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Online Offshore Basic Application Form

Designated Client Account.
Please fill in the form using BLOCK CAPITALS and Tick any boxes which apply.

1. Business Details:

Business Name/Company Name:

Business/Company Address:
Line: 1

Line: 2

Post Code:

2. Account Types:Tick the one that you apply for.

1. PERSONAL ACCOUNT: With Initial Deposit of $975.00
2. CORPORATE ACCOUNT:With Initial Deposit of $1,725.00
3.3.Designated Individual With
TRANSIT ACCOUNT: Details:
Initial Deposit of $2,535.00

3. Designated Individual Details.

Santander
Title: Mark the category you below to.
Bank
Original
Mr Mrs Ms Miss
Customers
First Name: Online
Basic
Middle Name: Application
Form.
Last Name:

Marital Status:

Next Of Kin:

E-Mail:

Fax Number if any:

Phone Number:

Date of Birth: D D M M Y Y Y Y

Home Address:

Post Code:

Nationality:

Second Nationality (If dual nationality)

Country of residence:

Date: Signature:
I Mr/Mrs/Ms/Miss..............................................……………………Hereby declare that every detail I have provided here are my original/legit
detail and should be used as my personal detail. Note: that every detail you have provided here would be recorded in our data base as your
personal details.