode of Payment __________________________________________________
Processing Bank/ FI/ WPS Agent ___________________________________________________
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 Details of Beneficial Owners / Controlling Persons / Authorized Signatories
(Account Holder 1)
Title (Mr. / Mrs. / Ms.) _________________________ First Name_______________________________
Middle Name ________________________________ Last Name _______________________________
Place and Country of Birth: _____________________ Ci zenship:_______________________________
% of Shares ____________________ Capacity (Proprietor / Partner/ Director Etc.) _________________
Residence for Tax Purposes: _____________________Current Residence: ________________________
Residence Number: ____________________________Mobile Number:__________________________
Email Address: ________________________________________________________________________
Local Residen al Address: Villa/ Apt No.____________________________________________________
____________________________________________________________________________________
Building/ Villa Name______________________Street Name / Number __________________________
Nearest Landmark_______________________________ P O Box _______________________________
State________________ ______________________ Country _________________________________

(Account Holder 2)
Title (Mr. / Mrs. / Ms.) _________________________ First Name_______________________________
Middle Name ________________________________ Last Name _______________________________
Place and Country of Birth: _____________________ Ci zenship:_______________________________
% of Shares ____________________ Capacity (Proprietor / Partner/ Director Etc.) _________________
Residence for Tax Purposes: _____________________Current Residence: ________________________
Residence Number: ____________________________Mobile Number:__________________________
Email Address: ________________________________________________________________________
Local Residen al Address: Villa/ Apt No.____________________________________________________
____________________________________________________________________________________
Building/ Villa Name______________________Street Name / Number __________________________
Nearest Landmark_____________________________ P O Box _________________________________
State_______________________________________ Country _________________________________

(Account Holder 3)
Title (Mr. / Mrs. / Ms.) _________________________ First Name_______________________________
Middle Name ________________________________ Last Name _______________________________
Place and Country of Birth: _____________________ Ci zenship:_______________________________
% of Shares ____________________ Capacity (Proprietor / Partner/ Director Etc.) __________________
Residence for Tax Purposes: _____________________Current Residence: ________________________
Residence Number: ____________________________Mobile Number:__________________________
Email Address: ________________________________________________________________________
Local Residen al Address: Villa/ Apt No.____________________________________________________
____________________________________________________________________________________
Building/ Villa Name______________________Street Name / Number __________________________
Nearest Landmark_______________________________ P O Box _______________________________
State________________ ______________________ Country _________________________________

(Please fill the FATCA/CRS Self Declara on to complete the applica on submission process)
Page 3 of 8
 FATCA/ CRS Self Declara on Form – (ENTITY)
Under the purview of UAE Central Bank Guidelines, it is an obligatory requirement to secure a Tax
Residency Self Cer fica on Form on behalf of the account rela onship maintained with Siraj Finance
PJSC for all US and Non-US tax disclosure status.
For US Persons, Residents and/ or En es incorporated in US, the Foreign Account Tax Compliance Act
(FATCA) declara on would need to be duly filled and retained with Siraj Finance PJSC for onward sharing
with the Regulatory Bodies and or affiliated en es as a pre-qualified disclosure.
Details to explore: h ps://www.irs.gov/businesses/corpora ons/foreign-account-tax-compliance-act-fatca
And/ Or
Common Repor ng Standard (CRS) a globally accepted standard for the automa c exchange of financial
account informa on, set forth by the Organiza on for Economic Coopera on and Development (OECD)
ins lls an obligatory exchange of informa on for tax related ma ers on account of the Mul lateral
Competent Authority Agreement (MCAA).
Details to explore: h p://www.oecd.org/tax/automa c-exchange/common-repor ng-standard/

Please select your Tax Status

1) I am NOT a U.S PERSON or US En ty and NOT liable to pay tax in U.S ✔
2) I am a U.S PERSON or a U.S En ty
If you have selected 1, please complete Part 1, 2, 4 and 5
If you have selected 2, please complete Part 1, 3,4 and 5 alongside W9 form submission.
Part-2
En ty Type- (please provide the Account Holder’s Status by cking one of the following boxes): -
1) Financial Ins tu on
a) Investment En ty located in a Non-Par cipa ng Jurisdic on and managed by another Financial
Ins tu on.
b) Depository Ins tu on, Custodial Ins tu on or Specified Insurance Company or Other Investment
En ty in a CRS Par cipa ng Jurisdic on.
A er appropriate selec on (a or b) please duly fill and sign Part 4 and 5.

2) Ac ve Non-Financial En ty (NFE)
a) a corpora on the stock of which is regularly traded on an established securi es market or a
corpora on which is a related en ty of such a corpora on.

If you have cked 2 (a), please provide the name of the established securi es market on which the
corpora on is regularly traded:
If you are a Related En ty of a regularly traded corpora on, please provide the name of the regularly
traded corpora on that the En ty in 2
(a) is a Related En ty to: ____________________________________________________________
(b) a Government En ty or Central Bank
(c) an Interna onal Organiza on
If you qualify under the 2 (a), (b), (c) please duly fill and sign Part 3 (where appropriate),4 and 5
(d) other (for example a start-up NFE or a non-profit NFE)
If you qualify under the 2 (d) please duly fill and sign Part 3 (where appropriate),4 and 5

Passive NFE
Passive NFE
If you qualify under the 3 (a) please duly fill and sign Part 3 (where appropriate),4 and 5

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Part 3
Select the Financial Ins tu on’s FATCA classifica on in its country/jurisdic on of tax residence. (Check
only one)
Direct Repor ng NFFE
Par cipa ng FFI, including a Repor ng Financial Ins tu on under a Model 2 IGA
Registered Deemed-Compliant FFI that is a Local FFI
Registered Deemed-Compliant FFI that is a Non-Repor ng Member of a PFFI Group Registered
Deemed-Compliant FFI that is a Qualified Collec ve Investment Vehicle
Registered Deemed-Compliant FFI that is a Qualified Credit Card Issuer or Servicer
Registered Deemed-Compliant FFI that is a Restricted Fund
Repor ng Financial Ins tu on under a Model 1 IGA
Sponsoring En ty of Sponsored Direct Repor ng NFFEs
Sponsoring En ty of Sponsored FFIs
Sponsoring En ty of Sponsored FFIs and Sponsored Direct Repor ng NFFEs
Trustee of a Trustee-Documented Trust
U.S. Financial Ins tu on

Please provide, if held, the Account holder’s Global Intermediary Iden fica on Number (“GIIN”)
obtained for FATCA purposes:

Part 4
Country/Jurisdic on of Residence for Tax Purposes and related Taxpayer Iden fica on Number or
func onal equivalent* (“TIN”). If a TIN is unavailable please state the appropriate reason A, B or C:

Reason A - The country/jurisdic on where the Account Holder is resident does not issue TINs to its
residents

Reason B – The Account Holder is otherwise unable to obtain a TIN or equivalent number (Please
explain why you are unable to obtain a TIN in the below table if you have selected this reason)

Reason C – No TIN is required. (Please Note. Only select this reason if the domes c law of the relevant
jurisdic on does not require the collec on of the TIN issued by such jurisdic on)

Country / Jurisdic on TIN/ Func onal If no TIN Available

of Tax Residence Equivalent Enter Reason A, B or C

For Reason B (kindly jus fy):

Page 5 of 8
Part 5
Declara on and Signature*
I/ We understand that the informa on supplied by me is covered by the full provisions of the terms and
condi ons governing the Account Holder’s rela onship with Siraj Finance PJSC in se ng out how Siraj
Finance PJSC may use and share the informa on supplied in this declara on.
I/ We accept the product being offered by Siraj Finance PJSC and are in consent to the Pricing, Terms and
Condi ons, schedule of charges, the product features and its deliverables as stated under the website
www.sirajfinance.com.
I/ We also confirm that any change in the Ownership Structure, Controlling Influence, Power of A orney and
Material Change in the Management Structure would be duly brought to the a en on of Siraj Finance PJSC for
its sa sfactory due diligence and contentment from a Legal, Regulatory and Compliance space.
I/ We acknowledge that the informa on contained in this form and informa on regarding the Account
Holder and any Reportable Account(s) may be reported to the tax authori es of the country/jurisdic on in
which this account(s) is/are maintained and exchanged with tax authori es of another country/jurisdic on
or countries/jurisdic ons in which the Account Holder may be a tax resident pursuant to the
intergovernmental agreements to exchange financial account informa on.
I/ We cer fy that I am authorized to sign for the Account Holder in respect of all the account(s) to which this
form relates.
I/We authorize Siraj Finance PJSC to have irrevocable right to engage internal or external consultant for
appraising and evalua ng performance or any other aspect of the business of the Customer and the
Customer agrees to pay the fees of consultants for such studies under in ma on.
I/ We declare that all statements made in this declara on are, to the best of my knowledge and belief,
correct and complete.
I/We also confirm on my/us willingness to secure relevant Al E had Credit Bureau (AECB) report of which
the processing charge would be borne by me/us under due in ma on.
I/ We undertake to advise Siraj Finance PJSC within 30 days of any change in circumstances which affects the
tax residency status of the Account Holder iden fied in Part 1 of this form or causes the informa on
contained herein to become incorrect or incomplete (including any changes to the informa on on
controlling persons iden fied and to provide Siraj Finance PJSC with a suitably updated Self-
Cer fica on/W8/W9 and Declara on within the agreed melines on such change in circumstances.
I/We accept to open the relevant internal accounts with Siraj Finance in due considera on of the products
been opted for.
I/We accept that as per the internal policy of Siraj Finance PJSC and further to the smart governance and
automa on mechanism, the physical instrument bearing any security cheque- upon return/ withdrawal
would be duly replaced with a cancella on le er- signed by the authorized personnel.
Authorized Signatories
Signature Signature
Date (DD/MM/YYYY) Date (DD/MM/YYYY)
% of Shares % of Shares
Print Name Print Name
Capacity Capacity
Signature Signature
Date (DD/MM/YYYY) Date (DD/MM/YYYY)
% of Shares % of Shares
Print Name Print Name
Capacity Capacity
Power of A orney Details
Signature Signature
Date (DD/MM/YYYY) Date (DD/MM/YYYY)
Print Name Print Name
Capacity Capacity
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Corporate Account is an account which is maintained “Controlling Person(s)” are the natural person(s) who
within Siraj Finance for pos ng relevant entries that exercise control over an en ty. Where that en ty is
reflect on the financial and or non-financial facility (ies) treated as a Passive Non-Financial En ty (“Passive
NFE”) then a Financial Ins tu on is required to
being u lized and or extended. Such accounts are also determine whether or not these Controlling Persons
called concentra on or transient account that helps to are Reportable Persons. This defini on corresponds to
maintain accoun ng pos ng records for onward the term “beneficial owner” described in
financial audi ng. Recommenda on 10 of the Financial Ac on Task Force
Recommenda ons (as adopted in February 2012).

“Custodial Ins tu on” means any En ty that holds, as “En ty” means a legal person or a legal arrangement,
a substan al por on of its business, Financial Assets for such as a corpora on, organiza on, partnership, trust
the account of others. This is where the En ty’s gross or founda on. This term covers any person other than
income a ributable to the holding of Financial Assets an individual (i.e. a natural person)
and related financial services equals or exceeds 20% of
the en ty’s gross income during the shorter of: (i)the 3
year period that ends on 31 December(or the final day
of a non-calendar year accoun ng period)prior to the
year in which the determina on is being made; or
(ii)the period during which the En ty has been in
existence. “Depository Ins tu on” means any En ty
that accepts deposits in the ordinary cause of a banking
or similar business.

Financial Ins tu on means a “Custodial Ins tu on”, a “FATCA” stands for the Foreign Account Tax Compliance
“Depository Ins tu on”, an “investment En ty “or a provisions, which were enacted into U.S. law as part of
“Specified Insurance Company”. Please see the relevant the Hiring Incen ves to Restore Employment (HIRE) Act
domes c guidance and the CRS for further classifica on on March 18, 2010. FATCA creates a new informa on
repor ng and withholding regime for payments made
defini ons that apply to Financial Ins tu ons.
to certain non-U.S. financial ins tu ons and other non-
U.S. en es.

GIIN “Global Intermediary Iden fica on Number” – is IRS “Internal Revenue Service” is the revenue service
assigned by the FATCA Registra on System to financial of the United States federal government. IRS is
ins tu ons and direct repor ng non-financial foreign responsible for collec ng taxes and administering the
en es. Those assigned a GIIN may use it to iden fy Internal Revenue Code. The du es of the IRS include
themselves to withholding agents and tax
administra ons for FATCA repor ng.” GIIN” number is a providing tax assistance to taxpayers and pursuing and
19-character iden fica on number that is made up of resolving instances of erroneous or fraudulent tax
several iden fiers from the FATCA registra on system. filings.

Investment en ty located in a Non-par cipa ng “Investment En ty” includes two types of En es:
Jurisdic on and managed by another Financial (i) an En ty that primarily conducts as a business one
Ins tu on The term “Investment En ty located in a or more of the following ac vi es or opera ons for or
Non-Par cipa ng Jurisdic on and managed by another on behalf of a customer:
Financial Ins tu on means any en ty the gross income • Trading in money market instruments (cheques, bills,
of which the is primarily a ributable to inves ng, cer ficates of deposit, deriva ves, etc.); foreign
reinves ng or trading in Financial Assets if the En ty is exchange; profit rate and index instruments;
managed by a financial Ins tu on and not a transferable securi es; or commodity futures trading;
Par cipa ng Jurisdic on Financial Ins tu on. • Individual and collec ve por olio management; or
• Otherwise inves ng, administering, or managing
Financial Assets or money on behalf of other persons.
Such ac vi es or opera ons do not include rendering
non-binding investment advice to a customer.
(ii) ”The second type of “Investment En ty”
(“Investment En ty managed by another Financial
Ins tu on”) is any En ty the gross income of which is
primarily a ributable to inves ng, reinves ng, or
trading in Financial Assets where the En ty is managed
by another En ty that is a Depository Ins tu on, a
Custodial Ins tu on, a Specified Insurance Company, or
the first type of Investment En ty.

Page 7 of 8
“Mul lateral Competent Authority Agreement on Parent Company is a firm that has a controlling interest
Automa c Exchange of Financial Account Informa on in another company, giving it control of its opera ons.
(MCAA)” Parent companies can be either hands-on or hands-off
The MCAA contains the rules on the exchange of owners of its subsidiaries, depending on the amount of
informa on between the UAE Competent Authority managerial control given to subsidiary managers.
and partner jurisdic on Competent Authori es. The
confiden ality, safeguards and the existence of the
necessary infrastructure for an effec ve exchange are
all covered by the MCAA.

“Par cipa ng Jurisdic on” means a jurisdic on with “Related En ty” An En ty is a “Related En ty” of
which an agreement is in place pursuant to which it will another En ty if either En ty controls the other En ty,
provide the informa on set out in the CRS. or the two En es are under common control. For this
purpose, control includes direct or indirect ownership
of more than 50% of the vote and value in an En ty.

“The Term United States Person” means: “The Common Repor ng Standard (CRS)” developed
A) An individual, being a ci zen or resident of the in response to the G20 request and approved by the
United States of America; OECD Council on 15 July 2014, calls on jurisdic ons to
B) Partnership or corpora on organized in the United obtain informa on from their financial ins tu ons and
States of America or under the laws of the United automa cally exchange that informa on with other
States of America or any State thereof; jurisdic ons on an annual basis. It sets out the financial
account informa on to be exchanged, the financial
C) A Trust if:
ins tu ons required to report, the different types of
i. a court within the United States of America would accounts and taxpayers covered, as well as common
have authority under applicable law to render due diligence procedures to be followed by financial
orders or judgments concerning substan ally all ins tu ons.
issues regarding administra on of the trust; and
ii. one or more U.S. persons have the authority to
control all substan al decisions of the trust;
D) An estate of a decedent who was a ci zen or
resident of the United States of America.

“TIN” (including “func onal equivalent”) The term “Wage Protec on System (WPS)” is an electronic
“TIN” means Taxpayer Iden fica on Number or a salary transfer system that allows companies /
func onal equivalent in the absence of a TIN. A TIN is a ins tu ons to pay worker’s wages via financial
unique combina on of le ers or numbers assigned by a ins tu ons/banks. The system developed by the
jurisdic on to an individual or an En ty and used to Central Bank allows the Ministry of Labour to create a
iden fy the individual or En ty for the purposes of database that records wage payments in the private
administering the tax laws of such jurisdic on. Further sector to guarantee the mely and full payment of
details of acceptable TINs can be found at the following agreed upon wages.
link:
h p://www.oecd.org/tax/transparency/automa cexch
angeofinforma on.htm

For Official Use Only

RM Name: RM Code: ____________________________
Signature: Date:________________________________
Line Manager Name Date:________________________________
Signature

Submit by Email Page 8 of 8 Print Form