ACCOUNT OPENING FORM-INDIVIDUAL

This form should be completed in CAPITAL LETTERS using BLACK INK.

Characters and marks should be similar in style to the following ABC

Category of Account:
(Tick as appropriate)

Fixed
Individual Joint Investment Others (Please specify)

Type of Account
(Please tick as appropriate) $ € ¥ £
Instant Instant
Individual Savings Savings Premier Premium Gold
Current Tier 1 Tier 2 Savings Current Current Domiciliary

High Interest Early Savers Early Savers Every Day Diamond

Solo Deposit Account Tier 2 Tier 3 Evergreen Banking Xtra
Account No. (for official use only) BVN :

Branch

1. PERSONAL INFORMATION

Title: Surname:

First Name:

Middle Name:
Marital Status:
(please tick) Single Married Others (please specify) Gender: F M

Mother’s Maiden Name:

State of Origin: Local Govt. Area

Nationality :
(for non Nigerian) Resident permit No.

Issue Date:
D D M M Y Y Y Y Expiry Date:
D D M M Y Y Y Y Date of Birth:
D D M M Y Y Y Y

Tax Identification Number (TIN) Purpose of Account:

Do you have dual citizenship? Yes No If yes, please specify

If US Citizen/Resident, please provide

Social Security Number:

2. CONTACT DETAILS
Residential Address

House Number: Street Name:

Landmark: City/Town:

Local Govt. Area: State:

Mailing Address:

E-mail address:

Mobile No.: Phone No.:

3. VALID MEANS OF IDENTIFICATION

National ID Card National Driver's License International Passport INEC Voter’s Card

* Others (please specify) ID No.:

D D M M Y Y Y Y D D M M Y Y Y Y
Issue Date: Expiry Date:
*People in peculiar circumstances- Artisans, Petty Traders, Students who may not have the prescribed ID’s

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4. ACCOUNT SERVICE(S) REQUIRED (please tick option below)

Card Preferences (Fees Apply): Debit Card Master Card

Verve Card VISA Card

Would you like to opt out of this service (Debit Card) ? Yes

Electronic Banking Preference (Fees Apply): Online Banking Mobile Banking Mobile Wallet

Token Preference (Fees Apply): Hard Token Soft Token

Transaction Notification Preference: Email Alert (Free) SMS Alert (Fees Apply)

Transaction Notification Rule: Debit Only Credit Only Debit & Credit Threshold(If Required)

Statement Preference: Email (free) By Post In-Branch

Statement Frequency: Weekly Monthly Quarterly Semi-annually Annually

Cheque Book Requisition: 25 Leaves 50 Leaves 100 Leaves Opened cheque Crossed Cheque

Cheque Confirmation: No Yes Threshold (if Yes)

5. EMPLOYMENT DETAILS

Employment Status: Employed Self Empolyed Unemployed Retired Student Others

Annual Salary/Expected Annual Income

Annual Salary: (a) N0 -N50,000 (b) N51,000 - N250,000 (c) N251,000-N500,000 (d) N501,000-Less than N1000,000

(e) N1milion-Less thanN5milion (f) N5million- Less-than N10million (g) N10million-Less than N20million (h) Above N20million

Date of Employment D D M M Y Y Y Y
Employer's Name: (if employed):

Employer's Address: Plot Number: Street Name

Nearest Bus Stop/Landmark:

City/Town: Local Govt. Area:

Nature of Business/
State: Occupation:

Office Phone Number: Fax Number:

6. DETAILS OF NEXT OF KIN

Title: Surname:

Middle Name: FirstName:

Relationship: Gender: F M

Date of Birth:
D D M M Y Y Y Y Mobile No.:

E-mail address:

Contact Details

House Number: Street Name:

Landmark: City/Town:

Local Govt. Area: State:

2.
7. ADDITIONAL DETAILS

Name of Beneficial Owner(s):

Spouse Name:

Spouse Date of Birth:

D D M M Y Y Y Y Spouse's Occupation

Sources of Fund to the Account

Expected annual income from

other sources

Name of associated business(es) (if any):

Type of Business:

Business Address:

8. ACCOUNT MANDATE

Account Name:

Account No. Mandate authorization/Combination rule:

(for official use only) (Please tick as appropriate) Either to sign Both to sign Sole Signatory

Signatories

Surname: First Name: Middle Name:

Identification Type: Identification No: Phone Number:

Signature
Date:
D D M M Y Y Y Y

Signatories (Joint Applicant)

Surname: First Name: Middle Name:

Identification Type: Identification No: Phone Number:

Signature
Date:
D D M M Y Y Y Y

9. DECLARATION
I/We hereby apply for the opening of account(s) with Access Bank PLC. I/We understand that the information given herein and the documents supplied are the basis
for opening such account (s) and I/We therefore warrant that such information is correct.

I/We further undertake to indemnify the Bank for any loss suffered as a result of any false information or error in the information provided by the Bank.

Name: Signature: Date:

Name: Signature: Date:

3.
10. JURAT (This should be adopted where the applicants is not literate or is blind and the form is read to him or her by a third party)
I agree to abide by the content of this agreement and acknowledge that it has been truly and audibly read over and explained to me by an interpreter

Mark of Customer/ Magistrate/Commissioner Date:

Thumbprint: for Oaths:

Name of Interpreter: Address of Interpreter:

Telephone Number: Language of Interpreter:

For Official Use Only

Name of Officer: Name of Officer:

Signature: Date: Signature: Date:

For Bank Use Only

11. REQUIREMENT CHECKLIST

Savings Account
Checked Deferred Waived

1. Duly completed account opening form

2. Specimen signature card duly completed

3. Proof of identity (Original must be sighted)

4. Resident permit (for non-Nigerians)

5. Proof of Address

6. Letter from Employer/School/NYSC

Current/Domiciliary/Other types of Account

Checked Deferred Waived

1. Duly completed account opening form

2. Specimen signature card duly completed

3. Two (2) independent and satisfactory references

4. Proof of identity (Original must be sighted)

5. Resident permit (for non-Nigerians)

6. Two (2) independent and satisfactory references

7. Letter from Employer/School/NYSC

8. Other document provided

4.
12. AUTHENTICATION FOR FINANCIAL INCLUSION

i Is the customer socially or financially disadvantaged? Yes No

ii If answer to the above (i) above is yes, state other documents obtained in line with the Bank's policy on socially/financially disadvantaged customer in compliance with
Regulation 77 (4) of AML/CFT Regulation, 2013

iii Does the Customer enjoy tiered KYC requirements? Yes No

iv If answer to question (iii) above is yes, identify the customer risk category: Low Risk Medium Risk High Risk

13. AUTHENTICATION FOR POLITICALLY EXPOSED PERSONS

Is the Applicant a Politically Exposed Person? Yes No

For Bank Use Only

14. ACCOUNT OPENED BY:

Surname: Name:

Signature
Date:
D D M M Y Y Y Y

15. DEFERRAL/WAIVER OF DOCUMENT (IF ANY) AUTHORISED BY:

Surname: Name:

Signature
Date:
D D M M Y Y Y Y

16. ADDRESS VERIFICATION CARRIED OUT BY:

Surname: Name:

Signature
Date:
D D M M Y Y Y Y

Comment(s) (Address description and result finding):

17. ACCOUNT OPENING AUTHORIZED/APPROVED BY:

Surname: Name:

Signature
Date:
D D M M Y Y Y Y

5.
18. PRODUCTS AND SERVICES: TERMS AND CONDITIONS
Please tick the appropriate account box

DIAMONDXTRA ACCOUNT
Product Features

Minimum opening amount of ₦5,000

2% interest per annum payable monthly
Free withdrawal limit of ₦10million monthly
Daily ATM withdrawal limit of ₦150,000
Access to Online and Mobile banking platforms

Additional Benefits
Opportunity to win Salary4Life, Education grant, free rent, cash prizes etc.
Access to Health Insurance (provided by Hygeia HMO) of ₦6,000 annually

Account operating conditions

A strict minimum balance of ₦5, 000 is put on hold upon account opening.
Monthly interest will not be earned if there are more than four (4) withdrawals within the month
A charge of ₦1 per mille applies on the excess amount if monthly debit turnover exceeds ₦10million in a month
All other terms and conditions contained in the account opening package shall also apply to the DiamondXtra account.

HIDA ACCOUNT

Product Features
Minimum opening amount of ₦100,000
A minimum operating balance of ₦500
A competitive tiered interest rate accrued daily and payable monthly.

Bands (₦) Rate (per annum)

Less than ₦100,000 2.00%

₦100,000 – ₦999,999 4.50%
₦1,000,000 – ₦4,999,999 5.00%
₦5 million and above 6.00%

No Debit Card
No cheque book
Allows deposit of Cheques and Dividend warrants from other Banks directly into your account
Access to Online and Mobile banking platforms

Additional Benefits
Standing Instruction set-up (This can be done on our Online banking platform or In-branch)

Account Operating Conditions

A charge of ₦150 applies monthly if account balance goes below ₦5,000 anytime in the month.
Interest is forfeited if more than 4 withdrawals are made in a month
All other terms and conditions contained in the account opening package shall also apply to the HIDA account.

PREMIUM CURRENT ACCOUNT

Product Features
Minimum opening amount of ₦25,000
Minimum operating balance of ₦25,000
No Current Account Maintenance Fee (CAMF)
Withdrawal limit of ₦50million
No restriction on number of withdrawals
Access to Online and Mobile banking platforms

Additional Benefits
ATM daily withdrawal limit of ₦200,000
Access to Consumer Loans (Personal Loans, Auto Loans etc.)

Account Operating Conditions

A daily minimum balance of ₦1,000,000 shall be maintained in the account. In any month where the daily balance in the account falls below the ₦1,000,000,
Negotiable Current Account Maintenance Fee (NCAMF) of ₦1/mille will be applied on all debit transactions for such month.
Zero NCAMF shall apply up to a maximum turnover of ₦50 million monthly. NCAMF of ₦1 per mille shall apply to turnover above this threshold.
All other terms and conditions contained in the account opening package shall also apply to the Premium Current Account.

6.
18. TERMS AND CONDITIONS
Individual Account Opening Form

To Access Bank Plc

I/WE (the Customer) HEREBY REQUEST AND AUTHORISE YOU TO

1. Open an account in my/our name and at any time subsequently open further accounts as I/We may direct.
2. Honour all orders which may be drawn on the said account provided such orders are signed by me/us and to debit such order to the said account whether such account be for the time being in
credit or overdrawn or may become overdrawn in consequence of such debit without prejudice to your right to refuse to allow any overdraft or increase of overdraft and in consideration , I/We agree
a) To assume full responsibility for the genuineness, correctness and validity of endorsements appearing on all cheques, orders, bills, notes, negotiable instruments, receipts and/or other
documents deposited im my/our account.
b) To be responsible for the repayment of any overdraft with interest and to comply and be bound by the Bank's rules for the conduct of a Savings Account receipt of which I/We hereby acknowledge.
c) To free the Bank from any responsibility for any loss or damage to funds deposited with the Bank due to any future government order, law, levy, tax, embargo and/or all other causes beyond
the Bank's control.
d) That all funds standing to my/our credit are payable on demand only in such local currency as may be in circulation.
e) To be bound by any notification of change in conditions governing the account directed to my/our last known address and any notice or letter sent to my/our last known address shall be considered
as duly delievered and received by me/us at the time it will be delivered in the ordinary course of post.
f) And I/We note that the Bank will accept no liability whatsoever for funds handed to members of staff outside the Bank's premises.
g) That any disagreements with entries on my/our Bank Statements will be made by me/us within 15 days of the dispatch of the Bank Statement. Failing receipt by the Bank of a notice of disagreement
of entries within 15 days from the date of dispatch of my/our Bank Statement as rendered is correct.
h) The Customer hereby agrees that the Customer shall, at his/its own expense, indemnify, defend and hold harmless ACCESS Bank from and against any and all liability any other loss that may occur,
arising from or relating to the operation or use of the Account or the Services or breach, non-performance or inadequate performance by the Customer of any of these Terms or the acts, errors,
representations, misrepresentations, misconduct or negligence of the Customer in performance of its obligations.
I) Under no circumstances shall ACCESS Bank be liable to the Customer for any indirect, incidental, consequential, special or exemplary damages in connection with the Account or the Services.
j) ACCESS Bank shall not be liable for any failure to perform any obligation contained in these Terms or for any loss or damage whatsoever suffered or incurred by the Customer howsoever caused
and whether such loss or damage is attributable (directly or indirectly) to any dispute or any other matter or circumstances whatsoever.
k) The Customer shall keep ACCESS Bank indemnified at all times against, and save ACCESS Bank harmless from all actions, proceedings, claims, losses, damages, costs, interest (both before and
after judgement) and expenses (including legal costs on a solicitor and client basis) which may be brought against or suffered or incurred by ACCESS Bank in resolving any dispute relating to the
Customer's Account with ACCESS Bank or in enforcing ACCESS Bank's rights under or in connection with these Terms and conditions contained herein, or which may have arisen either directly
or indirectly out of or in connection with ACCESS Bank performing its obligations hereunder or accepting instructions, including but not limited to, fax and other telecommunications or electronic
instructions, and acting or failing to act thereon.
l) If any sum due and payable by the Customer is not paid on the due date, including without limitation any moneys claimed under this Paragraph, the Customer shall be liable to pay interest
(both after as well as before any judgement) on such unpaid sum at such rate or rates as ACCESS Bank may from time to time stipulate from the date payment is due up to the date of payment.
m) The Customer shall solely be responsible for ensuring full compliance with all the applicable laws and regulations in any relevant jurisdiction in connection with establishment of his/her Account
with ACCESS Bank and shall indemnify and keep indemnified ACCESS Bank from all actions, proceedings claims, losses, damages, costs and expenses (including legal costs on a solicitor and
client basis) which may be brought against or suffered or incurred by ACCESS Bank in connection with any failure to comply with any such applicable laws/regulations.
n) The indemnities as aforesaid shall continue notwithstanding the termination of the Account.
o) That any sum standing to the debit of the current account shall bear interest charges at the rate fixed by the Bank from time to time. The Bank is authorized to debit from the account the
usual banking charges, interest, commissions and any service charge set by the Management from time to time.
p) I/We also agree that in addition to any general lien or similar right to which you as bankers may be entitled bylaw you may at any time without notice to me/us combine or consolidate all or any of
my/our accounts without any liabilities to you and set off or transfer any sumor sums standing to the credit of anyone or more of such accounts or any other credits, be it cash, cheques,
valuables, deposits, securities, negotiable instruments or other assets belonging tome/us with you in or towards satisfaction of any of my/our liabilities to you or any other account or in any other
respect whether such liabilities be actual or contingents, primary or collateral and joint or several.
q) I/We shall be solely responsible for the safe-keeping and the confidentiality of the statements of account, balance confirmation certificate, cheque books,
Debit card and its PIN, user id and passwords relating to internet banking and such other items relevant or pertaining to the Account.
r). I/we pledge that we shall not issue any cheque or instruction or instrument on our account without first ensuring that our account with the Bank is sufficiently funded to accommodate such
payments. Consequently, we hereby authorize the Bank to report to the Central Bank of Nigeria (CBN), Economic and Financial Crimes Commission and/or any other regulator, details
of any transaction or incident of returned cheque or instrument on our accounts due to insufficient funds for further investigation and prosecution.
s). I/we pledge to comply with the rules and regulations put in place by the CBN regarding dud cheque from time to time. Consequently, we hereby irrevocably and unconditionally authorize the Bank
to enforce without further recourse to us, such CBN rules and regulation on dud cheque as may be applicable against us in the event of our breach CBN rules.

(ADDITIONAL TERMS AND CONDITIONS FOR DUAL CITIZENSHIP HOLDERS AND/OR DUAL RESIDENCE HOLDERS)
I/we hereby irrevocably and unconditionally request and authorize the Bank to disclose my/our account details, transaction and confidential information on my/our account to the United States
Internal Revenue Service or European Union or any other entity or regulator whether international or local as may be requested from time to time without further recourse to me/us.
I/we hereby irrevocably and unconditionally authorize the Bank to comply without further recourse to me/us with such instructions and directive as may be issued by the United States Revenue
Service or European Union or any other regulator having authority over the country or jurisdiction where I/we reside or are nationalized. Such directives includes without limitation deducting
any sum on my/our account or withholding any payment on my/our account or made on my/our behalf and freezing my/our account without any need for any order of court.
Consequently, I/we hereby irrevocably and unconditionally indemnifies and hold the Bank, its officers, directors, employees and agents harmless against all claims, costs, liabilities, actions,
demands, damages, losses or expenses which they may suffer as a result of compliance with any such regulation or law or requirements as stated above.

Authorized Signatory

Date:
D D M M Y Y Y Y

Affix Affix
Authorized Signatory Passport Passport
Photograh Photograh
Here Here

Date:
D D M M Y Y Y Y

7.