Professional Documents
Culture Documents
Account No.:
(For official use only)
* Kindly initial at the bottom of each page as well as beside any alterations or additions. Also note that all our
client transactions are subject to the Rules and Regulations of the Securities and Exchange Commission, the
Nigerian Stock Exchange, the Anti-Money Laundering Act of the Federal Republic of Nigeria and other applicable
laws and regulations.
CLIENT NAME
New Name
Please provide copy of evidence of change of name (original to be presented for sighting)
B. Change of Nationality
New Nationality
Please provide copy of international passport and any other supporting evidence (original to be
presented for sighting)
Please provide copy of utility bill (not more than 3 months old) for new address (original to be
presented for sighting)
B. Email Address
C. Telephone Number
Address
Affix Company
Seal
RELATIONSHIP MANAGER:
_________________________________________________________________________________