REFERENCE FORM

From (Referee) Date______________________

Name ____________________________ CAUTION
IT IS DANGEROUS TO INTRODUCE ANY
PERSON NOT WELL KNOWN TO YOU
Address ____________________________

To: ECOBANK
Branch ____________________________

Dear Sirs,

NAME OF APPLICANT (NEW CUSTOMER)

The above named Company/Person wishes to open a current account with you. The Company/Person is well known to
me/us and I/We consider him/her/them suitable to maintain a current account with you.

Our/My Bankers are

___________________________________________ ___________________________________________
Name of Bank Branch

___________________________________________ ___________________________________________
Account No. Signature(s) of Referee

(To be completed by bank official)

FROM: ECOBANK

To: (Referee’s Bank)

_____________________________________

_____________________________________

Please verify the signature(s) of your customer as indicated above __________________________

Signature of Ecobank’s
Authorized Signatory

(To be completed by bank official)

From: (Referee’s Bank)

TO: ECOBANK
We hereby verify and confirm our customer’s signature(s) appearing hereon as correct/as irregular (indicate as
necessary).

____________________________ ______________________ ___________________________

Referee’s official stamp Name Signature of Authorized Signatory