Type of Account Company Details Account Services Signatory Details Account Mandate Indemnity/Declaration Welcome to Our Corporate Account Opening Section. Kindly fill the form appropriately to enable us commence your account opening procedures. Please ensure that all information supplied are accurate and current Category of Business * Partnership Sole Proprietorship MDA's School Church Others Kindly tick as appropiate Account Type * Corporate Current Account Fixed Deposit Account Kindly tick as appropiate NEXT COMPANY DETAILS Company/Business Name * Certificate of Incorporation/Registration Number * Date of Incorporation/Registration Country of Incorporation/Registration Nature of Business * Sector/Industry Operating Address * Email Address * Phone Number 1 * Registered Address (If different from Operating Address) Website Url Phone Number 2 Tax Identification Number PROCEED Annual Turnover * Less than N50M N50M - Less than N500M 500M - Less than 5 Billion 5 Billion and above Is your company listed in the Stock Exchange? Yes No What Stock Exchange and Symbol ACCOUNT SERVICES Card Preference Verve Card Master Card Visa Card Others Electronic Banking Preference Internet Banking Mobile Banking ATM POS Other Electronic Channels Transaction Alert Preference Email Alert (free) SMS Alert (fee Apllies) Cheque Book Requisition (Fee Applies) Open Cheque Crossed Cheque 50 Leaves 100 Leaves Cheque Confirmation:would you like to pre-confirm your cheques? Yes No Check confirmation threshold, if yes please specify the threshold PROCEED ACCOUNT SIGNATORY/DIRECTOR 1 Title * Other Names * First Name * Surname * Mother's Maiden Name * Date of Birth * Nationality * Gender * Male Female Country of Birth 2nd Nationality Means of Identification * ID Number * ID Issue Date * ID Expiry Date * BVN Number * Occupation * Status/Job Title Designation Residential Address * Please include Street, Nearest Bus Stop/Landmark, Local Government Area, City/Town and State Phone Number 1 * Phone Number 2 Email Address ACCOUNT SIGNATORY/DIRECTOR 2 Title Other Names First Name Surname Mother's Maiden Name Date of Birth Nationality Gender Male Female Country of Birth 2nd Nationality Means of Identification ID Number ID Issue Date ID Expiry Date BVN Number Occupation Status/Job Title Occupation Status/Job Title Designation Residential Address Please include Street, Nearest Bus Stop/Landmark, Local Government Area, City/Town and State Phone Number 1 Phone Number 2 Email Address ACCOUNT SIGNATORY/DIRECTOR 3 Title Other Names First Name Surname Mother's Maiden Name Date Of Birth Nationality Gender Male Female Country of Birth 2nd Nationality Means of Identification ID Number ID Issue Date ID Expiry Date BVN Number Occupation Status/Job Title Occupation Status/Job Title Designation Residential Address Please include Street, Nearest Bus Stop/Landmark, Local Government Area, City/Town and State Phone Number 1 Phone Number 2 Email Address PROCEED ACCOUNT MANDATE 1 Category of Business * Partnership Sole Proprietorship MDA's School Church Others Kindly tick as appropiate Account Type * Corporate Current Account Fixed Deposit Account Kindly tick as appropiate BVN Number * Mandate Authorisation Sole Signatory Either to Sign Both to Sign First Name * Other Names * Identification Type * Telephone Number Surname * Class of Signatory Identification No * Date * Recent Passport Photograph * Browse Upload your recent passport photograph ACCOUNT MANDATE 2 Category of Business Partnership Sole Proprietorship MDA's School Church Others Kindly tick as appropiate Account Type Corporate Current Account Fixed Deposit Account Kindly tick as appropiate BVN Number Mandate Authorisation Sole Signatory Either to Sign Both to Sign First Name Other Names Identification Type Telephone Number Surname Class of Signatory Identification No Date * Recent Passport Photograph Browse Upload your recent passport photograph ACCOUNT MANDATE 3 Category of Business Partnership Sole Proprietorship MDA's School Church Others Kindly tick as appropiate Account Type Corporate Current Account Fixed Deposit Account Kindly tick as appropiate BVN Number Mandate Authorisation Sole Signatory Either to Sign Both to Sign First Name Other Names Identification Type Telephone Number Surname Class of Signatory Identification No Date * Recent Passport Photograph Browse Upload your recent passport photograph Mandate Authorisation Sole Signatory Either to Sign Both to Sign PROCEED Date Authorisation/Indeminity for Email Messages Jubilee Life Mortgage Bank Plc with registered office at Plot 73 Adeola Hopewell, Victoria Island Lagos (hereinafter called "The Bank"), is hereby authorised to honour instruction for payment in relations to our account Account Name with the bank coming from Email Address being the email address bearing or purporting to bear our Account Name 2. The said email instruction will be preceded by the code/password Password 3. and are hereby authorised by the Company to send email instructions to the Bank 4. We undertake to forward the original copy of any given email instruction made in accordance with the account mandate to the bank on or before number of days days from the date of such instruction 5. We understand that emails are an insecure transmission medium and are subject to call back procedures and hereby indemnify you against any loss, liability or damage as well as cost, charges and expenses which may suffer or incur however arising by reason of your honouring such items be it erroneous, fraudulent or otherwise drawn as aforesaid. Date DECLARATION I/We hereby apply for the opening of account(s) with Jubilee Life Mortgage Bank Plc. I/We understand that the information given herein and the documents supplied are the basis for opening account(s) and therefore warrant that such information is correct. SUBMIT