ISI CLEARING FORM I
INFORMASI NOMOR REKENING BANK ANGGOTA Member Bank Accounts Information Tanggal Date
No. Identitas Anggota Member ID
Nama Anggota Member Name
Rekening Terpisah
Rekening Tidak Terpisah
Segregated Account
Unsegregated Account
Bank 1 Nomor Rekening
Bank 1 Nomor Rekening
Account Number
Account Number
Rupiah IDR US Dollar USD
Rupiah IDR US Dollar USD
Bank 2 Nomor Rekening
Bank 2 Nomor Rekening
Account Number
Account Number
Rupiah IDR US Dollar USD
Rupiah IDR US Dollar USD
Bank 3 Nomor Rekening
Bank 3 Nomor Rekening
Account Number
Account Number
Rupiah IDR US Dollar USD
Rupiah IDR US Dollar USD
Bank 4 Nomor Rekening
Bank 4 Nomor Rekening
Account Number
Account Number
Rupiah IDR US Dollar USD
Rupiah IDR US Dollar USD
Tandatangan yang Berwenang Authorised Signature(s) * Pilihlah salah satu * Choose one of the following
Salah satu Any one to sign
Keduanya Any two to sign
Lain-lain ( Dijelaskan ) Others ( Please Specify )
Nama & Tandatangan
Nama & Tandatangan
Name & Sign
Name & Sign
ISI CLEARING FORM II
KONFIRMASI PENGIRIMAN DANA MARGIN Confirmation of Margin Remittance Tanggal Date
No. Identitas Anggota Member ID
Nama Anggota Member Name Nama Bank yang Dipilih untuk Pengiriman Dana : Name of bank that funds have been remitted to :
Rekening Multilateral :
Rekening Over-the-Counter (OTC) :
Multilateral Account :
Over-the-Counter (OTC) Account :
Bank Central Asia
A/C (IDR) : 035-311.75.88 A/C (USD) : 035-315.33.98
CIMB Niaga
A/C (IDR) : 022.01.13139.00.5 A/C (USD) : 022.02.13019.00.8
Sinarmas
A/C (IDR) : 0000.884.669 A/C (USD) : 0001.267.377
B ank Central Asia
A/C (IDR) : 035-311.97.93 A/C (USD) : 035-311.97.42
Rekening Penyaluran Amanat Luar Negeri (PALN) : Standard Chartered Bank A/C (USD) : 306-085.152.02
Standard Chartered Bank A/C (IDR) : 306-085.499.56 A/C (USD) : 306-085.639.44 Jenis Mata Uang Type of Currency Rupiah
US Dollar
IDR
USD
Amount Jumlah
Setelah dana ditransfer harap melengkapi formulir ini. After deposit your fund, please complete this form.
Formulir atau bukti pengiriman dana HARUS dikirim ke ISI melalui fax ke nomor +62.21.5367-6963 atau email ke
[email protected]. Either this form or Bank Remittance SHOULD BE sent to ISI by fax to +62.21.536-76963 or email to
[email protected].
ISI telah menerima setoran dana dan telah mengkreditkannya ke rekening transaksi kami. ISI have acknowledged your deposit and have credited your funds into our trading account.
Untuk mengetahui saldo Anda, dapat dilihat di laporan kliring Anda. To check your balance, please see your clearing statement.
Tandatangan yang Berwenang Authorised Signature(s)
Nama & Tandatangan
Nama & Tandatangan
Name & Sign
Name & Sign
DIISI OLEH ISI For ISI Used Only
Proses
Veri kasi
Waktu Diterima
Processed
Veriiied
Time Received
ISI CLEARING FORMIII MIII
FORMULIR PENARIKAN DANA Funds Withdrawal Form Tanggal Date
No. Identitas Anggota Member ID
Nama Anggota Member Name
(1 )
Jenis Mata Uang
Jenis Rekening
Type of Currency
Type of Account
Rupiah
US Dollar
Rekening Multilateral
Rekening Over-the-Counter (OTC)
IDR
USD
Multilateral Account
Over-the-Counter (OTC) Account
Saldo Ak hir Sebelum Penarik an Equity balance before withdrawal
Jumlah Penarik an Withdrawal amount ( 3 ) Saldo Ak hir Setelah Penarik an (2 )
(3 = 1-2 )
Equity balance after withdrawal
Ak ank ah Anda melak uk an penutupan rek ening ? Will you be closing your account ? YA
TIDAK
Yes Yes
No
Perincian Bank Bank Details :
Nama Rekening
Alamat Bank
Account Name
:
Bank Address
:
Kota City
:
Kode SWIFT SWIFT Code
:
Negara
:
Nama Bank Nama Bank
:
Nomor Rekening Account Number
State
Nomor Telepon
Name of Bank
:
Telephone Number
Untuk menarik dana dari rekening transaksi, harap melengkapi dan menandatangani formulir ini. To withdraw funds from your trading account, please complete and sign this form. Formulir harus dikirim ke isi ke nomor fax +62.21.536-76963 atau melalui email ke
[email protected]. The form should be sent to ISI by fax to +62.21.536-76963 or email to
[email protected]. Harap diketahui bahwa dapat dikenakan biaya administrasi tertentu oleh bank. Please note that certain bank charges may apply. Jika menutup rekening Anda, harap dipastikan bahwa tidak ada posisi terbuka.
If you are closing your account, please ensure that there are no open positions. Jika tidak menutup rekening Anda dan hanya ingin menarik dana, harap dipastikan bahwa terdapat kecukupan dana pada rekening anda
If you are not closing your account and merely want to withdraw funds, please ensure that there is sufficient funds in your account (setelah penarikan) untuk menjaga setiap posisi terbuka yang Anda miliki. (after the withdrawal) to maintain any open positions that you have. Biaya administrasi bank akan dipotong dari dana yang akan ditarik. Bank Charges deduct from funds to be withdrawn. .
Tandatangan yang Berwenang Authorised Signature(s)
Nama & Tandatangan
Nama & Tandatangan
Name & Sign
Name & Sign
DIISI OLEH ISI For ISI Used Only
Proses
Veri kasi
Waktu Diterima
Processed
Veriiied
Time Received
ISI CLEARING FORMIV MIV
KONFIRMASI PENGIRIMAN DANA JAMINAN Confirmation Of Collateral Deposit Remittance Tanggal Date
No. Identitas Anggota Member ID
Nama Anggota Member Name
Tujuan dari Jaminan Purpose of Collateral
Dana Jaminan
Margin Awal
Security Deposit
Initial Margin
Jenis Jaminan Type of Collateral Tunai Cash
Jenis Mata Uang
Nama Bank
Type of Currency
Name of Bank
Rupiah
US Dollar
Lain-lain
IDR
USD
Others
Bank Central Asia
Bank Sinarmas
Rincian Pembayaran Payment Details Bank Central Asia
A/C (IDR) : 035-399.9998
Bank Sinarmas
A/C (USD) : 000.4 00.6 585
Jumlah Amount
NON TUNAI Non Cash
Time Deposit
Certi ed Deposit
Jumlah Amount
Bank Penerbit : (Hanya Bank Kustodian)
Tanggal Rancangan:
Issuing Bank
Draft Date
(Custodian Bank Only)
Nomor Rancangan:
Tanggal Jatuh Tempo:
Draft Number
Expired Date
Nomor Surat Pernyataan & Kuasa Pencairan: Agreement Number & Authority of Dilution Anggota dapat memberikan dana jaminan dalam bentuk tunai dan non-tunai. Members can place cash & non-cash as collateral. Minimum 50% dari Dana Jaminan harus dalam bentuk tunai. Up to 50% of Security Deposits must be placed in cash. Sisanya Dana Jaminan dapat ditempatkan dalam bentuk Deposito Berjangka atau Bilyet Deposito.. The rest of Security Deposits can be placed in the forms of time deposits or certiÿcate deposits. Formulir HARUS dikirim ke ISI melalui fax ke nomor +62.21.536-76963 atau email ke
[email protected]. The form SHOULD BE sent to ISI by fax to +62.21.536-76963 or email to
[email protected].
Tandatangan yang Berwenang Authorised Signature(s)
Nama & Tandatangan
Nama & Tandatangan
Name & Sign
Name & Sign
DIISI OLEH ISI For ISI Used Only
Proses
Veri kasi
Waktu Diterima
Processed
Veriiied
Time Received
ISI CLEARING FORMV MV
