CRUTECH COMMUNITY MICROFINANCE BANK

LTD

ACCOUNT OPENING FORM - INDIVIDUAL

FORM A2
 ACCOUNT OPENING FORM-INDIVIDUAL
This form should be complected in CAPITAL LETTERS. Characters and marks should be number in style to the following
ACCOUNT No. (for official use only) Affix
Passport
BRANCH Photograph
here

BIOMETRIC ID NO:

I. PERSONAL INFORMATION

Title Surname

First Name Other Name

Marital Status (Please tick as appropriate) Single Married Others (please specify) Gender F M

D D M M Y Y Y Y
Place of Birth
Date of Birth
Mother’s Maiden Name

Tax Identification Number (TIN)

(if available)
State of Origin
L.G.A.

2 CONTACT DETAILS
Residential Address
Street Number Street Name

Nearest Bus Stop/Landmark

City/Town Local Govt. Area

State

Mailing Address

Phone Number (1) Phone Number (2)

E-mail Address (Optional)

3. MEANS OF IDENTIFICATION
Please Specify
D D M M Y Y Y Y D D M M Y Y Y Y
ID No. ID Issue Date ID Expiry Date

4. ACCOUNT SERVICE(S) REQUIRED (Please tick applicable option below)

Card Preferences: Verve Card Master Card Visa Card Other (Specify)
Electronic Banking Preferences: Internet Banking Mobile Banking ATM/POS Others Electronic Channels (Fee may apply) Specify
Transaction Alert Preferences: Email Alert (Free) SMS Alert (Fee applies)
5. EMPLOYMENT DETAILS (OPTIONAL)
Employment Status: Employed Self Employed Unemployed Retired Student Others (Please specify)
D D M M Y Y Y Y
Date of Employment (if employed)

Business Employer’s Name

Employer’s/Emploment Address

State

Business/Occupation

6. DETAILS OF NEXT OF KIN

Surname Other Name(s)

First Name

D D M M Y Y Y Y
Date of Birth Gender F M Title (Specify)
1
 Relationship

Phone Number (1) Phone Number (2)

E-mail Address

Contact Details

House Number Street Name

Nearest Bus Stop/Landmark

City/ Town Local Govt, Area

State

TERMS AND CONDITIONS:

1. The operations of the account is limited to a maximum single deposit amount of N20,000 and maximum cumulative balance of
N200,000 at any point in time.

2. Mobile banking is limited to a maximum transaction limit of N3,000 and daily limit of N30,000

3. International funds transfer is prohibited.

4. You will be required to provide further documents at any point in time when transacting above the regulated threshold.

5. This account is strictly savings.

DECLARATION:

FOR BANK USE ONLY

Account Opened by:

Name: ............................................................................................ Signature: .......................................................... Date: ..............................................

Confirm Opened by:

Name: ............................................................................................ Signature: .......................................................... Date: ..............................................

2
INDIVIDUAL ACCOUNT MANDATE
TO: CRUTECH COMMUNITY MICROFINANCE BANK LTD

I/WE HEREBY REQUEST AND AUTHORISE YOU TO

1 Open an account in my/our name and at any time subsequently to open further accounts I/We may
direct.
2 Honour all cheques or other orders which may be drawn on the said account provided such cheques or
orders are signed by me/us and to debit such cheques or order to the said account whether such
account be for the time being in credit or overdrawn or may become overdrawn in consequence of
such debit without prejudice to your right to refuse to allow any overdraft or increase of overdraft and
in consideration, I/We agree:
a) to assume full responsibility for the genuineness of correctness and validity of endorsements
appearing on all cheques, orders, bills, notes, negotiable instruments, receipts and/or other
documents deposited in my/our account.
b) to be responsible for the repayment of any overdraft with interest and to comply and be bound
by the Bank's rules for the conduct of a Current Account receipt of which I/We hereby
acknowledge.
c) to free the Bank from any responsibility for any loss or damage to funds deposited with the Bank
due to any future government order, law, levy, tax, embargo and/or all other causes beyond the
Bank's control.
d) that all funds standing to my/our credit are payable on the demand only in such local currency as
may be in circulation.
e) to be bound by any notification of change in conditions governing the account directed to my/our
last known address and any notice or letter sent to my/our last known address shall be
considered as duly delivered and received by me/us at the time it will be delivered in the ordinary
course of post.
f) that if a cheque credited to my/our individual current account is returned dishonoured, the
same may be transmitted to me/us through my/our last known address either by the bearer or by
post.
g) and I/We note that the Bank will accept no liability whatsoever for funds handed to members of
staff outside the Bank's premises.
h) that my/our attention has been drawn to the necessity of safeguarding my/our cheque book so
that unauthorized persons are unable to gain access to it and to the fact that neglect of this
precaution may be a ground for any consequential loss being charged to my/our account.
i) that the Bank is under no obligation to honour any cheque(s) drawn on this account unless there
are sufficient funds in the account to cover the value of the said cheques and I/We understand
and agree that any such cheque may be returned to me/us unpaid but if paid, I/We are obliged to
repay the Bank on demand.
j) that any disagreements with entries on my/our Bank Statements will be made by me/us within
15 days of the dispatch of the Bank Statement. Failing receipt by the Bank of a notice of
disagreement of entries within 15 days from the date of dispatch of my/our Bank Statement as
rendered is correct.
k) that any sum standing to the debit of the current account shall bear interest charges at the rate
fixed by the Bank from time to time. The Bank is authorized to debit from the account the usual
banking charges, interest, commissions and any service charge set by the Management from time
to time.
3 I/We also agree that in addition to any general lien or similar right to which you as bankers may be
entitled by law you may at any time without notice to me/us combine or consolidate all or any of
my/our accounts without any liabilities to you and set off or transfer any sum or sums standing to
the credit of anyone or more of such accounts or any other credits, be it cash, cheques, valuables,
deposits, securities, negotiable instruments or other assets belonging to me/us with you in or
towards satisfaction of any of my/our liabilities to you or any other account or in any other respect
whether such liabilities be actual or contingents, primary or collateral and joint or several.

I/WE HEREBY CONFIRM THAT I/WE HAVE READ THE AGREEMENT AND AFFIRM THAT I TRULY
UNDERSTAND AND ACCEPT SAME AS BINDING ON ME.

…………………………………… …………………………………
Authorized Signatory Authorized Signatory
Name/Signature/Date Name/Signature/Date