* Mandatory Fields
If you have any questions or need help call us anytime @ 1-888-424-2422 (ICICI CA)
  : : Applicant Information : :
Title* First Name* Middle name Last Name*
Date of Birth* Day Month Year Mother's maiden Name*
    For your protection, we require this information for future security verification
Are you a PEP or a HIO*
          Click here to learn more about PEP and HIO
Country of Birth*
Nationality* ?
Contact Details( +Either Home or Mobile number is mandatory)
Home telephone+ Business telephone E-mail Address*
(001) - - (001) - -
Mobile Number+
(001) - -
Social Insurance Number* How did you hear about us?*
 -  -
Canada Revenue Agency requires ICICI Bank Canada to include your Social Insurance Number (SIN) on tax receipts.
If you are unable to provide your SIN number at this moment, please visit one of our branches to open an account
Home Address (Please fill the address where you presently live. This address cannot include a PO Box, RR, Site, Comp or GD/ General Delivery Address)
Start Entering Address.* Street No.* Street Name* Suite City*
Province* Country* Postal Code (X1X1X1)*  
Canada  
 
Communication Address
Same as Home Address 		Yes No
Start Entering Address.* Street No.* Street Name* Suite City*
Province* Country* Postal Code (X1X1X1)*  
Canada    
       
Employment Information
Nature of Profession*
 
 : : Declaration of tax residence* : :

  Tick all the options that apply to you
I am a tax resident of Canada.
I am a tax resident or a resident of the United States.
I am a tax resident of a jurisdiction other than Canada or the United States.
 
If you need help with your tax residency information please visit Income Tax Folio, S5-F1-C1 - Determining an Individual’s Residence Status , on the CRA website.
 : : Other Party Information* : :


Please answer the following:
Will this Account be used by or on behalf of any party who is not an account holder in this application   :

Name of the Other Party*   Date of Birth*  
  Day Month Year
Incorporation No. (If Applicable)   Place of Incorporation (If Applicable) Unit
Home Address*   City*  
 
Province*   Country* Postal Code (X1X1X1)*
  Canada
     
Occupation or type of business of other person * Relationship with the other party*
   
: : Account Information* : :
Select the type of account you wish to open (This information has to be filled in)
Minimum amount of $1,000 is required for opening of all GIC / Term Deposits including RSP GIC and Tax-Free GIC
You may choose more than one option
                                                                                                                                                                                                                                                                                                                                                                                                                                               
Accounts Amount           Tenure/Time           Intended Use
Bank Accounts :
Canadian Dollar HiSAVE Savings Account
US Dollar HiSAVE Savings Account
Canadian Dollar HiVALUE Chequing Account
Canadian Dollar HiVALUE Plus Chequing Account
GICs / Term Deposits :
Canadian Dollar Redeemable GIC
Canadian Dollar Non-Redeemable GIC
US Dollar Redeemable Term Deposit Account
RSP Accounts :
Canadian Dollar RSP Savings Account
Canadian Dollar RSP GIC
Tax Free Accounts :
Canadian Dollar Tax-Free Savings Account
Canadian Dollar Tax-Free GIC
 
Do you wish to have a joint account?
(Joint account is not applicable for RSP Savings Account, Tax-Free Savings Account, RSP GIC and Tax-Free GIC. For opening of Spousal RSP Savings Account or Spousal RSP GIC, please call 1-888-ICICI-CA (42424-22). Further information will be required after you have agreed to the Terms and Conditions below)
 Yes  No
 
ICICI Bank can contact me for product offers by* :
Promo Code
If you are applying for an account in response to a specific promotion, please enter your promo code here.
RSP Beneficiary Information
(Complete this section if you would like to designate a beneficiary for RSP account)
Yes. I would like to designate a beneficiary for my RSP Account
(* Mandatory fields)
I designate the person below as Beneficiary.
First Name*
Middle name
Last Name*
Relationship To Applicant*
^Your designation of a beneficiary is subject to applicable laws. You may wish to discuss this designation with your legal advisor. If no beneficiary is designated, all amounts under this Account(s) will be payable to your estate and distributed in accordance with applicable laws.
TFSA Successor Holder and Beneficiary Information
(Complete this section if you would like to designate a successor holder and / or beneficiary for TFSA account)
Please note that the designation of a Successor Holder or Beneficiary in respect of the Account is subject to the laws of the applicable jurisdiction (Province or Territory). If the laws of the applicable jurisdiction do not permit such a designation, it may be made only in your will. If the laws of the applicable jurisdiction permit such a designation in the Account, the following applies:
SUCCESSOR HOLDER INFORMATION
I elect that my surviving spouse or common-law partner become the Successor Holder in the event of my death before termination of the Account, and confirm that my spouse or common law partner has the unconditional right to revoke any Beneficiary designation made by me.
Yes. I would like to designate a successor holder for my TFSA Account
(* Mandatory fields)
Spouse or Common Law Partner’s First Name*
Middle name
Last Name*
Social Insurance Number*
 -  -
BENEFICIARY INFORMATION
Yes. I would like to designate a beneficiary for my TFSA Account
(* Mandatory fields)
First Name*
Middle name
Last Name*
Relationship To Applicant*

By clicking on I accept, I/we hereby confirm that the information provided/to be provided is true and correct. I/we agree that ICICI Bank Canada (the “Bank”) will verify the information provided above and will clear my/our cheque upon receipt. I/we have received read and understood the following terms and conditions (a) Website Terms of Use (b) Account Terms and Conditions (including Tax-Free Savings Account Terms and Conditions for Tax-Free Savings Account or Tax-Free GIC, RSP Account Terms and Conditions for RSP Savings Account or RSP GIC) (c),Disclosure Statement, (d) Client Privacy Policy, (e) Filing a Complaint. (f) Coercive Tied Selling and (g) Interest Rates. I/we hereby consent to the Bank collecting, using and disclosing my personal information for the purposes identified in the Banks Privacy Policy, which I/we have received, read and understood. I/we understand that the Bank reserves the right to carry out any other additional checks for verification purposes on any information provided by me/us.

I hereby certify that the information in this application form regarding my tax residency status is true and correct. I will inform ICICI Bank Canada within 30 days of any change in circumstances that causes the information provided above to become inaccurate or incomplete.

For Tax-Free Savings Account or Tax-Free GIC, I request that the Bank file an election with the Minister of National Revenue to register the qualifying arrangement as a TFSA under section 46.2 of the Income Tax Act. I will notify the Bank if I change my country of residence. I understand that I may be liable for certain tax consequences in the case of a non-compliant qualifying arrangement.

For RSP Savings Account or RSP GIC, I request that the Bank apply for registration of my plan in accordance with section 146 of the Canadian Income Tax act and if necessary, with any Provincial Tax Act.

I Accept I Do not Accept
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