Fillable INDIVIDUAL ACCOUNT OPENING FORM

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INDIVIDUAL ACCOUNT OPENING FORM

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INDIVIDUAL ACCOUNT OPENING FORM
ACCOUNT TYPE
OTHER TYPES OF ACCOUNT
PERSONAL INFORMATION
TITLE SURNAME
FIRST NAME OTHER NAMES
DATE OF BIRTH GENDER
PURPOSE OF ACCOUNT
FOR OFFICIAL USE ONLY
ACCOUNT NO.
BRANCH
BVN NO.
ISSUE DATE
RESIDENT PERMIT
NUMBER
For Non-Nigerians
CONTACT DETAILS
HOUSE
NUMBER
LENGTH OF STAY AT
CURRENT ADDRESS
STREET NAME
MAILING ADDRESS
Residential Address
MOBILE
NUMBER
EMAIL ADDRESS
COUNTRY
ve address)
OTHER
NUMBER
SOCIAL MEDIA
EXPIRY DATE
CURRENT SAVINGS JOINT
TYPE OF ACCOUNT
FACEBOOK LINKEDIN TWITTER INSTAGRAM
SALARY INVESTMENT CHILDREN
OTHER
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y M F
Yr(s) Mth(s)
NEAREST BUS-STOP/
LANDMARK
LOCAL GOVT. AREA
STATE
CITY/TOWN
(Country Code) (Country Code)
RENTEDACCOMMODATION TYPE OWNED
NGN(₦) USD($) GBP(£)CURRENCY EUR(€)
STATE OF ORIGIN
PLACE OF BIRTH
LOCAL GOVT. AREA
NATIONALITY
RELIGION
O’ LEVELEDUCATION STUDENT
OTHER
GRADUATE POST-GRADUATE
(Please specify)
SINGLEMARITAL STATUS MARRIED
OTHER
(Please Specify)
(Please Specify)
Male Female
MOTHER’S MAIDEN NAME
NO. OF DEPENDANTS
NO. OF CHILDREN
ACCOUNT SERVICES
(Please tick applicable option below)
*E-BANKING
UNIONONLINE
UNIONMOBILE
MCASH
ANNUAL SALARY/INCOME
LESS THAN ₦500,000
₦500,000 < ₦1.5M
₦1.5M < ₦3M
₦3M < ₦7M
₦20M < ₦33M
ABOVE ₦33M
BUSINESS/EMPLOYER’S NAME
BUSINESS/
EMPLOYER’S PHONE NUMBER
OFFICE/HOUSE NUMBER
NEAREST BUS-STOP/LANDMARK
STREET NAME
STATE
₦12M < ₦20M
JOB TITLE
SOURCES OF FUNDS TO
THE ACCOUNT
1.
2.
EMPLOYMENT/INCOME INFORMATION
SELF EMPLOYED UNEMPLOYEDEMPLOYMENT STATUS EMPLOYED RETIRED STUDENT
PERMANENTNATURE OF EMPLOYMENT CONTRACT
CONFIRMED UNCONFIRMED
ENTRY
JOB LEVEL
MIDDLE MANAGEMENT SENIOR MANAGEMENT EXECUTIVE MANAGEMENT
YEARS WITH CURRENT
EMPLOYER
LESS THAN
1 YEAR
1 - 2 YEARS 3 - 6 YEARS 7 - 10 YEARS
ABOVE 10 YEARS
TRAVEL
*CARD TYPE
DEBIT
*PREFERRED USERNAME
SMS ALERT
COMMUNICATION PREFERENCES
EMAIL ALERT
25 50 100
(Fees Apply)
N
K
=
FOR A HIGHER PRE-CONFIRMATION LIMIT, PLEASE SPECIFY (i.e. above ₦150,000:00)
NATIONAL ID
VOTER’S CARD
ID. NUMBER
OTHERS
DRIVER’S LICENSE INT’L PASSPORT
EXPIRY
DATE
D D
M M
Y Y Y YD D
M M
Y Y Y Y
ISSUE
DATE
Are you a US Permanent Resident or citizen?
YES NO
SOCIAL SECURITY NUMBER
IDENTIFICATION
* Fees Apply
*All check
* Note: Terms and conditions apply. Kindly visit www.unionbankng.com/terms-and-conditions for more information
ed E-Banking services are provided automatically when the ac
*please confirm that you have provided a valid email
count is opened.
NAME OF ASSOCIATED BUSINESS(ES)
EXPECTED ANNUAL INCOME FROM OTHER SOURCES
1.
2.
₦₦77MM << ₦₦1122MM
TYPE OF BUSINESS
If yes, complete a W9 form for FATCA,
(Permanent)
(Please Specify)
_ _
Internet Banking
LOCAL GOVT.
AREA
CITY/TOWN
For Employed
(Country Code)
TAX IDENTIFICATION NUMBER
DO YOU WANT A CHEQUE BOOK?
NO
YES
IF YES, NUMBER OF LEAVES
DO YOU WANT A CREDIT CARD?
NO*YES
* If yes, complete a credit card application. Fees apply.
(Free) (Fees Apply)
*Special characters not allowed
PROFESSIONAL SERVICES
OTHERS
TYPE OF BUSINESS
TRADE
(Please specify)
For self employed
RETAILER
*EMAIL INDEMNITY
INVESTMENT
OTHERS
SOURCES OF OTHER INCOME
BUSINESS
(Please specify)
For Business
DATE OF BIRTH
D D M M Y Y Y Y
HOUSE NUMBER
NEAREST BUS-STOP/LANDMARK
STREET NAME
LOCAL GOVT.
AREA
STATE
CITY/TOWN
EMAIL ADDRESS
FIRST NAME
NEXT OF KIN
RELATIONSHIP
OTHER NAMES
SURNAME
TITLE
GENDER
M F
COUNTRY
ACCOUNT(S) HELD WITH OTHER BANK(S)
S/NO
NAME AND ADDRESS OF BANK/BRANCH
ACCOUNT NAME ACCOUNT NUMBER
ACTIVE/
DORMANT
DATA PROTECTION NOTICE
NAME OF ACCOUNT HOLDER
DATE
D D M M Y Y Y Y
SIGNATURE
NAME OF ACCOUNT HOLDER
DATE
D D M M Y Y Y Y
SIGNATURE
DECLARATION
MOBILE NUMBER
OTHER NUMBER
(Country Code) (Country Code)
SPOUSE’S NAME
D D M M Y Y Y Y
SPOUSE’S DATE OF BIRTH
Surname First
SPOUSE’S OCCUPATION
Male Female
I hereby apply for the opening of an account with Union Bank of Nigeria Plc. I have read the terms and conditions governing the account and those
relating to various products and services that I have requested for, as stated on the Bank’s website www.unionbankng.com/terms-and-conditions,
and I agree to be bound by them. I also indemnify the Bank fully for acting on all email instructions issued from the email address provided.
Complet erent from Next of Kin above
Union Bank of Nigeria Plc (“the Bank”) will process the above data, along with any other data you subsequently give us, in terms of the Nigerian Data
Protection Regulation 2019. The data will be used to give you statements and provide the Bank's products and services to you; for internal assessment
and analysis; for the detection and prevention of fraud and other criminal activities which the Bank is under legal obligation to report; to develop and
improve the Bank's services; for direct marketing, such as to inform you, by mail, telephone, e-mail or other electronic means, about other products
purposes For more information, please read our Privacy Notice on our website. Please note that your personal data may be disclosed to, exchanged
with or processed by employees of the Bank. You have the right to be informed by the Bank, at your request, about the personal data held by the Bank
about you that is processed and to request to correct such information where necessary. Should the data you provided to the Bank change, the Bank
must be informed without undue delay.
I/We hereby consent to the processing of my/our Personal Data (within or outside Nigeria), including transfer of my/our Personal Data to any third
party for reasons associated with the purpose for which the data is being processed as stated above.
NAME OF INTERPRETER
LANGUAGE OF
INTERPRETATION
JURAT (This should be adopted where the applicant is not literate or is blind and the form is read to him or her by a third party)
ADDRESS OF INTERPRETER
LOW MEDIUM HIGH
*If “Yes”, please provide details _________________________________________________________________________________________________
AUTHENTICATION FOR POLITICALLY EXPOSED PERSONS
SIGNATURE
IS THE APPLICANT A POLITICALLY EXPOSED PERSON?
*YES NO
ACCOUNT CODES
SEGMENT CODE
RM CODE
INTRODUCER CODE
REFERRAL CODE
BRANCH CODE
EMPLOYER CODE
ANCHOR CODE
DISTRIBUTORS CODE
SUPPLIERS CODE
OFFICIAL USE ONLY
DATE
D D M M Y Y Y Y
SIGNATURE
NAME
ACCOUNT OPENED BY
DATE D D M M Y Y
MOBILE NUMBER
OTHER NUMBER
(Country Code) (Country Code)
DEBIT CARD TYPE VERVE MASTERCARD
MARK OF CUSTOMER/THUMBPRINT
MAGISTRATE/
COMMISSIONER FOR OATHS
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.
SALARY PAYMENT DATE (DAY OF THE MONTH):
D D
(If customer is emplo
(Optional)
yed)
IDENTIFY THE CUSTOMERS RISK CATEGORY
S/N DOCUMENT REQUIRED CHECKED DEFERRED
W
AIVED
1. DULY COMPLETED ACCOUNT OPENING FORM
2. SPECIMEN SIGNATURE CARD DULY COMPLETED
3. TWO (2) RECENT PASSPORT PHOTOGRAPHS
7. RESIDENT PERMIT
9. TAX IDENTIFICATION / SOCIAL SECURITY NUMBER
4.
TWO (2) INDEPENDENT SATISFACTORY REFERENCES
8 .
LETTER FROM EMPLOYER (FOR SALARY ACCOUNT)
5.
PROOF OF ID: INT’L PASSPORT, DRIVER’S LICENSE, NATIONAL ID CARD,
VALID VOTERS CARD, ETC.
(Original must be sighted)
REQUIREMENT CHECKLIST
10. LOAN AGREEMENT FORM
6.
PROOF OF ADDRESS: UTILITY BILLS, ETC
(c opy is acceptable if original is not held)
(For non Nigerians)
CURRENT SAVINGS JOINT
TYPE OF ACCOUNT
SIGNATURE
NAME
ACCOUNT AUTHORIZED BY
DATE D D M M Y Y
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INDIVIDUAL ACCOUNT OPENING FORM

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Completed 3 October 2020

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