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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
*
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Gender
*
ຊາຍ / Male
ຍິງ / Female
ສະຖານະພາບ / Marital Status
*
Single
Married
Others
ສັນຊາດ / Nationality
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
ເລກບັດປະຈຳຕົວ ID / Passport / FB book No.
ລົງວັນທີ / Date of Issue
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ວັນໝົດອາຍຸ / Date of Expiry
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ຂໍ້ມູນການຕິດຕໍ່ / Contact Information
ທີ່ຢູ່ປັດຈຸບັນ / Residence Address House No.
*
ບ້ານ / Village
*
ເມືອງ / District
*
Province
*
Attapeu Province
Bokeo Province
Bolikhamxai Province
Champasak Province
Houaphanh Province
Khammouane Province
Luang Namtha Province
Luang Prabang Province
Oudomxay Province
Phongsaly Province
Salavan Province
Savannakhet Province
Vientiane Province
Vientiane Capital
Sainyabuli Province
Sekong Province
Xaisomboun Province
Xiangkhouang 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
ເງິນຝາກປະຢັດ / Savings
ເງິນຝາກເພື່ອທຶນການສຶກສາ / Save for Children
Merchant
ເງິນຝາກກະແສລາຍວັນ / Current
ເງິນຝາກປະຈຳ / Term Deposit
Currency
*
LAK
THB
USD
ຈຳນວນເງິນຝາກເບື້ອງຕົ້ນ / Initial Deposit AMT
*
ຜະລິດຕະພັນການບໍລິການເພີ່ມເຕີມ / Additional Product
*
ເປີດນຳໃຊ້ບັດ ATM
ເປີດນຳໃຊ້ແອັບ MJ Saduak
ບໍ່ຕ້ອງການ / No requirement
ອື່ນໆ / Others
Next
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
Submit
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CUSTOMER CARE
ONLINE LOAN APPLICATION