CUSTOMER REGISTRATION FORM - INDIVIDUAL

1. First Name:

2. Middle Name:

3. Surname:

4. Email Address:

5. Phone number:

6. Home Address:

7. Country of Residence:

8. BVN Number:

9. Date of Birth:

10. Nationality:

11. Employment Type:

12. Occupation:

13. Employer Name (if applicable):

14. Means of ID Number:

15. Monthly income (Tick):

● Less than N100,000.00

● Between N100,000.00 and N300,000.00
● Between N300,000.00 and N500,000.00
● Between N500,000.00 and N800,000.00
● Between N800,000.00 and N1,000,000.00
● Above N1,000,000.00

16. Consent to have direct debit mandate set up with your bank in favour of
Arnergy Solar Ltd for monthly payment with an acknowledgement copy submitted to
Arnergy(tick):
Yes No
17. Documents required in addition with this registration form

● Six (6) months bank statement with consistent credit balance at month end
● Copy of Valid ID card: International passport, Driver’s license, National ID card
or Permanent Voter card.
● Utility bill no more than 3 months old
● Signed Arnergy Solar Ltd contract
● Customer bank acknowledged copy of direct debit mandate form in favour of
Arnergy Solar Ltd

Note:
By signing this form, you consent to

● Making the caution fee payment and the 1st month's payment under your lease
to own contract.
● Providing the documentation listed in section 9 of this registration form.

Please be advised that installation will not commence until these documents have
been duly provided and a credit check on your profile has been passed.

SIGNATURE