Pakam Technology Limited

RC1796077
374 Ikorodu Road,
Maryland, Lagos, Nigeria
Telephone: 09122616778
www.pakam.ng
PRIVATE AND CONFIDENTIAL passport

GUARANTOR’S FORM

As part of our employment process, we normally and compulsorily require that a person seeking employment
in our Company should produce a credible, responsible and acceptable person as guarantor subject to
confirmation. If you are willing to stand as guarantor for the said Applicant, kindly fill out this form. Please
note that it is dangerous to stand as guarantor for someone whom you do not know.

PARTICULARS OF GUARANTOR

NAME: …………………………………………………………………………………………………

PROFESSION/OCCUPATION:
………………………………………………………………………………

POSITION:
…………………………………………………………………………………………………………..

BUSINESS/OFFICE ADDRESS:
………………………………………………………………………………………………….
(Please fill nearest bus stop)

TELEPHONE: ………………………………………………

EMAIL ADDRESS: …………………………………………………

RESIDENTIAL ADDRESS:
………………………………………………………………………………………………………
(Please fill nearest bus stop)

TELEPHONE NO.:
……………………………………………………………………………………………………………..

RELATIONSHIP TO APPLICANT:
………………………………………………………………………………………..
(If not related, state any other connection)
 Pakam Technology Limited
RC1796077
374 Ikorodu Road,
Maryland, Lagos, Nigeria
Telephone: 09122616778
www.pakam.ng
PRIVATE AND CONFIDENTIAL

DECLARATION

I,…………………………………………………………………………………………………………………
……………………… (Full Name), A ……………………………………… (Nationality) of
…………………………………………………………………………………… (Home Address) do hereby
solemnly and sincerely declare as follows:

1. That……………………………………………………………………………………………………
……………… (Name of Applicant) is proposing with my full knowledge and consent, to take up
employment with PAKAM.
2. That the particulars are given above and in the Reference Check Form are correct.
3. That I will be responsible for any financial loss suffered by PAKAM (or any other Firm where he/she
is seconded) arising from any malpractice or negligence committed by the Applicant in the course of
his/her employment with the Company (or any other Firm where he/she is seconded).
4. In the event of any pecuniary loss committed by the Applicant in the course of employment, I
voluntarily accept to take responsibility for all charges and expenses incurred in the process of recovery
of such loss and/or Litigation if any.
5. That I hold myself responsible for producing the Applicant as and when necessary, in the event that
he/she absconds from his/her employment with a view to avoiding criminal prosecution of
indemnifying the company (or any other Firm where he/she is seconded) or any malpractice allegedly
committed by him/her.
6. That I will indemnify the Company (or any other Firm where he/she is seconded) for all financial
losses arising from any malpractice and negligence committed by the Applicant in the course of his/her
employment with the Company.
7. That in the event of any pecuniary loss committed by the Applicant in the course of employment, I
voluntarily accept to take responsibility for all charges and expenses incurred in the process of recovery
of such loss and/or litigation (if any)

LEVEL OF GUARANTORS ACCEPTABLE

I. Senior Civil Servant.

II. C.E.Os, Business Man/Woman with an identified Registered Company/Business with the Corporate
Affairs Commission.
III. Practicing Professionals.
IV. Traditional Rulers and/or reputable Clergymen.
V. Equivalent of senior Banking Officer in Banks and Deputy Manager of a reputable company.

Dated this………………day of ………………………………………., 20……………

Name & Signature…………………………………………………………