NROPA Form

BANK NEGARA INDONESIA SYARIAH (BNIS) ONLINE APPLICATION FORM FOR A NONE RESIDENT OFFSHORE PRIVATE ACCOUNT (NROPA)
Fill the below form with complete and correct details to avoid rejection of your application

Customer's Full Name: Customer's Full Name:

Preferred Internet Banking User ID: Preferred Internet Banking User ID:

Identification: Identification:

Identification Number: Identification Number:

Address: Address:

City: City:

State: State:

Zip Code: Zip Code:

Home Phone: Home Phone:

Fax Number: Fax Number:

Mobile Number: Mobile Number:

E-Mail Address: E-Mail Address:

Invalid Email Invalid Email

Email must be filled Email must be filled

Sex/Gender: Sex/Gender:

Date of Birth (Date-Month-Year): Date of Birth (Date-Month-Year):

Place of Birth: Place of Birth:

Marital Status: Marital Status:

Religion: Religion:

Job: Job:

Income Salary Per Year (In USD): Income Salary Per Year (In USD):

Education: Education:

House Status: House Status:

Name of Reference: Name of Reference:

Next of Kins: Next of Kins:

Mother's Maiden Name: Mother's Maiden Name:

Company Name: Company Name:

Position/Rank: Position/Rank:

Line of Business: Line of Business:

Address: Address:

Nationality: Nationality:

Education: Education:

Country of Residence: Country of Residence:

Account Goal: Account Goal:

Account Type: Account Type:

PERNYATAAN PEMOHON APPLICANT's STATEMENT

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Kode Aplikasi Application Code :