Account Opening Form

(Individual)

Checklist (Bank use only)

Checked

Checked
Deferred

Deferred
Waived

Waived
N/A

N/A

1. Duly completed Account Opening Form 5. Resident Permit (non-Nigerian)

2. Specimen signature card duly completed 6. Proof of Address (original or true certified copy acceptable)

3. Two (2) recent passport-sized photographs 7. Letter from employment/School/NYSC (for salary and students’ account only)

4. Proof of identity (original must be sighted) 8. Two (2) independent and satisfactory references (current account only)
ACCOUNT OPENING FORM - INDIVIDUAL
This form should be completed in CAPITAL LETTERS. Characters and marks should be similar in style to the following

Category of Account: (Tick as appropriate)

Individual Joint Name of Account

Savings Current Fixed Deposit Domiciliary Account

Others

Branch

Bank Verification Number(BVN)

1 Personal Information
Title Surname
(Mr, Mrs, Dr, Chief )

First Name Other Names

Mother’s
maiden name Date of Birth D D M M Y Y Y Y

Place of Birth Gender: F M

Nationality State of Origin

Local Govt Home Town

Area

Martital Status: Single Married Others

Tax ID. Religion

No (TIN)
country code country code

Phone No 1 + Phone No 2 +

Email
Address
Residential N O S T R E E T N A M E
Address
N E A R E S T B U S S T O P

C I T Y L O C A L G O V T A R E A

S T A T E

Resident Permit Issue Permit Expiry

D D M M Y Y Y Y D D M M Y Y Y Y
Permit no Date Date

Means of National ID Card Driver’s Licence International Passport INEC Vote’s Card Others
Identity

ID Number ID Expiry Date D D M M Y Y Y Y

Purpose of
Account

Social media
Handles

2 Details of Next of Kin

Title Surname
(Mr, Mrs, Dr, Chief )

First Name Other Names

Date of Birth D D M M Y Y Y Y Gender F M Relationship

E-mail
address
country code

Phone No +
Residential Address N O S T R E E T N A M E

N E A R E S T B U S S T O P C I T Y

L O C A L G O V T A R E A S T A T E

3 Employment Details
Employment Status: Employed Self Employed Retired Student Others

Date of Employment D D M M Y Y Y Y
(Optional)

Annual Salary/Expected Annual Income:

(a) Below N500,000 (b) > N500,000 - 2M (c) > N2M - N5M (d) > N5M - N10M
(e) > N10M - N20M (f) > N20M - 50M (g) > N50M

Employer’s
Name

Employer’s/ S T R E E T N O S T R E E T N A M E
Employment
Address: N E A R E S T B U S S T O P C I T Y

L O C A L G O V T A R E A S T A T E

Nature of Business
or Occupation country code country code

Phone No 1 + Phone No 2 +

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

II. Sources
of Fund to 1.

the Account
2.

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

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 document and acknowledge that it has been truly and audibly read over and explained
to me by an interpreter.
Mark of Magistrate/Commissioner
Customer/ for Oaths
Thumbprint

Date D D M M Y Y Y Y

Name of
interpreter
Address of
interpreter
country code
Language of
interpretation Phone No +

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

 7 MANDATE

Name of Account

Account Number

Name of Signatory
country code

Phone No +
Specimen Signature

Name of Signatory 2
country code

Phone No +
Specimen Signature

N 0 0

(Joint applicant)

8 DECLARATION
I/We hereby apply for the opening of account(s) with Globus Bank Limited. 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.

By signing this document you have agreed to the general, electronic banking and general data protection regulation (GDPR) terms and conditions for account opening
contained on our website. www.globusbank.com

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

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

9 For Bank Use only

A. To be filled by sales/branch staff

Staff Name Staff ID

Branch Manager’s Name Branch Manager’s Signature

RM/GH Name RM/GH Signature

Address Verification Yes No

B. To be filled by branch
Currency Account Number

Branch Code ISIC Code (4 digit)

Team Code ISIC Code (6 digit)
Product Code

C. To be filled by Compliance
Risk Profile: Low Medium High Risk Justification

Name Sign & Date