First Addis Investment Bank Securities Trading Account Opening Form Individual client onboarding form. Fields marked * are required. 1 Personal Information / የደንበኛ ማንነት መለያ መረጃ First Name / ስም * Middle Name / የአባት ስም * Surname / የአያት ስም * Phone Number / ስልክ ቁጥር * Email Address / ኢሜይል አድራሽ * Country of Residence / የመኖሪያ ሃገር * Nationality / ዜግነት * Date of Birth / የትውልድ ቀን * TIN / 10 Digit የግብር ከፋይ መለያ ቁጥር * Gender / ፆታ * Male / ወንድFemale / ሴት Marital Status / የጋብቻ ሁኔታ * Married / ያገባ(ች)Unmarried / ያላገባ(ች)Divorced / የፈታ(ች) 2 Proof of Identity Verification / የደንበኛ ማንነት ማረጋገጫ Client Category / የደንበኛ ምድብ * Ethiopian National Living in Ethiopia / ኢትዮጵያ ውስጥ የሚኖር ኢትዮጵያዊ ዜጋDiaspora of Ethiopian Origin / በትዉልድ ኢትዮጵያዊ ዲያስፖራ National ID / FAYDA / ብሔራዊ መታወቂያ 16 Digit FAN Number / 16 ዲጂት ፋይዳ መታወቂያ ቁጥር * Issue Date / የተሰጠበት ቀን * Expiry Date / የማብቂያ ቀን * Yellow Card ID / የቢጫ ካርድ መለያ Yellow Card ID Number - 8 Digit / 8 ዲጂት * Issue Date / የተሰጠበት ቀን * Expiry Date / የማብቂያ ቀን * 3 Address and Contact Details / የደንበኛ መኖሪያ መረጃ Region / City Administration / ክልል/ከተማ አስተዳደር * City / Town / ከተማ Sub-City / ክፍለ ከተማ * Zone / ዞን Woreda / Kebele / ወረዳ/ቀበሌ * House Number / የቤት ቁጥር Preferred Method of Contact / መልእክት የሚመርጡት መንገድ * SMS / በስልክ መልእክትEmail / ኢሜይልBoth / በሁለቱም 4 Proof of Address / አድራሻ ማረጋገጫ One required / ከሁለት አንዱ በቂ ነው * Kebele ID / የቀበሌ መታወቂያDriving License / የመንጃ ፍቃድ ID Number / የመታወቂያ ቁጥር * Issue Date / የተሰጠበት ቀን * Expiry Date / የማብቂያ ቀን * 5 Payment Instruction / የክፍያ መመሪያዎች All payments from the sale of securities, including dividends, interest, and other amounts owed to you, will be transferred electronically to the bank account provided below. Payments in cash or by cheque will not be made. Bank Name / የባንክ ስም * Account No. / የሂሳብ ቁጥር * Branch Name / የቅርንጫፍ ስም Account Type / የሂሳብ አይነት I understand that it is my responsibility to notify FAB if my bank account status changes. / የባንክ ሂሳቤ ሁኔታ ከተለወጠ ለFAB ማሳወቅ የእኔ ኃላፊነት መሆኑን ተረድቻለሁ። 6 Client Settlement Information / የደንበኛ ክፍያ መረጃ All four options are mandatory. Fixed Income Interest Cash Entitlements / ወለድ የገንዘብ ክፍያ Fixed Income Principal Cash Entitlements / ዋናው የገንዘብ ክፍያ Equity General Cash Entitlements / የአክሲዮን ጥሬ ገንዘብ ክፍያ Deposit / Withdraw / ገንዘብ ማስገባት / ማስወጣት 7 Tax Status / የግብር ሁኔታ Are you tax exempt? / ከግብር ነፃ ነዎት? * Yes / አዎNo / አይደለሁም Supporting exemption document / የግብር ነፃነት ማረጋገጫ * 8 Employment Status / የሥራ ሁኔታ Employment Status / የሥራ ሁኔታ * Self-Employed / የግል ሥራEmployed / ተቀጣሪStudent / ተማሪRetired / ጡረተኛUnemployed / በመደበኛ ስራ ላይ ያልተሰማራ Self-Employed Details Name of Company / የድርጅቱ ስም * Nature of Business / የንግዱ ዓይነት * Position in the Company / የስራ መደብ * Profession / ሙያ * Business Telephone / የንግድ ስልክ ቁጥር * Employed Details Employer Name / የሚሰሩበት መስሪያ ቤት ስም * Position in the Company / የስራ መደብ * Profession / ሙያ * Employer Address / የአሰሪ አድራሻ * Employer Telephone / የአሰሪ ስልክ ቁጥር * Student Details Name of School / Institution / የትምህርት ቤቱ / ተቋሙ ስም * Level of Education / የትምህርት ደረጃ * Department / Field of Study / የጥናት መስክ * School Telephone / የትምህርት ቤት ስልክ * Annual Net Income / ዓመታዊ የተጣራ ገቢ * Below 100,000 ETB100,001–500,000 ETB500,001–1,000,000 ETB1,000,001–5,000,000 ETBOver 5,000,001 ETB 9 Source of Investment Funds / የኢንቨስትመንት ፈንድ ምንጭ Employment Income / ከሥራ ገቢBusiness Income / ከንግድ ገቢSale of Property / የንብረት ሽያጭSavings / ከቁጠባPension / ከጡረታInheritance / የዉርስ 10 Trade Order Placement / የግብይት ትዕዛዝ Online / በበይነ መረብPhysical / በአካልAll / ሁሉም 11 Investment Type / የኢንቨስትመንት አይነት Stocks / አክሲዮንBond / Fixed Income / ቦንዶች / ቋሚ ገቢBoth / ሁለቱም 12 Expected Transaction Volume / የሚጠበቀው የግብይት መጠን Stocks — Monthly Transaction Value Below 100,000 ETB100,001–500,000 ETB500,001–1,000,000 ETB1,000,001–5,000,000 ETB5,000,001–10,000,000 ETBOver 10,000,000 ETB Fixed Income — Monthly Value Below 100,000 ETB100,001–500,000 ETB500,001–1,000,000 ETB1,000,001–5,000,000 ETB5,000,001–10,000,000 ETBOver 10,000,000 ETB 13 Client Risk Tolerance / የኢንቨስትመንት ስጋት አመለካከት Low / ዝቅተኛMedium / መካከለኛHigh / ከፍተኛ Low: capital preservation and lower uncertainty. Medium: balanced risk and growth. High: willingness to accept volatility and potential loss for higher return opportunities. 14 Investment Objective / የኢንቨስትመንት ዓላማ Income / ገቢCapital Preservation / ካፒታልን ጠብቆ ማቆየትShort Term Growth / የአጭር ጊዜ እድገትSpeculation / ግምታዊ ኢንቨስትመንት 15 Investment Experience / የደንበኛ የኢንቨስትመንት ልምድ Stocks / Shares / አክሲዮኖች * None / BeginnerSome / IntermediateExtensive / Advanced Bonds / Fixed Income / ቦንዶች / ቋሚ ገቢ * None / BeginnerSome / IntermediateExtensive / Advanced 16 Politically Exposed Person / ለፖለቲካ ተጋላጭ ግለሰብ A PEP is a person who is or has been entrusted with a prominent public function, including family members and close associates. Do you consider yourself to be a PEP? * Yes / አዎNo / አይደለሁም Are you a family member or associated with a PEP? * Yes / አዎNo / አይደለሁም PEP Details Name of PEP Individual / የግለሰቡ ስም * Nature of Relationship / የዝምድና አይነት * Position / Title Held / የያዙት ስልጣን ወይም ማዕረግ * Country / Organization / አገር ወይም ድርጅት * I understand that it is my responsibility to notify FAB if my PEP status changes. 17 Disclosure / መግለጫ Have you ever declared bankruptcy or faced legal/tax/regulatory action for financial default, blacklisting, or travel restrictions? * Yes / አዎNo / አይ Provide details / ሁኔታውን ያብራሩ * Have you ever been arrested or convicted of a crime? * Yes / አዎNo / አይ Provide details / ሁኔታውን ያብራሩ * I understand that it is my responsibility to notify FAB if my financial, legal, or criminal status changes. 18 Ownership Disclosure / የባለቤትነት መግለጫ Are you a director, shareholder, or ultimate beneficial owner of 10% or more in a publicly traded company? * Yes / አዎNo / አይደለሁም Name of the Company / የኩባንያው ስም * Position in the Company / በኩባንያው ዉስጥ ያለዎት ቦታ * Are you currently employed by a brokerage firm, investment bank, market maker or securities dealer? * Yes / አዎNo / አይ Name of the Company / የኩባንያው ስም * Position in the Company / ቦታ * 19 Beneficiary Information / ስለ ተጠሪ መረጃ Do you have a beneficiary to declare? / የሚያሳዉቁት ተጠሪ አለዎት? * Yes / አዎNo / አይ Name of Beneficiary / የተጠቃሚው ስም * TIN / ግብር መለያ ቁጥር * Valid ID Type / የመታወቂያ አይነት * Relation / ግንኙነት * ID Number / የመታወቂያ ቁጥር * Mobile Number / የሞባይል ቁጥር * 20 Declaration, Terms, Fees, and Risk Disclosure / ማረጋገጫ I confirm that the details provided in this KYC form are true and valid. I certify that the details furnished above are true and correct to the best of my knowledge and belief, and I undertake to inform FAB of any changes immediately. I have read and accepted the terms and conditions. I have read and understood the Schedule of Fees and Charges. I have read and understood the Risk Disclosure Document. Applicant Name / የአመልካች ስም * Date / ቀን * For digital submission, the typed applicant name and confirmed declarations can be treated as the client's acknowledgement, subject to FAB's internal compliance approval. 21 Document Uploads / ሰነዶችን ያያይዙ Use this section for supporting KYC documents. Recommended file types: PDF, JPG, JPEG, PNG. Maximum 5MB per file. National ID / Yellow Card / መታወቂያ * Proof of Address / የአድራሻ ማረጋገጫ * TIN Evidence / የTIN ማረጋገጫ * Passport Photo, if required / ፎቶ ካስፈለገ
