Entity Account KYC Form

Apply to open an account for a company, business, school, cooperative, association, NGO or other eligible organisation.

01Application and organisation details

Office / branchBusiness category *Other categoryCompany / business name *Certificate of incorporation / registration number *Date of incorporation / registrationType / nature of business *Sector / industryEntity account mandateOperating business address *Corporate business addressOrganisation emailTax Identification Number (TIN)Phone number 1 *Phone number 2

02Other bank account

BankAccount numberStatusAccount name

03Signatory A: Personal details

Surname *Middle nameLast name *Politically exposed person?Mother's maiden nameTitleSexDate of birthReligionNationalityMarital statusClass of signatory

04Signatory A: Contact and employment

Phone number 1 *Phone number 2EmailBank Verification Number (BVN)Name of employerOccupationOffice addressOffice phoneOffice emailCompany/Personal TINAnnual salary

05Signatory A: Permanent home address

VillageTownLGAStateNearest bus stopLandmark

06Signatory A: Residential address

Street numberStreet nameTownCityLGAStateNearest bus stopLandmarkDescription of buildingColour of building

07Signatory A: Identification

Identification typeOther identification typeID numberPlace of issuanceIssue dateExpiry dateIssuance authority

08Signatory B: Personal details

Surname *Middle nameLast name *Politically exposed person?Mother's maiden nameTitleSexDate of birthReligionNationalityMarital statusClass of signatory

09Signatory B: Contact and employment

Phone number 1 *Phone number 2EmailBank Verification Number (BVN)Name of employerOccupationOffice addressOffice phoneOffice emailCompany/Personal TINAnnual salary

10Signatory B: Permanent home address

VillageTownLGAStateNearest bus stopLandmark

11Signatory B: Residential address

Street numberStreet nameTownCityLGAStateNearest bus stopLandmarkDescription of buildingColour of building

12Signatory B: Identification

Identification typeOther identification typeID numberPlace of issuanceIssue dateExpiry dateIssuance authority

13Signatory C: Personal details

Surname *Middle nameLast name *Politically exposed person?Mother's maiden nameTitleSexDate of birthReligionNationalityMarital statusClass of signatory

14Signatory C: Contact and employment

Phone number 1 *Phone number 2EmailBank Verification Number (BVN)Name of employerOccupationOffice addressOffice phoneOffice emailCompany/Personal TINAnnual salary

15Signatory C: Permanent home address

VillageTownLGAStateNearest bus stopLandmark

16Signatory C: Residential address

Street numberStreet nameTownCityLGAStateNearest bus stopLandmarkDescription of buildingColour of building

17Signatory C: Identification

Identification typeOther identification typeID numberPlace of issuanceIssue dateExpiry dateIssuance authority

18Final certification and signatures

Signatory A name *Signatory B name *Signatory C name *Upload Signatory A signature *PNG, JPG or WebP, maximum 2 MB. Empty margins are trimmed automatically.Upload Signatory B signature *PNG, JPG or WebP, maximum 2 MB. Empty margins are trimmed automatically.Upload Signatory C signature *PNG, JPG or WebP, maximum 2 MB. Empty margins are trimmed automatically.Date *

We certify that the information contained in this application is true and correct, and the named signatories agree to submit it electronically to Bethel Microfinance Bank Limited.

Submitting this form does not automatically open an account, approve a limit increase, or replace any verification and supporting documents the Bank may require.

Your information is sent securely to Bethel Microfinance Bank for review.