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fixed term deposit account opening form

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					         fixed term deposit account opening form


            Branch ________________________________
                  PERSONAL                                   NON-PERSONAL

   please             where applicable and complete this form in BLocK Letters                                                             *please delete whichever is not applicable

   i/We request that you accept our fixed term deposit as follows:

   Account Name and Address                                                                                                               Customer Number
   ............................................................................................................................
   ............................................................................................................................
   ............................................................................................................................


   type of fixed term deposit required                                                                                deposit currency
                 Fixed Term Deposit with Interest on Maturity                                                              AUD
                 Other (please specify) ...............................................................                    Other (please specify) ..............................................


   deposit amount                                                                                                    deposit period
                                                                                                                     fixed for .............. * days/year(s)
                                                                                                                     or to mature on ...................................................


   In payment please                          debit my/our account no. ...............................................................................................................
                                              receive cheque no. .................................... drawn on (bank/branch details) ..................................
                                              .......................................................................................................................................................
                                              receive cash



   maturity instructions

   Unless you instruct us otherwise, it is the Bank’s normal practice to automatically renew a fixed term deposit plus the accrued
   interest for the same period on maturity.
                 Renew principal plus interest on due date for .............. *days/year(s) OR to mature on
                 ........................................ at the rate of interest prevailing at the time.

   or            Renew principal at prevailing interest rate on due date for .............. *days/years(s) OR to mature on
                 ........................................ and pay interest by cash OR    to account no .........................................................
                 OR            by Bank Cheque.

   or            Pay principal and interest                        by cash OR                  to account no ...................................... OR                     by Bank Cheque

   or            Other ...........................................................................................................................................................................

  I/We indemnify the Bank for all actions taken in reference to the instructions contained in this application form. In addition, I/We have read the
 specific terms and conditions applicable to Fixed Term Deposits, as contained in the Bank’s Product Disclosure Statements.

 customer signature(s) ______________________________________________________________________ Date ____/____/____

  For bank use only

  Deal Reference No.                                                                                                Branch Stamp and Signature




Version - February 2008                                                                                   Bank of Cyprus Australia Limited ABN 51 092 167 907 AFSL 244611

				
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Description: fixed term deposit account opening form