Account Opening Form Corporate Document Account Opening Form - Corporate CORPORATE ACCOUNT OPENING FORM Category of Business Limited Liability CompanyPartnershipSole ProprietorshipSchoolsMDAsOthers Type of Account SG RegularSG PriorityInvestment 1. COMPANY DETAILS Company/Business Name Date of Registration Incorporation/Registration No Country of Incorporation Type/ Nature of Business Operating Business Address 1 Operating Business Address 2 Business Address/Registered Office (if different from above) Landmark Nearest Bus-stop Company E-mail Address Website (if any) Mobile Number Tax Identification Number (TIN) Official Number Special Control Unit against Money Laundry (SCUML) Reg No Purpose of Account 2. ANNUALTURNOVER Annual Turnover Less than N50 MillionN50 Million- Less than N500 MillionN500 Million- Less than N5 BillionAbove N5 Billion Ultimate Beneficiary Owner and their Shareholding Structure 1. 2. 3. Source of Fund: 3. ACCOUNT SERVICE(S) REQUIRED (Please tick option below) Electronic Banking Preference: Internet BankingMobile Banking Username (specify): 1. DETAILS OF THE DIRECTORS/SHAREHOLDERS/EXECUTIVES/ADMINISTRATORS/PRINCIPAL OFFICERS Title: Surname: First Name: Middle Name: Date of Birth: Sex: MaleFemale Nationality: Marital Status: SingleMarried Other (Please specify): Means of Identification: Driver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 2. DETAILS OF THE DIRECTORS/SHAREHOLDERS/EXECUTIVES/ADMINISTRATORS/PRINCIPAL OFFICERS Title: Surname: First Name: Middle Name: Date of Birth: Sex: MaleFemale Nationality: Marital Status: SingleMarried Other (Please specify): Means of Identification: Driver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 3. DETAILS OF THE DIRECTORS/SHAREHOLDERS/EXECUTIVES/ADMINISTRATORS/PRINCIPAL OFFICERS Title: Surname: First Name: Middle Name: Date of Birth: Sex: optionalMaleFemale Nationality: Marital Status: optionalSingleMarried Other (Please specify): Means of Identification: optionalDriver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 4. DETAILS OF THE DIRECTORS/SHAREHOLDERS/EXECUTIVES/ADMINISTRATORS/PRINCIPAL OFFICERS Title: Surname: First Name: Middle Name: Date of Birth: Sex: optionalMaleFemale Nationality: Marital Status: optionalSingleMarried Other (Please specify): Means of Identification: optionalDriver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 1. SIGNATORY’S DETAILS Title: Surname: First Name: Middle Name: Date of Birth: Sex: MaleFemale Nationality: Marital Status: SingleMarried Other (Please specify): Means of Identification: Driver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 2. SIGNATORY’S DETAILS Title: Surname: First Name: Middle Name: Date of Birth: Sex: MaleFemale Nationality: Marital Status: SingleMarried Other (Please specify): Means of Identification: Driver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 3. SIGNATORY’S DETAILS Title: Surname: First Name: Middle Name: Date of Birth: Sex: optionalMaleFemale Nationality: Marital Status: optionalSingleMarried Other (Please specify): Means of Identification: optionalDriver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date: 4. SIGNATORY’S DETAILS Title: Surname: First Name: Middle Name: Date of Birth: Sex: optionalMaleFemale Nationality: Marital Status: optionalSingleMarried Other (Please specify): Means of Identification: optionalDriver’s LicenseVoter’s CardInternational PassportNational ID ID Number: ID Issue Date: ID Expiry Date: BVN: Social Media: Status/Job Title: Occupation: Position/Office: Residential Address House Number: Street Name: City/Town: L.G.A: State: Landmark/Nearest Bus-stop: Mobile Number: Official Number: E-mail Address: Class of Signatory: Upload your ignature (Max size: 2MB, Formats: jpeg, png, jpg): Signature: Date:
