STATE BANK OF INDIA 19 S LaSalle Street, Suite 200, Chicago. IL 60603 Tel: 312-621-1200; Fax: 312-701-0232 STEP BY STEP GUIDE TO OPENING A NEW ACCOUNT Step 1 - Complete The Identification Requirement 1 2 3    Complete the Customer Identification Form (DEP-1). U.S. citizens and U.S. residents: Submit form W-9 (all applicants should fill separate forms). Non-U.S. residents: Submit form W-8 BEN (all applicants should fill separate forms). Identification Documents: Primary Photo ID (Must not have expired)  Photo bearing State Driving   License / State ID Card Passport / Military ID Card US Alien Registration Card Secondary ID  Utility Bill  Bank Statement  Social Security Card  U.S. Visa Page (in Passport)  Voter Registration Card  Student ID Card  Insurance/Credit Card  Birth Certificate If you come in person, bring with you in original any two of the above identification documents, at least one of which must be a Primary Photo ID and any one of the ID should contains the current residential address of the persons mentioned in account opening forms. If you are applying by mail, submit original or copy of any two of the above identification documents, at least one of which must be a Primary Photo ID and any one of the ID should contains the current residential address of the persons mentioned in account opening forms. Copy of the Primary Photo ID and signature on Form DEP-1 must be verified by Notary Public OR an Official of Indian Embassy / Indian consulate Important: Enclose your Personal Check for the Minimum Balance Requirements (Minimum Balance Requirements are $500 for US Based Savings/Checking account and $5000 for US Based Money Market Account) Step 2 - Complete The Account Opening Form For This Type of Account    Certificate of Deposit Use The Following Account Opening Form DEP-CD MMD / Checking / Savings Account DEP-MCS International Debit Card (Issued only with Checking Account) DEP-IDC IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you? When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. We may also ask you for source or proof for your funds. To ensure the security and confidentiality of your information please do not e-mail any sensitive non-public personal information (i.e. account numbers, social security numbers, etc.) to us. Revised November 2014 Form DEP -1 STATE BANK OF INDIA 19 S La Salle Street Suite - 200 Chicago IL 60603 Tel: 312-621-1200; Fax: 312-701-0232 For Office Use Customer No: __________________ Approved: Member (FDIC) Customer Identification Form for Deposit Accounts 1st Applicant 2nd Applicant rd 3 Applicant First Name Middle Name Last Name Social Security No. For non US resident, Passport No Date of Birth (mm/dd/yyyy) Nature of Photo ID (U.S. Driver License /State ID/ Passport) Photo ID Number Issue Date (mm/dd/yyyy) Expiration Date (mm/dd/yyyy) Place of Issue Place of Birth Country of Residence Residence Status (If US Residential status Check any One) USA USA U. S. Citizen Permanent Resident Resident Alien □ □ □ U. S. Citizen Permanent Resident Resident Alien USA □ □ □ U. S. Citizen Permanent Resident Resident Alien □ □ □ Resident Since (mm/yyyy) (If US Citizen mention NA) Occupation Name of the Employer Address of the Employer (With Zip Code) Work Phone No. Home Address (P.O. Box No is not acceptable) Home Phone No. Fax Number E-mail Address Annual Family Income (in U.S. $) Mode of Operation < 25,000 25,000 – 50,000 150,000 – 250,000 Any one or Self 50,000 – 100,000 250,000 – 500,000 100,000 – 150,000 > 500,000 Jointly with Right of Survivorship Revised November 2014 LETTER / FAX AGREEMENT FOR FUNDS TRANSFER I/We, the applicants/account holder(s), acknowledge that, State Bank of India, Chicago Branch (the “Bank”) has made available a variety of procedures for the transmission of instruction to the Bank. I/We are fully aware of the risks associated with transmitting instructions via letter or facsimile machine (“fax”) and hereby authorize the Bank to act upon each written payment order (funds transfer instruction or communication) sent to it by me/us by mail or fax if the signatures(s) on such payment order match, in the Bank’s judgment, with my/our signature(s) provided on this form, or provided subsequently, and to debit or credit, as the case may be, accounts which I/We may hold with the same customer number. The Bank’s understanding of any oral notice, instruction or other communication in regards to the payment order sent by person(s) mentioned above or their representatives shall be final and binding. This authorization applies to all accounts opened with the same customer number as for the current application. Prior to the executing of the instruction, the Bank may, at its discretion and only if it considers it necessary, reasonable and practicable, verify the payment order by telephone call to a person and telephone number given in this application or recorded later by me/us with the Bank, following which the Bank shall have no further duty to verify the identity or authority of the person giving or confirming the contents of any payment order or instruction. Not withstanding any provision hereof, the Bank shall have the right in its sole discretion to refuse to execute any payment order or instruction. I/We understand that the Bank may not act upon a payment order or instruction on the same business if the order or instruction is received by it after 2 p.m EST. I/We agree to be bound by a payment order or instruction whether or not authorized, issued in its name and accepted by the Bank in compliance with these procedures and further agree to indemnify and hold the Bank harmless for any loss, liability, claim, damage or expenses (including legal fees), collectively referred to herein as “claims”, attributable to executing and accepting the payment order or instruction in accordance with these procedures or action omitted to be taken, whether such claims are brought by me/us or our representative or by a third party. I/We shall notify the Bank if a payment order or instruction was not authorized by me us, within a reasonable time not exceeding 90 day after the date, I/We received the notification from the Bank that the order was accepted or my/our account was debited with respect to the order. The procedure established by this agreement may be varied only by a written agreement signed by both parties, and supersedes all prior agreements or practices, if any, in respect to instruction and may not be changed by an oral agreement or by a course of dealing or custom. This agreement shall be governed by the laws of the State of Illinois and any dispute in connection herewith shall be adjudicated in a federal or Illinois State Court located in the City of Chicago. I/We execute the above agreement: YES NO ACKNOWLEDGEMENTS 1. I/We undertake to abide by the usual terms and conditions governing accounts in the U.S. as well as the terms, rules and regulations in the State Bank of India’s Customer Manual, receipt of which is hereby acknowledged. I declare that funds offered by me/us to the Bank represent/ shall represent my/our own funds, earned through legitimate means and complying with all U.S. laws. 2. I/We understand that on no occasion my/our account will be permitted by the Bank to go into overdraft. 3. I/We understand that the Bank may not act upon my/our funds transfer instructions conveyed through a letter/fax, unless I/We execute a Letter/Fax agreement for funds transfer or attach a check to the instruction letter. 4. The information supplied in this application is true and correct to the best of my/our knowledge and belief. I/We authorize the Bank to obtain information about my/our identity, credit history and other banking history form consumer reporting agency (ies) or other sources. I/We further understand that if information in the credit history results in a decision to either disallow my/our-signing authority on the account or disallow opening the account, the Bank will communicate this fact to the owners and/or authorized signers of the (proposed) account. I/We further authorize the Bank to obtain this information at any time from one or more consumer reporting agencies or other sources that it may choose as long as I/We am/are (an) authorized signer(s) on the account. VERIFICATION OF SIGNATURE AND IDENTITY (If you send your application by mail, please get your signature verified below by an SBI Official OR Notary Public OR and Indian Embassy OR Consulate) -: Identity should be verified from the ORIGINAL of the photo ID mentioned on Page 1 above :-:PLEASE NOTE THAT IN ADDITION THE VERIFIER MUST ATTEST THE COPY OF THE PRIMARY PHOTO-ID:- 1st Applicant 2nd Applicant 3rd Applicant Name: Name: Name: Signature: Signature: Signature: Signature and Seal of the Verifier: Signature and Seal of the Verifier: Signature and Seal of the Verifier: Date of Verification: Date of Verification: Date of Verification: Place of Verification: Place of Verification: Place of Verification: Telephone # of the Verifier: (If Applicable) Telephone # of the Verifier: (If Applicable) Telephone # of the Verifier: (If Applicable) Revised November 2014 W-9 Form (Rev. August 2013) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. Name (as shown on your income tax return) Business name/disregarded entity name, if different from above Exemptions (see instructions): Check appropriate box for federal tax classification: Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶ Other (see instructions) ▶ Address (number, street, and apt. or suite no.) Exemption from FATCA reporting code (if any) Requester’s name and address (optional) City, state, and ZIP code List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Social security number Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Employer identification number Part II – – – Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person ▶ Date ▶ General Instructions withholding tax on foreign partners’ share of effectively connected income, and Section references are to the Internal Revenue Code unless otherwise noted. Future developments. The IRS has created a page on IRS.gov for information about Form W-9, at www.irs.gov/w9. Information about any future developments affecting Form W-9 (such as legislation enacted after we release it) will be posted on that page. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, payments made to you in settlement of payment card and third party network transactions, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners’ share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. Cat. No. 10231X Form W-9 (Rev. 8-2013) Page 2 Form W-9 (Rev. 8-2013) In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States: Updating Your Information • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust, and You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account, for example, if the grantor of a grantor trust dies. • In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Penalties Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity, Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships on page 1. What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requester of Form W-9 for more information. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part I of the form. Sole proprietor. Enter your individual name as shown on your income tax return on the “Name” line. You may enter your business, trade, or “doing business as (DBA)” name on the “Business name/disregarded entity name” line. Partnership, C Corporation, or S Corporation. Enter the entity's name on the “Name” line and any business, trade, or “doing business as (DBA) name” on the “Business name/disregarded entity name” line. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a “disregarded entity.” See Regulation section 301.7701-2(c)(2)(iii). Enter the owner's name on the “Name” line. The name of the entity entered on the “Name” line should never be a disregarded entity. The name on the “Name” line must be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on the “Name” line. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on the “Business name/disregarded entity name” line. If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN. Note. Check the appropriate box for the U.S. federal tax classification of the person whose name is entered on the “Name” line (Individual/sole proprietor, Partnership, C Corporation, S Corporation, Trust/estate). Limited Liability Company (LLC). If the person identified on the “Name” line is an LLC, check the “Limited liability company” box only and enter the appropriate code for the U.S. federal tax classification in the space provided. If you are an LLC that is treated as a partnership for U.S. federal tax purposes, enter “P” for partnership. If you are an LLC that has filed a Form 8832 or a Form 2553 to be taxed as a corporation, enter “C” for C corporation or “S” for S corporation, as appropriate. If you are an LLC that is disregarded as an entity separate from its owner under Regulation section 301.7701-3 (except for employment and excise tax), do not check the LLC box unless the owner of the LLC (required to be identified on the “Name” line) is another LLC that is not disregarded for U.S. federal tax purposes. If the LLC is disregarded as an entity separate from its owner, enter the appropriate tax classification of the owner identified on the “Name” line. Other entities. Enter your business name as shown on required U.S. federal tax documents on the “Name” line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the “Business name/disregarded entity name” line. Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the Exemptions box, any code(s) that may apply to you. See Exempt payee code and Exemption from FATCA reporting code on page 3. Page 3 Form W-9 (Rev. 8-2013) Exempt payee code. Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding. The following codes identify payees that are exempt from backup withholding: 1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2—The United States or any of its agencies or instrumentalities 3—A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or instrumentalities 5—A corporation 6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—A real estate investment trust 9—An entity registered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for . . . THEN the payment is exempt for . . . Interest and dividend payments All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. G—A real estate investment trust H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I—A common trust fund as defined in section 584(a) J—A bank as defined in section 581 K—A broker L—A trust exempt from tax under section 664 or described in section 4947(a)(1) M—A tax exempt trust under a section 403(b) plan or section 457(g) plan Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on page 2), enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Barter exchange transactions and patronage dividends Exempt payees 1 through 4 Payments over $600 required to be 1 reported and direct sales over $5,000 Generally, exempt payees 2 1 through 5 To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, or 5 below indicate otherwise. Payments made in settlement of payment card or third party network transactions Exempt payees 1 through 4 For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on the “Name” line must sign. Exempt payees, see Exempt payee code earlier. 1 See Form 1099-MISC, Miscellaneous Income, and its instructions. 2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney, and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A—An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B—The United States or any of its agencies or instrumentalities C—A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities D—A corporation the stock of which is regularly traded on one or more established securities markets, as described in Reg. section 1.1472-1(c)(1)(i) E—A corporation that is a member of the same expanded affiliated group as a corporation described in Reg. section 1.1472-1(c)(1)(i) F—A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state Part II. Certification Signature requirements. Complete the certification as indicated in items 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. “Other payments” include payments made in the course of the requester’s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. Page 4 Form W-9 (Rev. 8-2013) What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual 2. Two or more individuals (joint account) The individual The actual owner of the account or, if combined funds, the first 1 individual on the account 3. Custodian account of a minor (Uniform Gift to Minors Act) The minor 4. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law 5. Sole proprietorship or disregarded entity owned by an individual 6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulation section 1.671-4(b)(2)(i)(A)) The actual owner The owner 1 1 The grantor* Give name and EIN of: The owner 4 9. Corporation or LLC electing corporate status on Form 8832 or Form 2553 10. Association, club, religious, charitable, educational, or other tax-exempt organization The corporation 11. Partnership or multi-member LLC 12. A broker or registered nominee The partnership The broker or nominee 13. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments The public entity 14. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulation section 1.671-4(b)(2)(i)(B)) The trust 1 2 3 Identity theft occurs when someone uses your personal information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. 3 Legal entity Secure Your Tax Records from Identity Theft To reduce your risk: The grantor-trustee For this type of account: 7. Disregarded entity not owned by an individual 8. A valid trust, estate, or pension trust 2 Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. The organization If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: spam@uce.gov or contact them at www.ftc.gov/idtheft or 1-877IDTHEFT (1-877-438-4338). Visit IRS.gov to learn more about identity theft and how to reduce your risk. List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished. Circle the minor’s name and furnish the minor’s SSN. You must show your individual name and you may also enter your business or “DBA” name on the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. 4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 1. *Note. Grantor also must provide a Form W-9 to trustee of trust. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information. Form W-8BEN Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding (Rev. February 2006) Department of the Treasury Internal Revenue Service 䊳 OMB No. 1545-1621 Section references are to the Internal Revenue Code. 䊳 See separate instructions. 䊳 Give this form to the withholding agent or payer. Do not send to the IRS. Do not use this form for: ● A U.S. citizen or other U.S. person, including a resident alien individual ● A person claiming that income is effectively connected with the conduct of a trade or business in the United States ● A foreign partnership, a foreign simple trust, or a foreign grantor trust (see instructions for exceptions) ● A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or government of a U.S. possession that received effectively connected income or that is claiming the applicability of section(s) 115(2), 501(c), 892, 895, or 1443(b) (see instructions) Note: These entities should use Form W-8BEN if they are claiming treaty benefits or are providing the form only to claim they are a foreign person exempt from backup withholding. ● A person acting as an intermediary Note: See instructions for additional exceptions. 1 Name of individual or organization that is the beneficial owner 3 Type of beneficial owner: Grantor trust Central bank of issue Individual 2 Corporation W-8ECI or W-8EXP W-8IMY Complex trust Estate Tax-exempt organization Private foundation Country of incorporation or organization Disregarded entity Partnership Government International organization Simple trust Permanent residence address (street, apt. or suite no., or rural route). Do not use a P.O. box or in-care-of address. City or town, state or province. Include postal code where appropriate. 5 Country (do not abbreviate) Mailing address (if different from above) City or town, state or province. Include postal code where appropriate. 6 Country (do not abbreviate) 7 U.S. taxpayer identification number, if required (see instructions) SSN or ITIN 8 Foreign tax identifying number, if any (optional) EIN Reference number(s) (see instructions) Claim of Tax Treaty Benefits (if applicable) Part II 9 10 W-8ECI W-8ECI or W-8IMY Identification of Beneficial Owner (See instructions.) Part I 4 Instead, use Form: W-9 I certify that (check all that apply): a The beneficial owner is a resident of b If required, the U.S. taxpayer identification number is stated on line 6 (see instructions). within the meaning of the income tax treaty between the United States and that country. c The beneficial owner is not an individual, derives the item (or items) of income for which the treaty benefits are claimed, and, if applicable, meets the requirements of the treaty provision dealing with limitation on benefits (see instructions). d The beneficial owner is not an individual, is claiming treaty benefits for dividends received from a foreign corporation or interest from a U.S. trade or business of a foreign corporation, and meets qualified resident status (see instructions). e The beneficial owner is related to the person obligated to pay the income within the meaning of section 267(b) or 707(b), and will file Form 8833 if the amount subject to withholding received during a calendar year exceeds, in the aggregate, $500,000. Special rates and conditions (if applicable—see instructions): The beneficial owner is claiming the provisions of Article % rate of withholding on (specify type of income): treaty identified on line 9a above to claim a Explain the reasons the beneficial owner meets the terms of the treaty article: Notional Principal Contracts Part III 11 of the . I have provided or will provide a statement that identifies those notional principal contracts from which the income is not effectively connected with the conduct of a trade or business in the United States. I agree to update this statement as required. Part IV Certification Under penalties of perjury, I 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 further certify under penalties of perjury that: 1 I am the beneficial owner (or am authorized to sign for the beneficial owner) of all the income to which this form relates, 2 The beneficial owner is not a U.S. person, 3 The income to which this form relates is (a) not effectively connected with the conduct of a trade or business in the United States, (b) effectively connected but is not subject to tax under an income tax treaty, or (c) the partner’s share of a partnership’s effectively connected income, and 4 For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions. Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any withholding agent that can disburse or make payments of the income of which I am the beneficial owner. Sign Here 䊳 Signature of beneficial owner (or individual authorized to sign for beneficial owner) For Paperwork Reduction Act Notice, see separate instructions. Date (MM-DD-YYYY) Cat. No. 25047Z Printed on Recycled Paper Capacity in which acting Form W-8BEN (Rev. 2-2006) STATE BANK OF INDIA Form DEP-MCS 19 S La Salle Street Suite - 200 Chicago IL 60603 Tel: 312-621-1200; Fax: 312-701-0232 Account No. Member FDIC APPLICATION FOR MMD/ CHECKING / SAVINGS ACCOUNT (New customers should fill this form along with Form DEP-1) Application for (Please select one) Money Market Deposit Account Checking Account Savings Account (If you want to open more than one account, submit separate DEP-MCS Form and separate Personal Check for the Minimum Balance requirements) st nd rd 1 Customer Name Applicant 2 Applicant 3 Applicant First Name Middle Name Last Name Customer Number For already existing Customers I / We request you to open the account(s) as mentioned above with your branch. I /We have read and understood the terms and conditions governing the account(s). I/We acknowledge the receipt of the account disclosures applicable for Deposits Account. Purpose of the Account Savings and Salary Receiving Social Security benefits Collection / Issue of checks (Check all that are applicable) Expected Annual Volume of Transactions < $10,000 $50,000 – 100,000 Source of Funds (Check all that are applicable) Sending remittances to India Cash receipts / payments Others (specify): $10,000 – 25,000 $100,000 – 150,000 Current Income/wages Past savings Sale of property Pension/S.S. Benefits $25,000 – 50,000 > $150,000 Liquidation of investments Others (specify): End use of Funds Expected Annual Volume Loan Accounts ( Home Loan / Education Loan) End use of Funds for Remittance Transactions NRI Accounts ( Savings / Fixed Deposits) House Construction Others ( Personal Expenses/ Family Maintenance/ Education Expenses) Mode of Deposit (Funding) & Amount Debit my/our Checking / MMD /Savings Acct. No.___________________with you, OR Check No. ____________ attached for the Amount: USD___________ Mode of operation of the Any one or Self Jointly Account Do you want check book on your Checking/MMD account? (Check with Right of Survivorship Yes No books are charged and not issued for savings accounts. No temporary checks are issued) Do you want International Debit Card on your Checking Account? Yes* No (Debit card is issued only to Checking account) I/We acknowledge the receipt of terms and conditions governing the Debit Card Policy & Procedure Do you prefer to have online banking access to our Account? Yes* No I/We acknowledge the receipt of terms of service document governing the Online banking access Policy & Procedure * (If your choice is YES, kindly fill out the relevant applications attached below) Signature Signature Signature Signature of the Applicants Date: (For Office use only) Account Opened by Place: Verified by Revised November 2014 State Bank of India, 19 S LaSalle Street , Suite 200, Chicago, IL, 60603 Application for issue of Debit Card Member FDIC To Vice-President (PB) State Bank of India, Chicago. I wish to avail the debit card services offered by State Bank of India, Chicago. Please arrange to issue me debit card. Name of Customer: (In the order of First, Middle and Last Name)** Name as I would like to appear on the card:** My Account Numbers** Account Type Primary – Checking Account (27 Characters) (21 Characters) Single/ Joint Accounts* Account Number 7 7 7 7 7 7 *Joint account holders with mode of operation as anyone or survivor need to submit separate application forms Address:** Street Address Apt # State Zip City Phone*** (Day) Phone*** (Eve) *** Phone number provided in the application should be used to activate / reset the PIN – Use Cell/Landline Numbers only Validation Data (This data will be used for identification when you call the customer service centre for all purposes): Mother’s maiden name ** Social Security(Last 4-Digit)** XXX-XXDate of Birth ( mm-dd-yyyy)** Driver’s License - ** Mandatory Columns to be filled up. 1. Charges are waived for transactions performed at any ATM with any bank within USA up to Dec 2013. 2. The bank has decided to waive the charges levied by the service provider for transactions done at State Bank Group ATMs in India/USA up to Dec 2013. 3. For transaction done at ATMs / POS terminals outside USA, cross country (0.2% of transaction amount) and crossborder (0.8% of transaction amount) fees are levied by Master Card. In addition to these the respective ATM network service provider might also charge a fee for each transaction. 4. I have received, read and understood the provisions contained in the terms and conditions letter of “State Bank of India, Chicago Debit Card Agreement” and I accept these. I agree that the transactions executed using my debit card will be binding on me. Customer’s Signature Date: Encls: Debit Card Agreement For Office Use only Account and Signature Verified Supervisor PB Application Processed Manager Card Number Revised November 2014 STATE BANK OF INDIA, CHICAGO Registration for Internet Banking : Individual Member FDIC To Vice President (PB) State Bank of India, 19 S LaSalle Street, Suite 200, Chicago, IL - 60603. I wish to Register as a user of ‘OnlineSBIGlobal’, SBI, Chicago Internet Banking Service. OR I am an existing user of ‘OnlineSBIGlobal’,SBI, Chicago Internet Banking Service and Reset my Password Name of Customer (25 Characters) Date of Birth (mm/dd/yyyy): Street Address Apt # City State Zip Phone** (Day) Phone** (Eve) E-Mail ** My Account Number/s Single New Account Joint Account(s) Existing Account Resetting Password (Must give User ID * in the Specific Column) If you wish to add your existing account/s to internet banking facility, please list them below 7 7 7 7 7 7 I have read the provisions contained in the “Terms of service document” of “OnlineSBIGlobal” and accept them. I agree that the transactions executed over OnlineSBIGlobal under my Username and Password will be binding on me. USER ID* (Only in case of Password Reset) Customer’s Signature: Date: For Office Use only : Account and Signature Verified. Application Processed. Supervisor / Manager (PB) Manager (Systems/PB) Revised November 2014