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(Fill your data completely)
*Make sure all fields with (*) are filled!
1. Personal Details
2. Occupation & Source of Fund
3. Upload Form
4. Preview

PERSONAL DETAILS

Full Name *
Sex *
Place & Date of Birth *
Nationality *
ID Card/Passport *
Issued Date *
Expiry Date *
Tax Identification No
Issued Date
Limited Stay Permit Card No
Expiry Date
Religion *
Marital Status *
Spouse Name *
Mother’s maiden name *
Name of relative not staying in same address *
Email Address *
ID Card Address *
Country *
Province *
City *
Region *
Sector *
Neighbourhood *
Ward *
Postal Code *
Mailing Address *
Country *
Province *
City *
Region *
Sector *
Neighbourhood *
Ward *
Postal Code *
Residential Address
Country *
Province *
City *
Region *
Sector *
Neighbourhood *
Ward *
Postal Code *
Home Telp No
Mobile no *
Fax No
Heir *
1. Name *
Relationship *
2. Name
Relationship
Educational Background *
Residential Status *
Bank Reference *
Bank Name *
Branch *
Account Name *
Account Number *
Client Instruction *
Are you related to any employee of PT UOB Kay Hian Securitas ? *
Name
Relationship
Are you, or a member of your immediate family, employed with a brokerage firm, Stock Exchange, a company controlled by a Stock Exchange, insurance company or other financial institutions ? *
Institution Name
Do you have previous experience in Securities Trading ? *
Name of Brokerage
Please indicate your objectives in trading Securities

OCCUPATION & SOURCE OF FUND

Occupation *
*To complete the data below, use data from the Guardian / Parent
*To complete the data below, use previous work data
*To complete the data below, use data from husband/breadwinner
Name of Company *
Line of Business *
Position *
No of years with present employeer *
Year(s)
Month(s)
Address of Company *
Country *
Postal Code *
Office Telp No
Fax No
Office Email Address
Annual Income *
Funds Source *
Asset Owner *

UPLOAD FORM

#Make sure your files are JPG, JPEG, or PNG and Maximum 3MB
ID / Passport / KITAS *
*Please make sure photo ID is clear
Tax ID
*Leave it blank if not available
Passbook Cover *
*Please make sure the details on the Savings Book Cover are clearly visible
If there is no Savings Book Cover, please upload the Mutation in E-Banking / other with the Bank Name, Name Account Owner and Account Number
Specimen Signature *
*Upload your signature on plain white paper with black ink according to the ID Card
Guradian ID Card *

PREVIEW

Personal Details

Full Name
:
-
Sex
:
-
Place & Date of Birth
:
-, - , -
Nationality
:
-
ID Card/Passport
:
-
Issued Date
:
-
Expiry Date
:
-
Tax Identification No
:
-
Issued Date
:
-
Limitied Stay Permit Card No
:
-
Expiry Date
:
-
Religion
:
-
Marital Status
:
-
Spouse Name
:
-
Mother's Maiden Name
:
-
Name of relative not staying in same address
:
-
Email Address
:
-
ID Card Address
:
-, Neighbourhood - Ward - -, -, -, -, -, -
Neighbourhood
:
-, Neighbourhood - Ward - -, -, -, -, -, -
Residential Address
:
-, Neighbourhood - Ward - -, -, -, -, -, -
Home Telp No
:
-
Mobile No
:
-
Fax No
:
-
Heir
:
Name
:
-
Relationship
:
-
Name
:
-
Relationship
:
-
Educational Background
:
-
Residential Status
:
-
Bank Reference
:
Bank Name
:
-
Branch
:
-
Account Name
:
-
Account Number
:
-
Client Instuction
:
-
Are you related to any employeeof PT UOB Kay Hian Securitas ?
:
-
- -
Are you, or a member of your immediate family, employed with a brokerage firm, Stock Exchange, a company controlled by Stock Exchange, insurance company, or other financial institutions?
:
- ,
-
Do you have previous experience in Securitas Trading?
:
- ,
-
Please indicate your objectives in trading securitas:
:
-.

Occupation & Source of Fund

Occupation
:
-
Name of Company
:
-
Line of Business
:
-
Position
:
-
No of Yrs with Present Employer
:
- Year(s)
- Month(s)
Company Address
:
-, -, -
Office No Telp
:
-
Fax No
:
-
Office Email Address
:
-
Annual Income
:
-
Funds Source
:
-.
Asset Owner
:
-

Upload Form

ID / Passport / KITAS
:
-
TAX ID
:
-
Passbook Cover
:
-
Specimen Signature
:
-
Guardian ID Card
:
-