Corporate Account Opening Form

+233 (0)30 220 0748

*CATEGORY OF BUSINESS

CSD Number (if you have one already)

*CATEGORY OF BUSINESS

If Others, Specify

*BUSINESS DETAILS

Company / Business Name

Certificate of Incorporation Number

Date of Incorporation/Registration

License Number

Jurisdiction of Incorporation / Registration

Parent Company (if any)

Type / Nature of Business

Sector / Industry

Principal Place of Business

Company Postal Addresss

Ghana Post GPS

TIN

Contact Number 1

Contact Number 2

*TURNOVER
Monthly Turnover (GH¢)Below 10,000Above 10,000Above 100,000Above 10 million

Annual Turnover (GH¢)Below 10,000Above 10,000Above 100,000Above 10 million

*STATEMENT SERVICES

Mode of Statement DeliveryEmailBy postSMSCollection

Mode of Statement DeliveryQuarterlyYearlyMonthlyWeekly

*CLIENT INVESTMENT PROFILE

Investment Objective

Risk ToleranceLowMediumHigh

Investment HorizonShort TermMedium TermLong Term

Investment KnowledgeLowMediumHigh

*EXPECTED ACCOUNT ACTIVITY

Source of FundsMember ContributionProceeds from Businessothers

If Others, Specify

Initial Investment Amount

If Others, Specify

Anticipated Investment Amount

Regular Top-up Amount (expected)

Regular Withdrawal Amount (expected)

*KEY CONTACT PERSON

Surname

First Name

Other Names

Date of Birth

GenderMaleFemale

GenderResident GhanaianNon Resident GhanaianResident ForeignerNon Resident Foreigner

If country of origin is not Ghana, please provide following

Resident Permit Number

Place of Issue

Date of Issue

Date of Expiration

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

Job Title

Contact Number 1

Contact Number 2

*SIGNATORY DETAILS 1

Surname

First Name

Other Names

Date of Birth

GenderMaleFemale

Residential StatusResident GhanaianNon Resident GhanaianResident ForeignerNon Resident Foreigner

If country of origin is not Ghana, please provide following

Resident Permit Number

Place of Issue

Date of Issue

Date of Expiration

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

Job Title

Contact Number 1

Contact Number 2

*SIGNATORY DETAILS 2
KEY CONTACT PERSON

Surname

First Name

Other Names

Date of Birth

GenderMaleFemale

Residential StatusResident GhanaianNon Resident GhanaianResident ForeignerNon Resident Foreigner

If country of origin is not Ghana, please provide following

Resident Permit Number

Place of Issue

Date of Issue

Date of Expiration

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

Job Title

Contact Number 1

Contact Number 2

SIGNATORY DETAILS 3

Surname

First Name

Other Names

Date of Birth

GenderMaleFemale

Residential StatusResident GhanaianNon Resident GhanaianResident ForeignerNon Resident Foreigner

If country of origin is not Ghana, please provide following

Resident Permit Number

Place of Issue

Date of Issue

Date of Expiration

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

Job Title

Contact Number 1

Contact Number 2

AFFILIATIONS

If part of a group, kindly state all entities within the group structure

*BENEFICIAL OWNERSHIP
Beneficial Owner 1

Surname

First Name

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

PEP Status

Contact

Address

Date of Birth

Ownership %

Beneficial Owner 2

Surname

First Name

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

PEP Status

Contact

Address

Date of Birth

Ownership %

*DIRECTORS
Director 1

Surname

First Name

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

PEP Status

Contact

Address

Date of Birth

Ownership %

Director 2

Surname

First Name

ID TypeVotersDrivers LicenseSSNIT Biometric CardNational ID

ID Number

Place of Issue

Date of Issue

Date of Expiration

PEP Status

Contact

Address

Date of Birth

Ownership %

*BANK ACCOUNT DETAILS
Bank 1

Bank Name

Bank Branch

Account Name

Account Number

Bank 2

Bank Name

Bank Branch

Account Name

Account Number

*EMAIL/ PHONE/ FAX INDEMNITY

Email/ Telephone/ Fax Indemnity

Upload all files / signatory's signature

DeclarationI/we hereby declare that all the information submitted by me/us in this form is correct, true and valid, that by my/our request, to open and maintain securities account(s) in my/our name and undertake to notify (Me and or my Company) of any changes to my/our particulars or information as may be necessary. I/We also declare that we have read thoroughly and understood the contents of this application and have given my/our consent by virtue of my/our signature(s) on this form. I/We consent that investment decisions are my/our prerogative without sole reliance on the investment advice received from (Me and or my Company). (Me and or my Company) accepts no liability for any direct or consequential loss arising from my/our decision. I/We also declare that all debits incurred on my/our securities account(s) by virtue of my/our trade orders shall be settled by me/us accordingly.