N.B: Fields with (*) are mandatory
Date of Birth*
If "Other", kindly state:
Mother's Maiden Name*
Type of ID
---Driver's LicenceInternational PassportVoter's CardNational ID Card
ID Card Issue Date*
ID Card Expiry Date*
Date of Employment*
Occupation / Nature of Business*
Monthly Regular Income (₦)*
Source of Regular Income (₦)*
Source of Investment Income (₦)*
Full Name* (Surname first)
Preferred Method of Correspondence*
Frequency of Statement*
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
Bank Verification Number (BVN)*
Utility Bill (attach as proof of address change)*
Form of Identification*
I guarantee that all information herein is complete and correct.
If this investment is cancelled by me, MWML will have the right to refund the principal amount up to the date of cancellation plus the residue of accrued interest after a penalty charge as MWML may prescribe on the accrued interest.
All amounts relating to this investment in particular payments and benefits will be expressed, calculated and paid in Nigerian currency. Payment will be made in Nigeria.
I accept full responsibility for informing MWML of any changes in current identification information provided (e.g. address change, surname change, contact details, etc.). If any details change, I will provide MWML with new certified proof of identity and a utility bill, not older than 3 months.
In terms of the Anti-money Laundering (Prohibition) Act (2011), I confirm that the funds with which any payment is or will be made to MWML, in terms of this investment, are derived from a lawful source. In addition, I am willing to answer any questions with regard to the origin of such funds and to provide additional information as and when it may be required by MWML or other Regulatory Agencies.
I understand that information in this application may be recorded electronically with MWML in addition to physical records. Such records will form the record of this investment for all purposes and may be used as evidence at any proceedings.
I 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.