Mandate Form

SIGNATURE CARD (SAVINGS/INDIVIDUAL CURRENT/JOINT & DOMICILIARY ACCOUNT)

Account Name:*

FIRST SIGNATORY

Name of Signatory:*

Occupation:*

Residential Address (not P.O.Box):*

Telephone Number:*

Mandate Instruction:*

*

SECOND SIGNATORY (Optional)

Name of Signatory:

Occupation:

Residential Address (not P.O.Box):

Telephone Number

Mandate Instruction:*

*

CHEQUE CONFIRMATION

You will be required to pre-confirm and N1,000,000 and above cheque. If you would like to have a higher threshold for pre-confirmation, please specify the amount. i.e. The threshold above N1,000,000:

Page 3 of 4