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APPENDIX D
Mrs.
Ms.
: ____________________________________________________________________________
TM BHD (4863)
PERISAI (0047)
1 LOT
5 LOT
3 LOT
Monthly Purchases
OTHERS _____________________
Quarterly Purchases
C. DECLARATION BY CLIENT
I hereby declare that I have read and accepted the accompanying Terms and Conditions by execution
of this Application Form, in addition to the terms and conditions of my Cash Trading Account.
Yours faithfully
Verified by
Signature:____________________
Name: _______________________
Date: