INDIVIDUAL ACCOUNT

OPENING FORM

REQUIREMENTS FOR ACCOUNT OPENING

     
   
            
   
 
 INDIVIDUAL ACCOUNT
OPENING FORM

INDIVIDUAL ACCOUNT OPENING

*Please complete in CAPITAL LETTERS. All Sections Marked '' * '' are MANDATORY
(Please request for supplementary sheets
*TYPE OF ACCOUNT YOU WOULD LIKE TO OPEN: INDIVIDUAL JOINT for Joint Account holders up to a max. of 3)
1 CURRENT: STANDARD CURRENT PAYCHECK PLUS PREMIUM CURRENT
2 SAVINGS: STANDARD RESERVE STUDENTS BRIGHT KIDS
3 INVESTMENT: FLIP

*PLEASE INDICATE ACCOUNT CURRENCY GHS USD EUR GBP

IF FOREIGN CURRENCY PLEASE SELECT: ONSHORE OFFSHORE

PRIMARY CUSTOMER PARTICULARS For Joint Account, the same information on one of the supplementary joint account sheets
(excluding ID details - Type, No., Issue date, etc.) should be captured in this section

Prefix: Mr. Mrs. Ms Dr. Prof. Rev. Other

(For Joint Account, the Joint Account
*Name: Name should be entered here)
SURNAME/LAST NAME FIRST NAME MIDDLE NAME

*Date of Birth: *Marital Status: Single Married Divorced Widowed

*Gender: Male Female *No. of Dependants: SSNIT No.:

*Nationality: Ghanaian Others (Please Specify)

*Hometown:
*Identification Type: NIA ID Passport Driver's License Voter's ID NHIS Card Student ID

*ID No.: Issue Date:

*Issuing Country: Expiry Date:
TIN:
Residence Type: Self Owned Rented Family Owned Employer Provided Mortgaged
 
Nearest Landmark: City:
MMDA: Region:
*Country: Ghana Others Please Specify
 
City: Region:
*Country: Ghana Others Please Specify
*Contact Details: *Mobile 1: Mobile 2:
Email:
*Mother's Maiden Name:
   *Name:
*Contact Details: *Mobile 1: Mobile 2:

*Date of Birth: *Relationship:

*Residential Address:
MMDA: Region:

Spouse Name: (Tick box if same as Next of Kin) Date of Birth:

Wedding Anniversary:
1
MMDA: Metropolitan Municipal District Assemblies
 EMPLOYMENT DETAILS
*Occupation:
*Gross Annual Income in GHS: 0 to 25k 25k to 50k 50k to 75k 75k to 100k 100k and Above

*Industry Sector: Manufacturing Trading Financial Services Agriculture/Allied IT

Real Estate and Construction Others:

*Mode of Employment: Salaried Self-Employed Retired Student Others

If Self-Employed please specify:

*Employer/Bus. Name:
*Position Held:
*Employer/Bus. Address:
City/Town: Region:
MMDA: Phone Number:
*Country: Ghana Others Please Specify
Employer/Bus. Email Address:

Grade of Employment: Lower Middle Executive Car Ownership: Owned Leased None

FOR NON GHANAIANS ONLY: (Please fill where applicable)

Arrival Date: Visa Issue Date:

Visa No.: Visa Expiry Date:

Resident/Work Permit Number:

INITIAL DEPOSIT DETAILS

Currency: Amount: Cash (To open an account with cash, the customer must
deposit the cash in person at the Teller)

Transfer Cheque Cheque No.: Dated:

Drawn on Bank: BANK NAME Branch:

CHEQUE / SAVINGS WITHDRAWAL BOOK REQUEST

*Please issue a cheque/savings withdrawal book containing: Current Account 25 Leaves 50 Leaves
Savings Account 25 Leaves 50 Leaves

E-BANKING SERVICE (Please tick the services you wish to sign up for)

 

SMS Alerts Email Alerts Mobile Banking Internet Banking E-Statement

E-Statements (Freq.): Daily Weekly Monthly

Cards: (GHS) Visa Electron Visa Gold Other

 

SMS Alerts Email Alerts Mobile Banking Internet Banking E-Statement

E-Statements (Freq.): Daily Weekly Monthly

Cards: (GHS) Visa Electron Visa Gold Other

2
MMDA: Metropolitan Municipal District Assemblies
DETAILS OF MINOR (Please fill this section if you opted for Bright Kids Account)

*Child's Name:

*Date of Birth: *Relationship:

Educational Institution:
*ID No.: *ID Type:

FLIP ACCOUNT Minimum Period of Investment is 36 Months. Investment permitted in GHS & USD ONLY

Contribution: Monthly Quarterly Amount: GHS USD

Mode of Payment: Cash Cheque Standing Instruction Account:

PAYCHECK PLUS ACCOUNT (Please fill this section if you opted for this product)
*Employee ID: *Designation:

*Net Monthly Income in GHS: *Employment Date:

*Employer HR Contact Name:

*Email

*Telephone: Mobile:

*TRANSACTIONS YOU EXPECT TO PERFORM

*Operation Purpose: Personal Savings Investments Loan Servicing
Salary Remittances Personal Transactions
*Expected monthly Withdrawals in GHS and corresponding *Expected monthly Deposits in GHS and corresponding
number of transactions number of transactions
Monthly Monthly Monthly Monthly Monthly Monthly Monthly Monthly
Value & Value & Value & Value & Value & Value & Value & Value &
Number Number Number Number Number Number Number Number
Amt. Amt.
Amt. Amt. Amt. Above Amt. Amt. Amt. Above
Transaction Type 0-5k No. No. No. 50k No. Transaction Type 0-5k No. No. No. 50k No.
5-20k 20-50k 5-20k 20-50k
Cash Cash
Cheques/Drafts Cheques/Drafts
Funds Transfer Funds Transfer
Forex Forex

*SOURCE OF FUNDS
Savings Business Income Inheritance Investments Sale of Property Others
Please provide details if you selected Business Income, Inheritance, Sale of Property or Others

*COUNTRIES WHERE FUNDS ARE LIKELY TO BE TRANSFERRED

INWARD OUTWARD

*REASONS FOR SUCH TRANSFERS

3
ASSOCIATED BUSINESS(ES)
Details of Associated Business(es) 1
(where applicable) 2
Type of Associated Business(es):
Associated Business Address(es):

ACCOUNTS WITH OTHER BANKS

1 Bank Name: Account No.:
2 Bank Name: Account No.:
3 Bank Name: Account No.:
4 Bank Name: Account No.:

*DECLARATION ON U.S PERSON STATUS

This section of the account opening form must be completed by any individual who wishes to open a banking account.
Please complete in BLOCK LETTERS
*Name:
*Country of Residence:
*Country of Birth:
Please tick ‘‘√’’  or  for each of the following questions:
*1. Are you a U.S. Resident? Yes No
*2. Are you a U.S Citizen? Yes No
*3. Do you hold a U.S. Permanent Resident Card (Green Card)? Yes No
If you answered yes to any of the questions above please provide the following.
4. U.S Social Security/Tax Identification number
5. U.S Identification Document: Passport Driver's License

ID Number: Expiry Date:

FATCA Form Completed W9 W8 Date Form Completed:

I hereby confirm that the information provided above is true, accurate and complete. Subject to the applicable local laws,
I hereby consent to Fidelity Bank Ghana Limited or any of its affiliates sharing my information with local or foreign tax
authorities where necessary to establish my tax liability in any jurisdiction.

Where required by local/domestic or foreign/overseas regulators or tax authorities, I consent and agree to the Bank to
withhold from my account(s) such amounts as may be required according to applicable laws, regulations and directives.

I further consent to notify the Bank within a period of 30 days of any changes to my personal circumstances which include
but not limited to citizenship, marital status,residential and mailing addresses and contact telephone numbers.

Signature:

Date:

4
TERMS AND CONDITIONS

Please read this page carefully. It provides you with important transaction on your account we may take all steps necessary including
information about your Fidelity Bank Ghana Limited Individual but not limited to debiting your account without prior notice. In such
Current/Savings Account. circumstances we may notify you within fourteen (14) days of
processing the transaction.
A. SCOPE
C. CHEQUES
These terms and conditions together with any account specific
conditions, tariffs, guides, additional instructions from Us and any All cheques or other orders signed by you in accordance with the
subsequent variations govern the relationship between you and Us and mandate (or either or both of you if a joint account) will be honoured by
are binding on You. the Bank and your account will be debited for such cheques. In addition
to the reasons set out in Clause “B.” We may at our discretion refuse to
EFINITIONS pay a cheque if it is postdated, stale, defaced, crossed, altered or for any
other technical reason.
“We/Our/Us” means Fidelity Bank Ghana Limited
“You/your/ yours” means the customer or customers We may at our discretion take any additional steps we deem
appropriate to confirm the validity of a cheque. This may include calling
“Account” means a Personal/Individual Account with Us.
you; if we are unable to confirm, we may return the cheque unpaid with
“Fidelity Virtual” means Fidelity Bank online and or mobile banking “Drawer’s Confirmation Required”.
platform
“Security passcode” means User ID, Passwords, PINS, Codes and any other We may refuse to accept cheques drawn on banks based in the United
States of America and any other country. If any foreign cheque paid in
personal identifiers.
by you is returned unpaid for any reason whatsoever, and even if the
“User” means the person mandated to access and use the online and or return takes place after we have advised you that the cheque is
mobile banking service. available to be drawn against, we will have recourse against you and
will debit your account accordingly.
. YOUR ACCOUNT
The Bank may exercise its discretion in allowing withdrawals against
You will assume full responsibility for the correctness and validity of all an un-cleared cheque. Where a cheque is returned unpaid thereafter,
endorsement appearing on all cheques, orders, bills, notes, negotiable the bank shall have the right to hold on to the returned cheque and take
instruments and receipts, etc. deposited in your account. any action it deems appropriate to recover the value of the cheque from
you.
You agree that we may contact you by email, online messaging, phone,
SMS, post and by any other means we deem appropriate. All notices or You are wholly responsible for the safe keeping of cheques and in any
letters may be sent to the address supplied by you and be considered event where the cheques are mislaid, lost or stolen the customer must
duly delivered and received at the time it is delivered or seven days after immediately inform the Bank.
posting.
You will assume full responsibility for the correctness and validity of all
You authorize us to act on instructions from you electronically via endorsements appearing on cheques drawn on your account.
Online Banking, Fidelity Mobile Applications, SMS, Telephone, Card, in
writing. We may, but are under no obligation to take any steps we deem D. ATM CARD
necessary to ensure the authenticity of instructions, these may include
additional security requirements we may set from time to time. You must ensure that you comply with any instructions we may give
regarding the use and safekeeping of cards. You can use your card to
We may refuse to carry out an instruction: access funds at any ATM worldwide that displays the VISA or
MasterCard sign or any other payment company and to pay for charges
• If it does not comply with the Mandate incurred by the Merchant. The Merchant reserves the right at any time
• If you do not have sufficient funds available to refuse to permit the use of the card at the outlet for any reason
• If we doubt the authenticity of an instruction whatsoever. You must sign your card as soon as you receive it and follow
• If the instruction is ambiguous or not sufficiently clear any relevant instructions that we give. You can use your card(s) if you
• Where we believe acting on such instruction might put us in have adequate funds in your account. Limits and restrictions may vary
breach of any law, regulation, code or contractual obligation from each ATM and Merchant; the Bank will not be liable for any losses
binding on us this may cause you.
• If we suspect that your Account has been or is likely to be
misused, whether fraudulently or otherwise We will convert all overseas transactions into Ghana Cedis currency
• If, in our reasonable discretion, any other valid reason applies. using the prevailing exchange rate and will factor in a percentage
commission on the amount of the transaction. The exchange rate we
It is your responsibility to check your statements and any transaction use may not be the same as the rate when the transaction was
notifications carefully. Any anomaly in the entries on your bank completed. If we have good reason, we may:
statement must be brought to our attention as soon as reasonably
practicable, in writing, and in any case within twenty-one (21) days from a) refuse to approve a transaction;
the date on which the statement and/or transaction notification was b) cancel or suspend your right to use the card for any or all
dispatched to you. purposes; or refuse to replace any card without prior notice to you;
c) limit number or frequency of transactions within any period.
If you make a claim that an unauthorized transaction has been made
on your account, we may ask you to make or support us to make a We will credit your account with a refund for a transaction if the
report to the Police. You agree that you will provide us with all the retailer asks us to or if you notify us that a transaction with retailer has
information you have about the transaction and take steps we deem been incorrectly debited to your account after
necessary to assist with the recovery of funds. You warrant that the ascertaining/establishing veracity of the claim. You cannot use a claim
information you provide is accurate, true and complete. If the you may have against someone else to make a claim against us, or
information is found to be false or you misrepresented the facts we refuse to pay us, unless you have a legal right to do so. You cannot
may report you to the police and you will be responsible for all costs we transfer any rights of action against us to anyone else.
may incur.
The card remains our property at all times, and must be returned to us
All transactions will be processed in accordance with our processes and immediately if we ask for it.
procedures. However, if in a rare instance we mistakenly perform a

5
TERMS AND CONDITIONS

E. OVERDRAWN ACCOUNT eighty (180) days we will classify your account as dormant. If you wish to
use a dormant account you must write to us or complete a dormant
We expect you to keep your account in credit unless we have agreed an account re-activation form.
overdraft with you. We may, at our discretion, allow a withdrawal that
creates an unauthorized overdraft or results in you going over any K. CLOSING YOUR ACCOUNT
agreed overdraft limit. We may charge you the relevant fee and interest
at our current rate for unauthorized borrowing; that is, if your account We may in some circumstances agree to defer certain documents for a
does not have enough cleared funds to cover the amount you want to time period when you open your account with us. Failure to submit any
withdraw. deferred document within the specified time will result in your account
being closed.
We may demand the repayment of, or reduction in your overdraft at
any time and without prior notice. You may ask us to close your account at any time by giving us notice in
writing provided that your account is in credit or that you have no
F. SET OFF outstanding liabilities to us. If your account is a joint account we will
require signed instructions from all account holders. The closure will
We can treat any deposits or other sums owed by us to you (in any not be finalized until all outstanding instructions have been
currency) as collateral for any liabilities you may have to us, either now completed.
or in the future. This may include general or special, contingent or
unmatured liabilities. We can at any time and without prior notice or We may choose to end our banking relationship with you at any time,
demand, apply or set off deposits or other sums against liabilities you but will give you reasonable notice unless there are specific
may have to us. We may use credit balances on any account you have circumstances that prevent us from doing so such as suspicion that you
with us to reduce or repay any overdrawn balances or other sums you have committed or attempted a fraud, impersonation, forgery, etc.
owe us and will inform you after we have done so.
Where we choose to close your account and your account is overdrawn
G. PAYING INTEREST AND CHARGES you must pay all sums outstanding on the account otherwise we may
take appropriate legal action for recovery.
You will be liable for the payment of interest charges at the rate fixed by
the Bank from time to time for any sum(s) outstanding to the debit of On account closure the Bank may issue to you a draft or effect a transfer
the current account. The current account may also be debited with our in the currency of the account or cedi equivalent, less any applicable
banking charges, service charges, interests, commissions, etc. Our charges or fees and made payable to the Account holder(s). Any benefits
current charges and fees including those applicable to cheques and or additional services provided in relation to your Account will end
ATM cards can be found on www.fidelitybank.com.gh and at our immediately on account closure. You must return all Cards, Cheque
branches. Books and any other equipment provided by the Bank.

H. JOINT HOLDERS L. SECURITY

You may open a joint account for up to three (3) account holders. Security Passcode means User id, Passwords, PINS, Codes and any other
Personal Identifiers
We will act on instructions given by any one of you or all of you as
stated on the mandate card. If your mandate requires all of you to sign You must ensure that you use your best endeavours to safeguard your
we will not be able to issue you with a debit card. account, and keep your cards, cheque books and any security passcodes
safe from access or use by unauthorized persons.
We cannot allow you to operate the Account if you told us of any
dispute between the account holders or you have told us only to accept You agree to use your best endeavours to keep all security passcodes
instructions given by more than one of you. We reserve the right to secret, never to disclose them to anyone and to prevent their fraudulent
freeze the account until the matter is resolved or until we have received or unauthorized use. You must never disclose your security passcode to
further instructions agreed by all the account holders. anybody or allow any other person to use your card or online banking. If
you do you will be liable for all transactions without limit.
As Joint Account Holders, you are individually and jointly liable for
complying with the Bank’s terms and conditions, running the account When entering your security passcode you must use your best
and for repaying any money owed to us. We may demand from any of endeavours to prevent fraudulent use. These include but are not
you, some of you or all of you repayment of all or part of any money limited to shielding the keypad at ATMs, POSs at premises of retailers
owed. when entering your secret passcode for transactions, complying with
all instructions we issue including keeping your security passcode safe.
You agree that if one of you dies, the survivor(s) will become the We will never request your security passcode via telephone, text
owner(s) of the Account and may (subject to our right of set-off) message, in writing or via email. If you receive such request please
withdraw any Account balances (subject to the applicable legislation). report it to us.

I. SERVICES You must contact us immediately without undue delay if;

We may at our discretion change or withdraw any Services including • You become aware that any of your security passcodes have been
but not limited to SMS, Mobile Banking, and Online Banking. compromised. You must contact us immediately and ask us to
deactivate it.
You may also write to us to tell us that you no longer wish to • Your card, cheque book, withdrawal books are lost, compromised or
have/continue using or patronizing a Service provided by us. We will stolen.
require a minimum of Seven (7) days’ written notice.
If you fail to comply with any of the conditions set out or any security
We will not be responsible to you for any losses, direct or indirect, instruction we give you, or act fraudulently, you will be responsible for
caused by the change, suspension, and or withdrawal of any Services, any direct, indirect and consequential losses suffered by you and us.
any delay, interruptions or errors in transmission and any breach of
confidentiality. The Bank shall not be held liable for any unauthorized withdrawals
during the period that the Bank has not been notified. You must allow
J. DORMANT ACCOUNTS a reasonable time after notification for us to deactivate the security
passcode or stop the cheque.
If you do not operate your account for a period of one hundred and

6
TERMS AND CONDITIONS
M. ONLINE BANKING given in excess of the powers vested in you or where we
believed that by so acting would result in a breach of any duty
• We will send you a username and passcode. We will ask you to imposed on us;
change the passcode to one that you can remember.
h. Failure by you to pay or repay to us on demand any sum due to
• Where you forget your password you can request for a new one us (including all interest accrued thereon);
using the “Forgotten Password” icon on the online banking
service. i. You breaching of any one or more provisions of these Terms and
Conditions;
• You can use the online banking service to block or request an
ATM card, stop a cheque or request a cheque book. j. The enforcement by us of our rights (including rights of sale,
set-off, recovering payment or enforcement proceedings)
• We will set a payment limit on transfers between your under or in connection with these Terms and Conditions;
accounts using the online banking service and notify you of
these limits. k. Any claim or action brought by a third party which is in any way
the result of improper use of the Account, Online Banking, ATM
• You agree to indemnify, defend and hold the Bank harmless and any other Banking services
against all claims, costs, liability, losses and expenses incurred
by it in connection with any use or alleged use of the online l. The Bank using any system or means of communication or
banking serve under your password by any person with or transmission in carrying out your instructions which results in
without your consent or authorization. the loss, delay, distortion or duplication of such instructions;
and
• We reserve the right to modify, suspend or discontinue
temporarily or permanently, this service or any part of it, with m. Any lost, stolen or mislaid cheque book, passbook, ATM Card,
or without notice, at any time. Time Deposit advice, personal identification number(s) or
advice, or other security passcode(s) in relation to the Account
• You shall not use or permit the use of the online banking and any re-issuance or replacement of the same by us.
service or any related service for any illegal or improper
purposes. FOREIGN ACCOUNT INDEMNITY

• You may request for the termination of the service anytime by a. The Bank will be indemnified and have no responsibility for or
giving 7days written notice to the Bank. liability to the undersigned for any diminution due to taxes or
imports or depreciation in the value of funds credited to the
• We may suspend or terminate the service without prior notice Account (which funds may be deposited by the Bank in the
if you have breached these terms and conditions or we learn of Bank’s name and subject to the Bank’s control with which
your death, bankruptcy or lack of legal capacity. depository (ies) as you may select) or for the unavailability of
such funds due to restrictions on convertibility, requisition,
involuntary transfers, or other similar causes beyond the Bank’s
N. INDEMNITY
control.
You hereby undertake to indemnify the Bank, its officers and staff from
b. Where any currency in which the Bank's payment obligations
and against all actions, proceedings, liabilities, costs, claims, demands,
are denominated becomes unavailable due to restrictions on
expenses or losses sustained as a result of:
convertibility, transferability, requisitions, government acts,
orders, decrees and regulations, involuntary transfers, distraint
a. The operation of your account. of any character, exercise of military or usurped powers, acts of
war or civil strife, monetary union or exchange or similar
b. The provision of any service and or product by us to you. causes beyond the Bank's reasonable control, the Bank shall be
deemed to have satisfied such payment obligation by making
c. Any instructions received supported by your security passcode payment in such other currency.
whether made by yourself or another without your consent or
authorization. You hereby agree that this indemnity shall be governed by and in
accordance with the laws of the Republic of Ghana.
d. You acknowledging and accepting that we need no further
steps to confirm the identity and authority of the source of any O. DISCLAIMER CLAUSE
such instructions and agree that we shall be entitled to debit
your account(s) with the amount of any payment made We will not be responsible for any loss or damage to funds deposited
pursuant to such instruction. with the bank due to any further Government order, law, levy, tax,
embargo, moratorium, exchange restriction or any other cause beyond
e. In connection with us having acted on such instructions or our control.
alleged instructions with or without your consent or
authorization. We will not be liable for funds handed over to members of our staff
outside the Bank premises. The Bank may exercise its general lien or any
f. By reason of us, as a collecting bank, relying upon or similar right it is entitled to or consolidates all or any of your accounts
guaranteeing any endorsement or discharge on a cheque, bill, with any liabilities you may have to the Bank and set off or transfer any
note, draft or other instruments presented by you for collection, sum or sums standing to the credit of any one of more of such accounts
and in all cases, such reliance or guarantee by us shall be or any other credit. The Bank shall in no circumstances be liable to you
deemed to have been exercised at your express request. if access to e-banking/SMS is not available for any reason, including but
not limited to force majeure, fault in network or hardware error. The
g. The Bank taking, relying and acting upon or omitting to act on Bank will not be liable to you if it is unable to carry out its
any Instructions given or purported to be given by you or by any responsibilities as a result of anything it cannot control.
person(s) purporting to be your attorney, regardless of the
circumstances prevailing at the time of such Instructions or The Bank disclaims any liability for any funds/assets deposited by you
the nature of the transaction and notwithstanding any error, which are subsequently found to have been derived from illegal sources
misunderstanding, fraud or lack of clarity in the giving, receipt or activities. You confirm that the funds/assets deposited are not
or the contents of such instructions, including where we derived from any illegal sources or activities. You agree to indemnify,
believed in good faith that the instructions or information was defend and hold the Bank harmless from or against all claims, cost,

7
TERMS AND CONDITIONS

liability, losses or expense incurred by the Bank in connection with your ii. Money Laundering/Terrorism Financing
use or alleged use of your PIN, passwords, or e-banking details without
your consent or authorization. You should not use any service, or your Transfer of funds shall not be executed if the transaction
account, or permit your account to be used for any illegal and improper contravenes the laws and regulations on Money Laundering
purposes. and Financing of terrorism or its related acts. Payment could be
delayed, suspended or refused where a party is implicated in
We shall not be liable to you if there is service interruption or if our the violation of the law, or an authority requires information or
service is not available in the desired manner for reasons including but clarification to comply with the law or regulation.
not limited to natural calamity, floods, fire and other natural disasters,
legal restraints, faults in the telecommunication network or internet or The Bank shall not be held liable for funds deposited for
network failure, software or hardware error or any other reason beyond transfer which are subsequently discovered to be from criminal
the control of the Bank. or other illegal sources.

P. DISCLOSURE POLICY R. FUNDS TRANSFER INSTRUCTIONS

Where we are required under anti money laundering regulations to i. The Bank or its affiliates, subsidiaries or any of its
verify the identity of potential account holders and authorized persons correspondents, shall not be responsible for any loss caused by
when opening an account we shall do so. This shall include but not be any country restriction, order, or any Government Agency.
limited to verifying your name and address. We may carry out searches
at credit reference agencies who may add a record of our search to their ii. The Bank may engage any correspondent bank or agent to
records. effect the transfer on behalf of the customer, but neither the
Bank nor its affiliates or correspondents shall be liable for any
You agree that we may use your data and customer information for risk Interruption, Error, Loss or Delay, direct or consequential arising
assessment, behavior credit scoring and analyses, generally and to from failure of Networks, Wire or Cables, or arising from Lock
meet our compliance obligation on your account held with the bank or Outs, Riots, Civil Revolt, War or other cause beyond its control.
another group member of its relationship with the Bank or another
group member to any of the following: iii. The Bank may send any transfer in explicit language, coded or
cipher. Fidelity will not be liable for any mishap which may
1. Any office or branch of the bank, affiliate or another group occur in the transmission of the message or its interruption by
member. the Receiving Bank arising from the Clearing System of the
country in which the payment is to be made or any other Act or
2. Any agent, contractor or third party service provider, or any Failure or Negligence of the Receiving Bank in connection with
professional advisor of the bank or another group member. the transfer.

3. Any guarantor or third party security provided by the customer. iv. In the absence of specific instructions, the funds transferred
will be paid in the currency of the country where the payment
4. Any credit reference Bureau, Rating Agency and a collection will be made. For transfers requiring conversion into foreign
Agency. currency, funds deposited by the customer shall be converted
into the currency of payment at the Bank's prevailing selling
5. Any regulatory, supervisory, governmental or rate on the date the funds are received. Where a transfer
quasi-governmental authority with jurisdiction over the Bank involves a third currency payment other than the currency of
or another Group Member. the beneficiary, the funds may be converted by the
Correspondent bank to the currency of payment (Third
6. Any actual or potential participant in, or assignee, novatee or Currency) at the prevailing buying rate of the correspondent
transferee of, any of the bank’s right and/or obligations and after the deduction of the Correspondent Bank Charges.
relation to the customer
v. The Bank shall debit the customer’s account for all fees and
7. Any person to whom the bank is required or authorized by law commissions in accordance with the Bank's current tariffs.
or court order to make such disclosure. These fees and commissions may be reviewed from time to
time at the discretion of the Bank.
8. Any person who is under a duty of confidentiality to the bank.
Sometimes, a Correspondent Bank may charge fees and
9. Any bank or financial institution with which I/We have as or commissions. If it does, it may either deduct the fees and
proposed to have dealings. commissions from the funds received or may charge the fees
and expenses to the account of the Bank. If the fees are
10. Any Overseas Regulator or Tax Authority for the purpose of deducted from the funds received, the beneficiary shall receive
establishing any tax liability in compliance with an order, a sum lesser than the sum sent. Where the expenses and
agreement with the Overseas regulators or tax Authorities commissions are charged to the account of Fidelity, the
customer will be obliged to reimburse the bank for same. In the
We shall at our sole discretion and without your consent publish your absence of specific instructions to the contrary, all
name in the national daily newspapers in the event that you default in Correspondent Bank expenses and commissions shall be borne
your obligations under any loan Agreement. by the beneficiary.

Q. FATCA POLICY The Bank may at its discretion retain fees and commissions
charged, where the transfer cannot be concluded due to
i. The Bank’s Foreign Account Tax Compliance Act (FATCA) Policy insufficient funds in the customer's account.

The “FATCA Policy” forms part of the terms and conditions vi In some instances, the Bank may be requested to use its best
governing your relationship with the Bank established under efforts to stop or suspend the execution of a transfer. At the
these Terms and Conditions. The FATCA Policy shall be binding request of the customer and after receipt of the funds from the
on you and you agree to comply with and adhere to the FATCA beneficiary's bank, the bank shall pay the customer at the
Policy, which is available on request. These Terms and prevailing purchase rate less expenses and commissions for
Conditions are subject to the FATCA Policy. Should there be any the cancellation of the instructions. For manager's cheques or
conflict or inconsistency between any of the contents of the bank drafts, the repurchase will be done after receipt of the
FATCA Policy and these Terms and Conditions, the contents of original cheque, at the Bank's prevailing purchase rate for the
the FATCA Policy shall prevail. currency concerned, less the expenses and commissions for
8
TERMS AND CONDITIONS

vii. The Bank reserves the right to determine the priority in the S. ELECTRONIC MONITORING OR RECORDING
execution of multiple requests for Transfers, Bank Drafts or
Manager's cheque and to refuse to carry out a present The Customer and Fidelity Bank Ghana Limited consent to telephone,
instruction if, after having determined (in its discretion) the video or electronic monitoring or recording for security, training and
priority between the various concurrent payments, this request quality of service purposes and agree that either may produce
could result in the customer's account going into debit or telephonic recording, video or electronic monitoring or computer
exceeding any authorised limit for the account. records as evidence in any proceedings brought in connection with
these conditions or any local conditions, or for training purposes.
viii. If Fidelity is notified that it did not transfer the full amount
stated in a request, Fidelity’s sole liability will be to correct the T. DECLARATION ON CUSTOMER INFORMATION
error.
You warrant that information given in respect of this account opening
ix. The customer warrants that each instruction initiated in is correct. You further undertake to indemnify the bank for any loss
connection with a transfer instruction is fully authorized by suffered as a result of any false information or error in the information
himself and by any other party whose authorization is provided to the Bank.
required. Fidelity shall not be liable for any loss, damage, or
liability, which may arise from the unauthorized use of the             
Funds Transfer Service.            .

NAME: NAME:

AUTHORISED AUTHORISED
SIGNATURE: SIGNATURE:

DATE: DATE:

NOTE: PLEASE REFER TO LAST PAGE FOR THE MANDATE CARD

9
FOR OFFICE USE ONLY

CSO/PB: CSO/PB ID:

ACCOUNT SEGMENT: SEGMENT ID:

KYC DOCUMENTS - MANDATORY

VALID IDENTIFICATION (SELECT ANY ONE):

Passport; Driver’s Licence; National Identity Authority ID; Voter’s ID; NHIS ID Student ID supported by an Introduction
Letter from the Head of institution/ Representative or Admission Letter not more than 1 year from the date of issue.

VALID RESIDENTIAL ADDRESS VERIFICATION (SELECT ANY ONE):

Utility Bill, Introduction Letter by a Doctor/Lawyer/Accountant, Government or Local Authority Bill (not more than 3
months old), Fully Completed Address Confirmation by an Existing Customer (at least one year relationship with the Bank
and the prospective customer), Tenancy Agreement, Bank Statement or Passbook containing current Residential Address
(at most 3 months old), Solicitor’s Letter confirming recent house purchase or Search Report from the Lands Commission,
Letter from a Public Authority/Statutory Declaration, Search Report on prospective customer’s place of employment and
residence, Confirmation from the Electoral Register, Tax Assessment Statement, Record of home visit (Visitation Report)
Student accommodation contract for only students,Document verifying Home Address of Parent of a student.

*KYC PROFILE (Please Tick Appropriate Risk Profile)

Low Moderate Above Average High

Indicate if customer is a PEP Yes No (If Yes, kindly complete a PEP form)

I CONFIRM THAT ALL APPLICABLE DOCUMENTS REQUIRED TO OPEN AN ACCOUNT HAVE BEEN RECEIVED FROM THE
CUSTOMER
BRANCH NAME:
ACCOUNT NO:

NAME OF PB/CSO: SIGNATURE:

PB/CSO ID:
DATE:

CSO/PB/RM ASSIGNED:
NAME: SIGNATURE:

PRIM. RM CODE:
DATE:

SECONDARY RM ASSIGNED:
NAME: SIGNATURE:

SEC. RM CODE:
DATE:

10
*MANDATE CARD
*MANDATE AUTHORISATION / COMBINATION RULE (ACCOUNT MESSAGE):

SINGLE JOINTLY (Both to Sign)

OTHERS (Specify)

PRIMARY ACCOUNT HOLDER

1 NAME:
TELEPHONE NUMBER: Signature:

CLASS OF SIGNATORY: USE “A” OR “1”

SIGNATURE MESSAGE: PHOTO

(Mandate instruction
specific to signatory)

Date:

JOINT ACCOUNT HOLDERS

2 NAME:
TELEPHONE NUMBER: Signature:

CLASS OF SIGNATORY: USE “B” OR “2”

SIGNATURE MESSAGE: PHOTO

(Mandate instruction
specific to signatory)

Date:

3 NAME:
TELEPHONE NUMBER: Signature:

CLASS OF SIGNATORY: USE “C” OR “3”

SIGNATURE MESSAGE: PHOTO

(Mandate instruction
specific to signatory)

Date:

4 NAME:
TELEPHONE NUMBER: Signature:

CLASS OF SIGNATORY: USE “D” OR “4”

SIGNATURE MESSAGE: PHOTO

(Mandate instruction
specific to signatory)

Date:

11