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ONLINE LOAN APPLICATION

Online Account Opening

Home / Online Account Opening

- Step 1 of 2

Customer Type

Date / Time//

Select Customer Type *

Individual Account

Select Individual Type *

Lao Citizen
Foreigner
US Citizen

Personal Details

ຊື່ / Name and Surname (in Lao) *

ຊື່ / Name and Surname (in English) *

ວັນ, ເດືອນ, ປີເກີດ / Date of Birth *//

Gender *

ຊາຍ / Male
ຍິງ / Female

ສະຖານະພາບ / Marital Status *

Single
Married
Others

ສັນຊາດ / Nationality *

ເລກບັດປະຈຳຕົວ ID / Passport / FB book No.

ລົງວັນທີ / Date of Issue//

ວັນໝົດອາຍຸ / Date of Expiry//

ຂໍ້ມູນການຕິດຕໍ່ / Contact Information

ທີ່ຢູ່ປັດຈຸບັນ / Residence Address House No. *

ບ້ານ / Village *

ເມືອງ / District *

Province *

ປະເພດທີ່ຢູ່ອາໄສ / Residence Type *

ຂອງຕົວເອງ / Owned
ເຊົ່າ Rented
ອາໄສຢູ່ກັບພໍ່ແມ່ / Living with Parents
ອື່ນໆ / Others

Mobile Number *

Email

ອາຊີບ / Employment Status

ພະນັກງານ / Employed
ທຸລະກິດສ່ວນຕົວ / Self-employed
ວ່າງງານ / Unemployed
ອາຊີບອິດສະຫຼະ / Freelance
ອື່ນໆ / Others (Place Specify)

ຕຳແໜ່ງ / Job Title *

ບ່ອນປະຈຳການ / Name of Business / Company

ລາຍຮັບຕໍ່ເດືອນ / Total Monthly Income Level *

LAK 1,500,000
LAK 1,500,000 - LAK 4,000,000
LAK 4,000,000 - LAK 8,000,000
LAK 8,000,000 - LAK 15,000,000
LAK 15,000,000

ປະເພດບັນຊີ ແລະ ຈຳນວນເງິນຝາກເບື້ອງຕົ້ນ / Type of account and Initial Deposit (Amount)

ປະເພດບັນຊີ Account Type

Currency *

LAK
THB
USD

ຈຳນວນເງິນຝາກເບື້ອງຕົ້ນ / Initial Deposit AMT *

ຜະລິດຕະພັນການບໍລິການເພີ່ມເຕີມ / Additional Product *

ເປີດນຳໃຊ້ບັດ ATM
ເປີດນຳໃຊ້ແອັບ MJ Saduak
ບໍ່ຕ້ອງການ / No requirement
ອື່ນໆ / Others

Customer Risk Profile Form (Know Your Customer-KYC)

Section 1-Country risk

1.Does applicant/related persons**come from ,reside in or work in a high risk country (FATF high risk list)

Yes
No

Section 2-Customer risk

1.Is the applicant/ related to person* listed within our internal black list?

Yes
No

2.Is the applicant/related person-a shell company, having no physical commercial presence?

Yes
No

3.Does the applicant use P.O Box address without physical address or asked for anonymous name

Yes
No

4.Is the applicant/related person ***listed in the World Check prohibit list (FATF, UN, OFAC or BOL full economic sanction list)?

Yes
No

5.Is the applicant a non – face to face customer

Yes
No

6.Is the applicant /related person *involved in the below business activities?

Yes
No

-Arm related business -Casino, Betting, and other gambling related activities -Night club, Karaoke, Bar -Pawn shop -Money changer -Dealer in precious goods(jewels, gem, art, antique, real estate) -Special purpose vehicle, unregister hedge fund, offshore bank and trust

Insufficiency document required in policy but waived by management

Yes
No

8.Customer is correspondent bank

Yes
No

9.Is the applicant/related person*classified under PEPs category

Yes
No

10.Is the applicant a high net worth customer, whose monthly average balance with MJBL exceeded USD500.000 or equivalent

Yes
No

11.Does customer have complex controlling/ownership structure?

Yes
No

12.Is the customer NGO, foundation or society?

Yes
No

13.Is the account a trust, nominee, client of law/accounting firm

Yes
No

Section 3-Product and services risk

Does the customer instruct oversea Telegraphic Transfer immediately after opening the accounting the amount exceeding USD10K? i.e. the purpose of account is mainly for fund transfer oversea

Yes
No

Section 4 –Total risk score and approval

Low(TRS = 0 )
Medium (TRS = 1)
High (TRS > 2)

Total risk score(TRS) (A+B+B+C)=

Waiver request(if any) please cross this section if none

MJBL Call Center +856 (21) 411777

[email protected]

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