eunittrust.com.my | It's a matter of trust

Full Name as per NRIC/Passport* Full name is required

NRIC/Passport* NRIC is required

Race* Race is required

Gender* Gender is required

Date Of Birth* Date of Birth is required

Nationality* Nationality is required

Agent Code(if any)

Security Purpose:
Mother Maiden Name

Email* Valid email is required

Contact No.Mobile* Mobile No is required

Home

Residential Address* Residential Address is required

Postcode* Postcode is required

State

Country

Correspondence Address* Correspondence Address is required

Postcode* Postcode is required

State

Country

Occupation* Occupation is required

Nature of Business* Nature of Business is required

Present position* Present position is required

Name of company* Name of company is required

Company Address* Company Address is required

Postcode* Postcode is required

State

Country

Contact No. Mobile* Contact No.Mobile is required

Fax

Present Annual Income* Annual Income is required

Estimated Net Worth* Estimated Net Worth is required

Source of Fund* Source of Fund is required

Number of estimated transaction in a year:* Number of estimated transaction in a year is required

Estimated transactions amount in a year * Estimated transactions amount in a year is required

SECTION A - PRELIMINARY IDENTIFICATION

All investors (individual, legal entity or corporate) are required to complete the following declaration.

I / We declare that I / We are *

Tax resident in Malaysia ONLY

Foreign tax resident (other than Malaysia). Please list ALL the countries in which you are foreign tax resident:

Name	Country of Tax Residence	Tax Identification No

Declaration for Foreign Account Tax Compliance Act (“FATCA”) and Common Reporting Standard (“CRS”)

I/We declare that I have examined the information on this form and to the best of my knowledge and belief, it is true, correct, and complete.

I/We hereby consent for Phillip Mutual Berhad (PMB) that PMB shall have right to provide my/our personal data and information to regulatory authorities in accordance with the requirements of Foreign Account Tax Compliance Act (FATCA) and Common Reporting Standard (CRS) for the Automatic Exchange of Financial Account Information as may be stipulated by applicable laws, regulations, agreement or regulatory guidelines or directives.

If there is any update to the account information/ FATCA/ tax residency status/ controlling persons or if updates reveal any change of U.S. indicia or change to FATCA status or tax residency status or controlling persons, I/We hereby agree to notify and furnish PMB with the relevant documentary evidence within 30 Days of such change.

I/We consent to and authorise PMB to perform any of the following, if applicable:

Withhold any applicable payments in the account
Report or disclose all relevant information relating to or arising from the account
Terminate (with prior notice) my/our contractual relationship(s) with PMB

Please attach your scanned Identification Card or Passport. If not available, please fax or send via mail
through the following fax no: 03-27113036 or mailing address :

Required Documents
1. A signed Account Opening Form.
2. A photocopy of your IC(both sides)/passport.

Email : phillipmutual@poems.com.my
B- 2- 7, Megan Avenue II
No. 12 Jalan Yap Kwan Seng
50450 Kuala Lumpur

Upload Your IC or Passport here :(Attachment Format : JPEG, DOC, DOCX, PDF, TIF, GIF, JPG only)

Declarations and Acceptance
I/We confirm that I/We have received, read and fully understood the Terms and Conditions of use and other terms and conditions
I/We is/are eligible to apply for the units in the collective investment scheme.
I/We hereby consent to the disclosure of information to the relevant entities including the Securities Commission
I/We acknowledge that the principal Applicant/Holder shall have the absolute authority to operate the account and/or any
transactions pertaining to the account

For Online Transaction
Phillip Mutual Berhad's online facilities are supported by computer-based component systems for opening of account and other
online transactions in relation to unit trusts. As with all facilities and computer systems, you will be exposed to the risks associated
with the systems including the failure of hardware and software.The result of any system failure may cause a delay in processing
your requests/transactions.
You also acknowledge that you are exposed to the inherent risks of conducting internet transactions and that you assume
such risks.

I/We hereby confirm that all the information given is true and accurate and that I/We have read and understood the Propectus,
Supplementary (if any) and Terms and Conditions and Unit Trust Loan Financing Risk Disclosure applicable to this transactions
and before investing

No.	U.S.Indicia	Applicant
1.	Are you a U.S. citizen or resident? (U.S. Passport/green card holder, U.S. taxpayer, etc.)	Yes No
2.	Is U.S. your place of birth?	Yes No
3.	Do you hold a current U.S. residence address / mailing address and U.S. post office box?	Yes No
4.	Do you have a current U.S. telephone number?	Yes No
5.	Standing instructions to pay amounts from Phillip Mutual account to an account maintained in the U.S.?	Yes No

Name
NRIC
DOB
Gender
Nationality
Race
Agent code
Security Purpose: Mother Maiden Name
Residential Address
Postcode
State
Correspondence Address
Postcode
State
Email
Contact No.Mobile
Occupation
Present Position
Nature of Business
Company Name
Company Address
Postcode
State
Present Annual Incomee
Estimate Net Worth
Source of Current Annual Income
Office
Fax No

Individual Account Registration

Foreign Account Tax Compliance Act("FATCA")