Phoenix Account Opening (Individual)

:: PERSONAL DETAILS (1)

OTHER

FIRST NAME

SURNAME

OTHER NAMES

DATE OF BIRTH

NATIONALITY

LOCAL GOV'T OF ORIGIN

STATE OF ORIGIN

MOTHER'S MAIDEN NAME

PROFESSION

IDENTIFICATION NUMBER

ISSUE DATE

EXPIRY DATE

BVN

PROFESSION

NATIONAL ID NUMBER (NIMC)

:: CONTACT DETAILS (1)

RESIDENTIAL ADDRESS

0 /

POSTAL ADDRESS

0 /

EMAIL ADDRESS

TELEPHONE

ALTERNATIVE TELEPHONE

:: EMPLOYMENT DETAILS (1)

DATE OF EMPLOYMENT

EMPLOYER'S NAME

EMPLOYER'S ADDRESS

INDUSTRY

NATURE OF BUSINESS

:: NEXT OF KIN INFORMATION (1)

OTHER

FULL NAME

RELATIONSHIP

ADDRESS

0 /

TELEPHONE

EMAIL ADDRESS

:: PEP STATUS (1)

If yes, please give details

0 /

Politically Exposed Person (PEP) is someone who is or has been entrusted with a prominent public position or function (e.g. President/Head of Government, Governor, Government Officials, Politicians, Military Officers, Senior Executive Officers of State Owned Parastatals, Political Party Officials etc) in Nigeria or foreign countries including family members or close associates.

:: PERSONAL DETAILS (2) - FOR JOINT ACCOUNT

OTHER

FIRST NAME

SURNAME

OTHER NAMES

DATE OF BIRTH

NATIONALITY

LOCAL GOV'T OF ORIGIN

STATE OF ORIGIN

MOTHER'S MAIDEN NAME

PROFESSION

IDENTIFICATION NUMBER

ISSUE DATE

EXPIRY DATE

BVN

PROFESSION

NATIONAL ID NUMBER (NIMC)

:: CONTACT DETAILS (2) - FOR JOINT ACCOUNT

RESIDENTIAL ADDRESS

0 /

POSTAL ADDRESS

0 /

EMAIL ADDRESS

TELEPHONE

ALTERNATIVE TELEPHONE

:: EMPLOYMENT DETAILS (2) - FOR JOINT ACCOUNT

DATE OF EMPLOYMENT

EMPLOYER'S NAME

EMPLOYER'S ADDRESS

INDUSTRY

NATURE OF BUSINESS

:: NEXT OF KIN INFORMATION (2) - FOR JOINT ACCOUNT

OTHER

FULL NAME

RELATIONSHIP

ADDRESS

0 /

TELEPHONE

:: PEP STATUS (2) - FOR JOINT ACCOUNT

If yes, please give details

0 /

:: INVESTMENT FOR A MINOR

SURNAME

FIRST NAME

OTHER NAME

COUNTRY OF BIRTH

DATE OF BIRTH

:: INVESTMENT DETAILS

Investment Amount

Funding Source

SalaryBusinessOthers

OthersPlease specify

Referral Code

:: BANK ACCOUNT DETAILS

NAME OF BANK

BANK ACCOUNT NUMBER

BANK ACCOUNT NAME

:: HOW DID YOU HEAR ABOUT US

OthersPlease specify

:: INVESTMENT OBJECTIVE

Capital PreservationIncomeIncome & GrowthGrowth

:: DECLARATION

We declare that all the information given for the purpose of account opening with FCSL ASSET MANAGEMENT COMPANY LIMITED is true and accurate. We fully understand that it is a crime punishable by fine, imprisonment, or both to make a false statement or attach false documentation knowingly.

NAME

SIGNATURE

DATE

NAME

SIGNATURE

DATE

:: SIGNATURE MANDATE - FOR JOINT ACCOUNT

Either to signBoth to signSole signatory

:: KYC DOCUMENTS UPLOADS

Upload Passport Photograph

Passport Photograph

Upload a recent utility bill

Recent Utility bill

Upload a means of identification Acount Holder 1

Identification

Upload a means of identification Account Holder 2

Identification

:: KYC DOCUMENTS UPLOADS (MINORS)

Birth Certificate of Child

Child Birth Certificate

ID Card of Parent/Guardian

Parent/Guardian ID

Passport Photograph of Child

Child Passport

Passport Photograph of Parent/Guardian

Parent/Guardian Passport

Utility Bill

Recent Utility Bill

Phoenix Individual Account Opening