Meristem Liquid Fixed Term Investment: Corporate Form

N.B: Fields with (*) are mandatory

Details of Applicant

Name of Account*

Registered Address

Corporate Address*

Correspondence Email Address*

Contact Telephone Number*

Contact Mobile Number*

Nature of Corporate Business

Business profile of company*

Date of Incorporation*

RC Number*

Affiliations (Company)*

Annual Turnover*
N5 Billion - AboveN4.999 Billion – 500 MillionN499.9 Million - N50 MillionN49 Million - Below

Key Contact Persons/Principal Officer Details (1)

Title*
—Please choose an option—MrMissMrsMsDrProfChief

Surname*

Other Names

Gender*
MaleFemale

Date of Birth*

Residential Address*

State*

Country*

Email Address*

Mobile Number*

Job Title*

Type of ID
—Please choose an option—Driver's LicenceInternational PassportVoter's CardNational ID Card

ID Number

ID Card Issue Date*

ID Card Expiry Date*

Bank Verification Number (BVN)

Key Contact Persons/Principal Officer Details (2)

Title*
—Please choose an option—MrMissMrsMsDrProfChief

Surname*

Other Names

Gender*
MaleFemale

Date of Birth*

Nationality*
—Please choose an option—Nigerian

Postal Address

Residential Address*

State*

Country*

Email Address*

Mobile Number*

Job Title*

Type of ID
—Please choose an option—Driver's LicenceInternational PassportVoter's CardNational ID Card

ID Number

ID Card Issue Date*

ID Card Expiry Date*

Bank Verification Number (BVN)

Authorized Signatories (1)

Title*
—Please choose an option—MrMissMrsMsDrProfChief

Surname*

Other Names

Gender*
MaleFemale

Date of Birth*

Postal Address

Residential Address*

State*

Country*

Email Address*

Mobile Number*

Job Title*

Type of ID
—Please choose an option—Driver's LicenceInternational PassportVoter's CardNational ID Card

ID Number

ID Card Issue Date*

ID Card Expiry Date*

Bank Verification Number (BVN)

Authorized Signatories (2)

Title*
—Please choose an option—MrMissMrsMsDrProfChief

Surname*

Other Names

Gender*
MaleFemale

Date of Birth*

Postal Address

Residential Address*

State*

Country*

Email Address*

Mobile Number*

Job Title*

Type of ID
—Please choose an option—Driver's LicenceInternational PassportVoter's CardNational ID Card

ID Number

ID Card Issue Date*

ID Card Expiry Date*

Bank Verification Number (BVN)

Reports

Preferred Method of Correspondence*
EmailSMSPost

Frequency of Statement*
MonthlyQuarterlyBi-AnnuallyAnnuallyNo-Statement

Maturity of Investment

Applicant should mark the preferred option for receiving the proceeds of investment after maturity*
ChequeTransfer Into Bank Account

If bank account, please fill in the following:

Name of Account Holder*

Name of Bank*

Account Number*

BVN*

Required KYC Documents

Authorised Signatory 1*


Authorised Signatory 2*


Certificate of Incorporation


Forms CAC -07 & Forms CAC -02


Memorandum & Articles of Incorporation


Passport Photograph of all directors in CAC-07


Form of Identification for all directors in CAC-07


Utility Bill (not older than 3 months)


Special Control Unit on Money Laundering (SCUML) Certificate as applicable to the company/Entity

Authorization

We hereby authorize MWML to:

act in accordance with our instructions or that of any person authorized by us in respect of this investment (including those transmitted and received by telephone, fax, electronic mail or the internet), and to do all things necessary to give effect thereto;

deduct sufficient amounts from our chosen investment for the purposes of transaction charges or its fees; provide our details and details in respect of this investment to companies with whom it has business arrangements or MWML’s regulators

to retain interest pro rata across the selected Fixed Term Investments in order to collect charges, including reduction charges.

Δ