Formulir Nasabah Institusional - Commonwealth Bank

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No. Ref. Appendix Subject : 102/WM/ONS/ /XII/2010 : - 'Additional Data of Know Your Customer’ Form - List of Commonwealth Bank Branches : Updating Mutual Fund Customer’s Dataa Jakarta, December 8, 2010 Dear Sir/ /Madam Referring to the Capital Market Supervisory Agency and Financial Institution (Bapepam-LK) Number V.D.10 regarding ‘Know Your Customer’, we hereby inform you that all Mutual Fund Sales Agent (Bank) is required to update Mutual Fund Customer’ Dataa by latest on December 31, 2010. Along with this letter, we would like to ask your willingness to update your data by completing the form of 'Additional Data of Know Your Customer’. This updating process is different from Bank Indonesia requirement. Here is a few things to follow in completing the 'Additional Data of Know Your Customer’ form : For Individual Customers : • Fill 'Individual Form' (attached) • Tax file Registration Date = Date of Registered in NPWP card • Bank Identifier Code is left blank. For Institutional/Corporate Customers: • Fill 'Institution/Corporate Form' (attached) • Tax file Registration Date = Date of Registered in NPWP card • Bank Identifier Code is left blank. After completing the form, pleasee return the form directly or by fax to our Customer Service at your nearest Commonwealth Bank branch, by the latest on Wednesday, December 29, 2010. Attached is the address and fax number of Commonwealth Bank branches. Please note for those who submit the form via fax, if theree is any changes from the recorded data before, then you will require to send the original form. Thank you very much for your attention and cooperation PT Bank Commonwealth Rian E. Kaslan Chief of Product & Marketing (This letter was printed by PT Bank Commonwealth through the system so it does not require a signature)
DATA TAMBAHAN PRINSIP MENGENAL NASABAH INSTITUSIONAL/KORPORASI (ADDITIONAL DATA OF KNOW YOUR INSTITUTION/CORPORATE CUSTOMER) CIF : Nama Perusahaan : (Company Name) Nomor NPWP : Tanggal Register NPWP : (Tax File Number) (Tax File Registration Date) (DD/MM/YY) Tax Rate : Jenis Badan Hukum : Perusahaan / Corporate Lembaga Keuangan / Financial Institution (Type of Business) Yayasan / Foundation Dana Pensiun / Pension Fund Asuransi / Insurance Perusahaan Efek / Securities Company Reksa Dana / Mutual Fund Lainnya / Others Karakteristik Perusahaan : BUMN / State Own Company PMA / Foreign Investment Company (Company Characteristic) Perusahaan Swasta / Private Company Perusahaan Keluarga / Family Corporation Institusi Sosial / Social Institution Perusahaan Afiliasi / Affiliated Company Perusahaan Gabungan / Joint Venture Lainnya / Others Nomor Surat Keterangan Domisili & Tanggal Kadaluarsa (SKD Number) wajib bagi institusi dengan domisili luar Indonesia / mandatory for institution with legal domicile non Indonesia. Tanggal Kadaluarsa / Expired Tempat & Tanggal Pendirian : (Place & Date of Incorporation) (DD/MM/YY) Tujuan Investasi : Investasi / Investment (Investment Purpose) Spekulasi / Speculation Mendapatkan kenaikan harga / Price Appreciation Mendapatkan penghasilan / Income Lainnya / others Sumber Dana Investasi : Hasil Usaha / Business Profit (Source of Fund) Dana Pensiun / Pension Funds Bunga simpanan / Interest Income Hasil Investasi / Investment proceed Lainnya / Others Alamat Perusahaan : Alamat e-mail perusahaan : (Company e-mail address) Telepon selular pejabat berwenang yang ditunjuk: (Cellular phone of appointed authorized person) Jumlah Pejabat Yang berwenang : (Authorized Person) (1 - 4)
Page 1: Nomor Lampiran Perihal : 102/WM/ONS
Page 5 and 6: Aktiva / Asset Laba Operasi / Opera
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Formulir Nasabah Institusional - Commonwealth Bank

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