Account Opening Form

ACCOUNT OPENING FORM

Personal Details

Full Name*

Email*

Residential Address*

Country of Origin

State of Origin

Mother's Maiden Name

Phone Number

Date of Birth

Next of Kin

Name of Next of Kin*

Next of Kin CHN (CSCS No.)

Relationship with Next of Kin*

Phone Number

Address*

Business Information

Occupation / Nature of Business*

Registration No. (RC Number)

Date of Incorporation

Office Address

CHN (CSCS) No.

Country of Incorporation

Bank Information

Banker*

Branch

Account No.*

BVN*

Date account was opened

Sort Code

Declaration & Uploads

Scanned Signature*

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Passport Photo*

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Utility Bill*

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Valid ID Card*

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I declare that I, a citizen of the aforementioned country is (are) a prospective shareholder(s) in securities quoted on the Nigerian Stock Exchange and I (we) hereby FREELY state that being aware of my (our) right to be issued with shares certificate(s) under sections 146 and 147 of the companies and Allied matters Act of 1999 and the Memoranda and Articles of Association of the listed companies for my (our) sole benefit and private purposes, do hereby waive the said right and also DECLARE that I (we) shall accept as sufficient certification of my (our) shareholding any memorandum to that effect delivered to me (us) by the said listed company/companies or the CENTRAL SECURITIES CLEARING SYSTEM PLC acting on behalf of same as satisfaction of my said right under the section and memoranda and articles of association aforementioned.*

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