INDIVIDUAL ACCOUNT OPENING FORM

This form should be completed in CAPITAL LETTERS. Characters and marks should be similar in style to the following ( A B C )
Zenith Bank Plc.
Category of Account: (Tick as appropriate) RC : 150224

Individual Joint Gold Platinum Timeless

Savings Current Fixed Deposit Domiciliary Account

Branch

Account No (for official use only)

Bank Verification Number (BVN)

1. PERSONAL INFORMATION

Title Surname

First Nam e

Other
Names
Mother’s
maiden
name
D D M M Y Y Y Y
Date of Gender Place of
Birth F M Birth
State of Marital Single Married Others
Origin Status

Local G ovt.
Home Town
Area
Tax ID. No. - Religion
(TIN) (optional)

Phone Phone
Number1 Number2

Email
Address

Residential
Address

City/
State L.G.A
Town

D D M M Y Y Y Y Permit D D M M Y Y Y Y
Residence Permit
Permit no Issue Date Expiry
Date
Means of
National ID Card Driver’s License International Passport INEC Voter ’s Card *Others (Please specify)
Identity

ID Number

D D M M Y Y Y Y D D M M Y Y Y Y
ID Issue ID Expiry
Date Date

Purpose
of account

2. DETAILS OF NEXT OF KIN

Surname First Name

Other Title
Names (Mr, Mrs, Dr, Chief, etc)

D D M M Y Y Y Y
Date of Relationship
Gender F M
Birth
Phone Number1 Phone Number 2

E-mail address

House Number Street City/

Name Town
State L.G.A
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3. EMPLOYMENT DETAILS
Employment Status: Employed Self Employed Retired Student Others
(Please specify)
D D M M Y Y Y Y
Date of Employment (Optional)
Annual Salary/Expected Annual Income:
(a) Below N50,000 (b) N50,000 - N250,000 (c) N250,001 - N500,000 (d) N500,001 - Below 1M
(e) N1M - Below N5M (f) N5M - Below N10M (g) N10M - Below N20M (h) N20M and Above
Employer’s
Name
Employer’s / Employment Address:
House Number Street City/
Name Town
State L.G.A

Nature of Business
or Occupation

Office Phone No Office Phone No 2

4. ADDITIONAL DETAILS

I. Name(s) of
Beneficial
owner(s) (if any):

II. Sources 1.
of Fund to
the Account 2.

III. Other 1.
Sources of
Income (if 2.
any)

5. JURAT (THIS SHOULD BE ADOPTED WHERE APPLICANT IS BLIND OR NOT LITERATE , AND FORM IS READ TO HIM BY A 3RD PARTY
I agree to abide by the content of this agreement and acknowledge that it has been truly and audibly read over and explained to me by an interpreter.

Mark of customer/
Magistrate/Commisioner for Oaths
Thumbprint

D D M M Y Y Y Y
Date

Name of interpreter

Address of interpreter

Language of interpretation Telephone number

6. ACCOUNT SERVICE(S) REQUIRED ( PLEASE TICK APPLICABLE OPTION BELOW)

Debit Card Preference(s) (Fees apply) : MasterCard Verve Visa Others
(Please specify)

Internet Banking Preference(s) : Internet banking Internet Banking Hardware token Software token
(Enquiries only)
(Funds Transfer with hardware token required at a fee)

Mobile Banking Mobile Banking App Cheque Book No of Leaves: 20 Cost of Cheque book is N525

Transaction Alert Preference(s) : E -mail Alert (Free) SMS Alert

(Fee applies)
Mobile Number for SMS Alert
*where a customer opts not to receive SMS Alert, the customer should issue an indemnity
Statement Delivery Preferences Online (for losses that may arise as a result) to the bank.
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7. MANDATE

NAME OF ACCOUNT
Affix
Passport
Photograph
here

ACCOUNT NUMBER

NAME OF SIGNATORY ……….………….………………… NAME OF SIGNATORY ……….………….…………………

SPECIMEN SIGNATURE SPECIMEN SIGNATURE

Mobile Phone No: Mobile Phone No:

PLEASE TICK AS APPROPRIATE SOLE SIGNATORY BOTH TO SIGN EITHER TO SIGN OTHERS

MANDATE

CHEQUE CONFIRMATION REQUIRED ? YES NO

If YES, please specify minimum amount to be confirmed

N : 0 0
Please note that the minimum cheque confirmation amount allowed by the bank is N500,000.00 in writing and before cheque presentation.

Mandate specified by Account holder(s)

Signature Signature

8. DECLARATION:

I/We hereby apply for the opening of account (s) with Zenith Bank PLC. I/We understand that the information given herein and the documents supplied
are the basis for opening such account (s) and I/We therefore warrant that such information is correct.

I/We further undertake to indemnify the Bank for any loss suffered as a result of any false information or error in the information provided to the Bank.

1. Name……………………………………………………………………………………………………...Signature………………………………...Date………………

2. Name………………………………………………………………………………………………………Signature………………………………..Date………………

3
 The Manager, ……………..…..20.….....

ZENITH BANK PLC

Dear Sir,

PROSPECTIVE ACCOUNT NAME

I/We understand that the above-named person has applied to open a Current Account with you.
I/We have known the above named person for ………………(period) and I/We comment on his/
her means and reputation as follows:

I/We also confirm that the applicant is a person to whom the usual banking facilities
may be extended.

I/We maintain current account(s) with:

NAME OF BANK/BRANCH BANKER’S ADDRESS ACCOUNT NUMBER

The above information is provided in confidence.

Yours faithfully,

REFEREE’S ACCOUNT NAME

REFEREE’S ADDRESS

REFEREE’S PHONE NUMBER

....................................................................................
Authorised Signatory Authorised Signatory

The Manager, ……………..…..20.….....

ZENITH BANK PLC

Dear Sir,

PROSPECTIVE ACCOUNT NAME

I/We understand that the above-named person has applied to open a Current Account with you.
I/We have known the above named person for ………………(period) and I/We comment on his/
her means and reputation as follows:

I/We also confirm that the applicant is a person to whom the usual banking facilities
may be extended.

I/We maintain current account(s) with:

NAME OF BANK/BRANCH BANKER’S ADDRESS ACCOUNT NUMBER

The above information is provided in confidence.

Yours faithfully,

REFEREE’S ACCOUNT NAME

REFEREE’S ADDRESS

REFEREE’S PHONE NUMBER

Authorised Signatory Authorised Signatory