Registration Form

KYC Registration Form

Personal Information

Title

Lastname

Firstname

Middlename

Gender

Marital Status

Residential Address

LGA

City

State

Country

Mobile Number

Email

Date of Birth

State of Origin

LGA of Origin

Place of Birth

Nationality

Mother's Maiden Name

Occupation / Nature of Business

Next of Kin

Next of Kin

Address of Next of Kin

Mobile Number

Email

Identification

Valid Means of Identification

ID Number

Issue Date

Expiry Date

Bank Details

Bank Name

Branch

Account Name

Account Number

Date Account Opened

Type of Account

BVN

Agreements

I agree to the Terms and Conditions here

I agree to the Anti Money Laundry Act here