Account Opening Form Individual form Account Opening Form - Individual Account Opening Form - Individual a. Category of Account (Tick as appropriate) IndividualJoint b. Bank Verification (BVN) c. National Identification Number (NIN) 1. Personal Information Title Surname First Name Middle Name Marital Status SingleMarriedOthers Sex MaleFemale Date of Birth Social Media Mother’s Maiden Name State of Origin Select a stateAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfaraFederal Capital Territory (FCT) L.G.A Nationality (For non-Nigerian) Resident Permit No. Upload a Valid identification (Max size: 2MB, Formats: jpeg, png, jpg, gif): Upload your picture (Max size: 2MB, Formats: jpeg, png, jpg, gif): Signature Upload (Max size: 2MB, Formats: jpeg, png, jpg, gif): ID Issue Date ID Expiry Date Do you have dual citizenship? YesNo If yes, please specify If US citizen/resident, please provide Social Security No. Purpose of Account 2. Contact Details House Number Street Name Landmark/Nearest Bus-stop City/Town L.G.A Upload Utility Bill (Max size: 2MB, Formats: jpeg, png, jpg, gif): State Select a stateAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfaraFederal Capital Territory (FCT) E-mail Address Mobile No. (1) Mobile No. (2) 3. ACCOUNT SERVICE(S)REQUIRED(please tick option below) Electronic Banking Preference Internet Banking Mobile Banking Username (specify) 4. EMPLOYMENT DETAILS Employment Status EmployedSelf EmployedUnemployedStudentRetiredOthers Others (please specify) Annual Salary/Expected Annual Income ₦ 0 - ₦ 50,000₦ 51,000 - ₦ 250,000₦ 251,000 - ₦ 500,000₦ 501,000-Less than ₦ 1,000,000₦ 1million-Less than ₦ 5million₦ 5million- Less-than ₦ 10million₦ 10million-Less than ₦ 20millionAbove ₦ 20million Employer's Name Date of Employment (if employed) Name of Business/Occupation Employer's Address: Number Street Name City/Town Nearest Bus-stop State Select a stateAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfaraFederal Capital Territory (FCT) L.G.A Official Number Mobile Number 5. DETAILS OF NEXT OF KIN Title Surname First Name Middle Name Relationship Gender MaleFemale Date of Birth Mobile Number E-mail Address Contact Details House Number Street Name Landmark City/Town State Select a stateAbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfaraFederal Capital Territory (FCT) L.G.A
