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Account specifications

Account type*

Currency of account


Personal delails

Title *

Gender *

Marital status

Means of identification




DETAILS OF NEXT OF KIN

Title

Gender

ADDITIONAL DETAILS

EMPLOYMENT DETAILS

Employment status

D.FOREIGN ACCOUNT TAX COMPLIANCE ACT (FATCA)

Do you hold a United State of America (USA) passport/citizenship?

Fatca waiver required if you are a us citizen

I hereby irrevocably and unconditionally DISCHARGE AND RELEASE Ecobank Nigeria ("the Bank"), from any duty or obligation of confidentiality owed to me in respect of the account(s) held with the Bank and I do also irrevocably and unconditionally DISCHARGE AND RELEASE the Bank from all and any claims, demands, liabilities, interest, damages, expenses, costs and penalties, present or in future in respect of any actions or liability whatsoever arising from the disclosure of information by the Bank to the US Internal Revenue Services (IRS) or other governmental authority of the United States of America.


ACCOUNT SERVICES REQUIRED (FEES MAY APPLY*)

Electronic banking products and services

Cheque confirmation

Other services


DETAILS OF ACCOUNT(S) HELD WITH OTHER BANKS

Status

Status

Are you a politically exposed person (PEP)?

DECLARATION

ISSUANCE OF DUD CHEQUE

I/We hereby pledge and undertake not to issue cheques on this account when same is not funded (dud cheque).

I/We agree that the Bank is under no obligation to honour any cheques issued on this account unless there is sufficient fund in the account to cover the value of the said cheque, and I/We understand that such cheque may be returned to me/us unpaid. In the event that such cheque(s) is/are honoured and paid for any reason whatsoever.

I/We hereby undertake to pay the Bank on demand the value of said cheque(s), plus bank charges, interests and fees as the Bank may require.

I/We hereby irrevocably and unconditionally consent to the bank providing all information to the relevant regulatory authority on all dud cheques issued on this account for appropriate action against me/us.

CUSTOMER INFORMATION

The information that I/We have provided in this form is accurate and is valid at the date of opening this account. I/We have also fully and understand that the terms and conditions for operating an Ecobank Account as contained herein, and also the accompanying booklet as applicable, and agree to be bound by all terms and conditions as applicable to the banking services applied for by me/us. I/We therefore request that you open an account and provide your services to me/us in line with the above information.

I/We hereby apply for the opening of any account or accounts with Ecobank Nigeria Limited. I/We understand that the information given herein is the basis for opening such account(s) and hereby 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.

I/We agree that my/our account should be placed on Post No Debit (PND) Status in the event that our account has incomplete documents.



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