Individual Application Form
Fund Type
*
Cash Management Trust Fund
Equity Income Fund
Sri Lankan Bond Fund
Repo Investment Fund
USD Income Fund
SECTION A - PERSONAL DETAILS
Title
*
Rev
Mr
Mrs
MS
Initials
First Name
*
Last Name
*
Postal Address
*
Date of Birth
*
NIC
*
Passport
Nationality
*
Country
*
District
*
Postal Code
Tel
Mobile
*
Fax
Email
*
Bank Details :
Bank
*
Branch
*
Type of Acc
*
Acc No
*
Investment Details :
Investment Amount
*
Upload Documents:
Attach NIC/DL or Passport
Choose file
SECTION B - ADDRESS VERIFICATION
National Identity Card
Letter of Public Authority
Employment Contract
Income Tax Receipt
Tenancy Agreement
Utility Bill (Specify)
Statement of Other Banks
Other
Attach Proof of Address
Choose file
SECTION C - SOURCE OF FUNDS (TICK ALL APPLICABLE)
Business Income
Investment Proceeds
Membership Contribution
Family Remittances
Export Proceeds
Contract Proceeds
Commission Income
Salary / Profit Income
Gift
Other
SECTION D - ANTICIPATED VOLUMES OF DEPOSITS FROM ABOVE SOURCE (IN RUPEES)
Less than 100,000/-
100,000/- to 500,000/-
500,000/- to 1,000,000/-
1,000,000/- to 5,000,000/-
Above 5,000,000/-
SECTION E - EMPLOYEEMENT DETAILS
Occupation
*
Company Name
Postal Address
Tel
Fax
Email
SECTION F - POLITICALLY EXPOSED PERSON
Are you or any of your immediate family is a politically exposed person(PEP)?
No
Yes
If yes please explain the relationship
Definition PEP
An Individual who is or has been entrusted with prominent public functions , domestically or by foreign country or is related to a Politically exposed person(PEP)either directly(Consanguinity) or through marraige or similar(Civil) forms of partnerships.An individual who is closely connected to a PEP,either socially or professionally.
SECTION G - NOMINEE DETAILS
Status
Single
Married
Nominee's Name
Nominee's Address
Relationship to Nominee
SECTION H - SECONDARY APPLICANT’S DETAILS
Title
Rev
Mr
Mrs
MS
Name of Applicant
Postal Address
NIC
Passport
Date of Birth
Nationality
Country
District
Tel
Mobile
Email
Attach Signature
*
Choose file
All fields marked as
*
are Mandatory.
Declaration
I/We hereby confirm that the above information provided to you is true and correct to the best of our knowledge. I/We acknowledge that if the information provided is found to be false or misleading then the business relationship may be annulled anytime at your discretion. I/We hereby agree to provide any additional information/documentation that may be required.
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