Vendor Disclosure

Related Party or Person” is any Director, staff, any nominee for director owning more than 5% of the total equity of the company in which such person or their immediate family member (child, step-child, parent, step parent, spouse, sibling, mother-in-law, father-in-law, son-in-law, daughter-in-law, brother-in-law or sister-in-law) owns more than 5% of its shareholding.

Name of Company:
   

Company's Registered Office Address:
   

Nature/Type of Business:
   

Contact Person:
   

Contact Phone Number/Email:
   

Kindly indicate below any related party interest with any staff and/or any Director of First Bank of Nigeria Limited.

Does any Director/Non- Executive Director of the Bank own 5% equity shares in your Company?:
    YesNo

Name:

Relationship:

Does any Staff of the Bank own 5% equity shares in your Company?:
    YesNo

Name:

Relationship:

Is there any Director/Non- Executive Director of the Bank that is a Director in your Company?:
    YesNo

Name:

Relationship:

Is there any Staff of the Bank that is a Director in your Company?:
     YesNo

Name:

Relationship:

I hereby confirm that my responses to the above questions are complete and correct to the best of my knowledge and belief.

I agree that if I become aware of any information that might indicate that this disclosure is inaccurate, I will notify Procurement Department immediately.

     

Name:
   

 

Designation:
   

Date: