ACCOUNT OPENING FORM DD MM YYYY

I/we request the opening of the following accounts (Please tick the appropriate)

Current Savings Investment Corporate Fixed

Account Deposit

Foreign Currency (State Currency)…………. Foreign Exchange (State Currency)………......

FIRST APPLICANT DETAILS

Title Mr. Mrs. Miss. Other (Please Specify)

Surname………………………………………….. First Name…………………………………………..

Other Names……………………………………. Maiden Name……………………………………..
Date of Birth……………………………………… Place of Birth……………………………………….
Nationality………………………………………… Country of Residence…………………………..

Marital Status: Married Single Divorced Separated Widowed

Beneficiary Name:……………………………………………………………………………………………………………................
Postal Address:………………………………………………………………………………………………………………………………..
Residential Address:…………………………………………………………………………………………………………………………
Telephone(Fixed Line):…………………………………………… Mobile Line:…………………………………………………..
E-mail Address:…………………………………………………………………………

IDENTIFICATION DOCUMENT (PLEASE TICK)

International Passport Driving License Authorization ID Voter ID National ID

ID No:………………………… Date of Issurance:………………………… Date of Expiration:…………………………

CONFIRMATION OF RESIDENTIAL ADDRESS

Tenancy Agreement Utility Bill Income Tax Certificate:

Other Banks Statement Reference Letter Employers Reference

Location:……………………………………………………………. House:………………………………………………………..
District:……………………………………………………………… Religion:…………………………………………………….

EMPLOYMENT DETAILS
Occupation:…………………………………………………………… Position Held:………………………………………………………
Employer:……………………………………………………………..........................................................................................
Address of Employer:…………………………………………………………………………………………………………………………………
Telephone No:……………………………………………………………. Mobile Line:………………………………………………………
Fax No:………………………………………………………………………. E-mail Address:………………………………………………….

Relationship with Other Bank(s) Yes No Bank Branch:……………………………………………………..

APPLICANT SIGNATURE:…………………………………………………………./RIGHT-LEFT HAND THUMB PRINTS