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    Individual Customer Application Form: Fresh Thinking. Smart Banking

    Uploaded by

    Witchcraft
    The document is an individual customer application form for BancABC bank. It requests personal details like name, address, ID, employment information. It also requests account details like type of account, currency. The applicant must complete digital and payments platform registration. The form includes a FATCA questionnaire. By signing, the applicant declares the information is true and authorizes credit checks. The declaration section is for bank use like receiving/authenticating documents and approving the new account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Individual Customer Application Form: Fresh Thinking. Smart Banking

    Uploaded by

    Witchcraft
    51 views2 pages
    The document is an individual customer application form for BancABC bank. It requests personal details like name, address, ID, employment information. It also requests account details like type of account, currency. The applicant must complete digital and payments platform registration. The form includes a FATCA questionnaire. By signing, the applicant declares the information is true and authorizes credit checks. The declaration section is for bank use like receiving/authenticating documents and approving the new account.

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    PersonalAccount

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    The document is an individual customer application form for BancABC bank. It requests personal details like name, address, ID, employment information. It also requests account details like type of account, currency. The applicant must complete digital and payments platform registration. The form includes a FATCA questionnaire. By signing, the applicant declares the information is true and authorizes credit checks. The declaration section is for bank use like receiving/authenticating documents and approving the new account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    51 views2 pages

    Individual Customer Application Form: Fresh Thinking. Smart Banking

    Uploaded by

    Witchcraft
    The document is an individual customer application form for BancABC bank. It requests personal details like name, address, ID, employment information. It also requests account details like type of account, currency. The applicant must complete digital and payments platform registration. The form includes a FATCA questionnaire. By signing, the applicant declares the information is true and authorizes credit checks. The declaration section is for bank use like receiving/authenticating documents and approving the new account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Fresh Thinking. Smart Banking.

    INDIVIDUAL CUSTOMER APPLICATION FORM


    Please complete in CAPITAL LETTERS only. All sectons are mandatory. The application must initial each page

    ACCOUNT TYPE

    Customer Type New Customer Existing Customer

    Account Type Currrent Account Savings Account Call Account Term Deposit Account

    Joint Account Minor Account

    Account Currency ZWL Account USD (Nostro) ZAR EUR GPB BWP Other

    PERSONAL DETAILS

    Title Mr Mrs Miss Ms Prof Dr Other

    First Name Gender Male Female

    Middle Name Date of birth

    Surname ID Number

    Maiden Name Marital Status

    Country of
    Country of Residence
    Nationality

    Kindly provide us with your Passport Details below, if you are not a Zimbabwean citizen.

    Passport Number Passport Issue Date

    Passport Issuer Country Passport Expiry Date

    CONTACT DETAILS
    Residential Address Email Address

    Telephone/Mobile Number

    Other Address Years at current residence

    Account Currency Owned Company Owned Mortgaged Rented Staying With Parents Other

    EMPLOYMENT DETAILS
    Occupation

    Source of Funds/ Employer’s contact


    Employer Name person name

    Business Address
    Designation
    /Employer’s Address

    Telephone number

    Other Source of Funds Email address

    NEXT OF KIN DETAILS (The details of the person we can contact if we are unable to reach you)
    First Name(s) Residential Address

    Surname Telephone/Mobile Number

    Relationship Email address

    1
    Fresh Thinking. Smart Banking.

    DIGITAL AND PAYMENTS PLATFORM REGISTRATION


    Yes No
    1. Internet Banking Registration Email address

    Wallet Type e.g.


    2. Mobile Money/ Bank Account Linking Mobile Number
    EcoCash,Telecash

    3. Prepaid VISA Card Application Reason for


    New Application Supplementary Replacement
    replacement
    4. Local ATM Card (ATM/POS Card) New Application Supplementary Replacement Reason for
    replacement
    5. Transactional SMS Alerts
    Mobile Number E-statements Yes No

    6. e-Statements E-mail Address Statement Frequency

    Please complete in CAPITAL LETTERS only. All sectons are mandatory. The application must initial each page

    FOREIGN ACCOUNTS TAX COMPLIANCE ACT(FATCA) QUESTIONNAIRE

    Please confirm your FATCA status by checking the relevant boxes


    Yes No
    (a) Are you a U.S citizen or lawful permanent resident?

    (b) Were you born in the U.S?

    (c) Have you signed a Power of Attorney (PoA) or granted signatory authority to a person holding a US address

    (d) Will you be transferring funds to their U.S based accounts or receiving funds regularly from their US based accounts?

    (e) Do you or will you use an address “in care of” “hold mail” or postal address or telephone number allocate in the U.S?

    (f) Do you hold a green card?

    DECLARATION
    I , the undersigned, hereby declare that;
    The information in this application is true and complete and I authorise BancABC to verify (This includes contacting my employer to verify my income). I consent to
    BancABC checking my credit record with any credit reference agencies with regular updates about the conduct of my accounts including the failure to meet the
    agreed terms and conditions.) I also agree that the credit reference agencies may in turn, make my record and details available to other credit grantors. I consent
    to BancABC carrying out identity and fraud prevention checks.

    By ticking this box you agreed to be bound by the BancABC Payments PlatformsTerms and Conditions as well as our General Terms and Conditions.

    Customer Name

    Signing Instruction (e.g.to sign alone)

    Customer Signature Date

    DECLARATION

    Customer Onboarding Name Signature Date

    1. All documents received and checked by:

    2. Signature authenticated by:

    3. Acount Approved/Declined:

    4. Account captured in FCUBS by:

    5. Account authorised in FCUBS by:

    6. Signature/Signing Mandate/Photos scanned by

    7. Documents filed by: Passport Size Photo 1 Passport Size Photo 1

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