Stanbic IBTC Bank ‘A member of Standard Bank Group ACCOUNT OPENING FORM - INDIVIDUAL Category of Account Ticks appropriate) Joie account CL] Fuesinvetment acount Clothertypesot acount C] Aecount Type (ik appropriate) Carethecit []ebeoit Acoust sings Act] dni cot A "ACCOUNT No. for ofl use ony) BRANCH BIOMETRIC ID NO: Personal banking application FORMA Mx Passport Photograph here Marsal Status. (Please tick as approprinta) Single | Marrieg| Others ipleave spec Sender F " rei te ES ED ES arg al Resident Aderase| PS Street Number Street Name Nearest Bus StopiLandmare Cif Town Local Gove Ares seas Maling Address Prone Number (1), Phone Number (2) E-mal Acdrest Twiter @ ERE eae acoatiOCad[] Natit vrs cee] lteraiona Paspore[]INeCVotws Cad] * Others a pa CardPreferences MasterCard (Debit) []VISACARD (Credi)L] Verve Card (prepaid] Others (specify) Transaction let rteences EmaiAter (Free) [] SMS Alert (Fee pps) [] SentementPreferences: Erai] Pox] Catecionat Branch] StetementFequency: Montiy[] Quay] Cheque Book equiston (Fees apply) Opened Cheque] Cros Chegie[] 25Lenes[] _ soLenesL] Cheque Confirmation: Will yu like to pre-confrm your cheques? — Yes] No] \CCOUNT SERVICE(S) REQUIRED (Please tick applicable option below) Electronic Banking Preferences Iteret Banking] Mobile Banking] ATM] POST] Other Ekcronic Chana Fet may pp) Sec Seni: Arma] Analy] 00 Lees Cheque Confimaton Threshold the answer tothe above is ye, pease pec the thresholdPE Employed |_| sotempoyes|_] Unemployed [_] retires |] seudene Coxnars Pease spect) oxectmomer tensions PETE TT] Annual alay/Expected Annual incr ‘oma Salary: a) Less than NS6,000 [_] ( NSI.000-N250.000[] (©) N25 1,000 = NS00.000] () NSO} 000 Less than Nimiion (@) Nein - Les than NSrion ] ()NSwalion - Less an NiOmilhon ] () NO - Las than N2Oron [] (+) Above N2Omon EngereriNe Employer's fimploymen Adare House Number Sreet Name Nearest Bus Stopflandmar Coy Town Leal Gov Area sue Nate of Busnes caption Office Phone Number Fax Number Sumae ‘Oxher Name(] Frat Name Dae of Birth Gender F [] [7] tlesoea) Reconship Mobile Numbor 1 Mie Nonber2 ont Details House Number Street Name Nearest Bu toitandmark CCieyfTown Loa Gor. Area state 16) (amy) 1 Spouse's Name Gi aplicabie| W Spouse Date of tic A ‘Spouse's Occupation 1V Sources of Fund to the Account 2 V Name OF Associated Business ( Hany 2 a Vi Type of Busines ‘VilBusiness Adress LeNAME AND ADDRESS OF ENN) Procol! ect DRATITHS SHOULD BE ADOPTED WHERE THE APPLICANTS NOT LITERATE ORS BUND AND THE FORM IS READ TO HIM OR HERBY A THRD PARTY) MAGISTRATE / COMMISSIONER FOR OATHS MARK OF CUSTOMER) THUMBPRINT DATE: NAME OF INTERPRETER: ‘ADDRESS OF INTERPRETER: TEL: No. LANGUAGE OF INTERPRETATION: FOR BANK USE ONLY Savings Account LE = Duly completed account opening form Z | Specimen sgntre ard dly completed 3, [Reser passport photograph 4: | SaisleigstanVears Car ong na bec 5. | Resident Permit (for non-Nigerin) | Proof of Adress Uy ils, er (Cartd we copy nace orga wot el 17, | Leer trom Employer School) NYSC ferry enue nor SetonFixed /Current/Domiclary/Fixed Investment/Other types of account n= cco 1. | Duly completed account opening form 2. | specimen srature car duly completed 3. |_Twe @) recane passport photographs 1. | Te (independ and satefactory references Proof of Address: Uli lls et cad ns copys epee Forgral zat fale 7, | Later from employer orale acto «, | Residen pari formar Nigerian) 9. | other document Provided 2. AUTHENTICATION FOR. FINANCIAL INCLUSION i Is the customer socially/financally disadvantaged? Yes] no[_] ii, If answer to (I)above is yes, state other documents obtained in line with the bank's policy ‘on socially financially disadvantaged customer in compliance with Regulation 77 (4) of AML/CFT Regulation 2013 ii) Does the Customer enjoy KYC requirements? ves] no[_] iv If answer to question (iii) above is yes, identify the customer risk category: Low Risk [—] Medium Risk [] High Risk [] RL aed Is the Applicant Politically Exposed Person? YES [—] No[_] For Bank Use Only Spatce: Name Snare: Siqnaure = Emenee Sener SignatureName Name CCOMMENT(S/Adess description and result finding) PR Name Name Go hha | consent to the Bank making enquiries about my credit record(s) with any credit reference agency and anyother party to confirm any oral the information provided by me. |/We conti that I/We will only issue cheques on my (our account where there ae suficent Funds in my (our) account to cove the Face Value of such cheques on presentation | hereby confirm the information provided above is true, accurate and complete. Subject to applicable local laws, | hereby consent and authorize for Stanic IBTC Bark Pe or any of is afilates (including branches) to share my information with domestic and overseas tax ‘authorities where necessary to establish my tax lblity in any jurisdiction. Where required by domestic or oversea regulators or tax authorities, | consent and agree that the Bank may withhold from my account(s) such amounts as may be required according to Spalcable laws, regulations and directives | understand to notify the bark within 30 calendar days if there isa change in any information which | have provided tothe bank. | consent to you carrying out identity and fraud prevention checks ané sharing information relating to this aplication through the Fraud Prevention Service | further confirm that! will not move my salary account whist lam subscribed to any loan facity withthe bark Unreby apply forthe opening of acount) with, Bank Pe. | understand thatthe information given herein ané the documents supaied ae basis for opening sch accounts) and therefore warran that such information is correct [further undertake to indemnify the Bank fr any las suffered a2 resuk of any fle information or err inthe infermtion provided to the bank l. name Signature Date 2. ame Signature DateSete ies eats lee amor me mere emo Fos oe eat recur aad soar See cae ee nmemen see ‘here moma noe er se be ep w ee tear we ctmamemse ert net eaeeen erent ieccemietennes Ses Oe a Bee ee eee ‘thas chermstedh teats meena rbot eemicaate tne rnet crt nt rei bo — See a aiea eens rns rete ane oc ‘hee telophase certs Seek rater pede shins ocean tsa Ero cree aermeteeraneer metre horace rpc gat moan mete es ese mt Ringnautnce sess tehuhoctj sean 1. Patan nae th ye ac) a at king rans ome mes ‘Zeemcepieedtystrtncondteeruchageenetycoonrybakey ie 2 Tattiasyecebsteenh aaoctsbientwst teenie 4 Tce bm enmeshed nes ‘Tonite tye prt non an ord th IM Siam en dey rons Seder TianotetongeuRiefen/rencoatetuh soe sayopaae ‘irae natn con uy td ry a ogee at icyaaiae statement ay onercrtens(Please tick as appropriate) Category of Account Joint Account [“}Fxed investment Account. [[] OtherTypes of Account [] ‘Account Type Cuest Account [] Faxed DepositAccount [] savings Account [] Demian Acount Account Name Account No, (foro cial use only) Mandate authorisation/Combination rule (Please tick as appropriate}Soe Signatory [] either to sign] Both to sign C] Signatories: 1. Name (Please tickas appropriate) Category of Account Joint Account [}Fxed investment Account [] other Types of Account ] Account Type: ‘current Account [7] Fixed Deposit Account] Savings Account] domician Account b, Account Name Account No. (foro cal use only) 4, Mandate authorisation/Combination rule (Please tick as appropriate}Sole Signatory [] Either to Sign[_] Both to Sign ] Signatories: other Name eS PHOTO lee cation Tipe: leeRe enc Account rumberL_| | | | | | | | 1 Branch The above named person/ company has expressed interest in opening an account with us and has glven your name asa referee We shouldbe grateful you would confi, in confidence, thatthe applicant f known to ou and i 3 peson/ company to whom the usual banking facilis may be extended. In replying, kindly complete the form belo, ging the name and addtess ofthe Bank wth which you ‘maintain a current account, and return to StanbielBTC Bank PLC at the address below. Please nae that most banks wll nly give the equired Fesponse where you have maintained an account with them fora least six months. We would also recommend that you only issue a reference in respect ofa person who i wel know 10 you, Ee Cae tocar tha Ue sve ret ned pen] Sopra bon tet Us fons hare | Address | | | A/C Town | conty | Telephone | eee | Signature Date @O/MM/YY) | Coane ie chebubser bene) ion Address | | LcA/Ciy/Town | county | Telephone | Perec | AccountrumberL_|_| | | | | | | 1 [And hereby authorize you to request 2 reference from my bank Signature Date @O/MM/YY) Coed"ACCOUNT OPENING REFERENCE Account rumber|_| | | | | | | | | Branch Re The above named person/ company has expressed interest n opening an account with us and has given your name asa referee We shouldbe grateful if you would confirm, in confidence, that the applicant is know to you and isa person/company to whom the usual banking facities may be extended. In replying, kindly complete the frm below, giving the name and address of the Bank with which you maintain a current account, and return to StanbielBTC Bank PLC atthe adéress below. Please note that most banks wl nly give the required response where you have maintained an account with them fora least ix months, We would alo recommend that you ony issue @ reference in respect of person whois wel know t you. EFENENCE INFORMATION \/We wish o conti that the above mentioned person/company has been kno to me/us for years Name ess LeA/cy/Town | Country Telephone | Mobile number Signature Date (00 /MM/v"D [BARKER'S INFORMATION (NAME AND ADDRESS OF REFEREE'S BANKER) i Address LsA/y/Town J country Teleohone | Moe number rccouncrumder| | | | | | | 1 1 | ‘And hereby authorize you to request a reference from my bank Signature Date (D0/MM/Y) Cticsiaeus