Individual Account Opening Form

Account Opening Requirements

SCANNED COPY OF IDENTIFICATION OF SIGNATORY(IES) (E.G. INT’L PASSPORT, DRIVERS’ LICENCE, PERMANENT VOTER’S CARD, NIMC CARD – NATIONAL ID CARD)

PROOF OF ADDRESS (E.G. ELECTRICITY BILL, WATER BILL, WASTE BILL OR TELEPHONE BILL)

BIRTH CERTIFICATE (FOR MINOR ACCOUNT)

CERPAC/RESIDENT PERMIT (FOR FOREIGNERS)

Type Of Account

Individual Joint Estate

1. Personal Information

MOTHER'S MAIDEN NAME

COUNTRY OF RESIDENCE

MEANS OF IDENTIFICATION

Driver's License International Passport National ID Card Permanent Voter's Card

NATIONAL IDENTIFICATION NUMBER (NIN)

CERPAC/RESIDENT PERMIT NUMBER

Do you have other country’s passport other than Nigerian?

Yes No

If yes, please state the country

3. Employment Information

Paid Employment Self Employed Retired Others (Please Specify)

If others, please specify

EMPLOYER/ NATURE OF BUSINESS

EMPLOYER/BUSINESS ADDRESS

EMPLOYER/ BUSINESS TELEPHONE NUMBER

EMPLOYER/ BUSINESS EMAIL ADDRESS

Source of Fund/Wealth: Employment

Paid Employment Self Employed Retired Others (Please Specify)

If others, please specify

Monthly Salary/Income range

₦0-500,000.00 ₦501,000.00-1,000,000.00 ₦1,001,000.00-1,500,000.00 ₦2,001,000.00 and above

4. Bank Account Details

Bank Verification Number (BVN)

5. Joint Account Holder

Relationship with Joint Account Holder

Name of Joint Account Holders

6. Next of Kin Details

7. Initial Investment

Initial Investment (N)

Mode of Initial Opening Investment

Cheque/Draft Share Certificates/Demat Intermember Transfer Electronic Funds Transfer

Clearing House Number (CHN) (if you have another Stockbroking account)

8. Online Access & Research/Market Reports

Online Access & Research/Market Reports

Activate online access Direct Market Access Research Reports Market News

(a) Are you a Director, 10% shareholder or someone who has the ability to direct the affairs of a public company?

Yes No

If yes, state company’s name

(b) Have you held any political post?

Yes No

If yes, please state the most recent political post held

Have any of your close relatives/friends/associates held a political post?

Yes No

If yes, please state the most recent political post held

10. Attestation & Signature

I/We hereby confirm that:

(a) All information provided by me/us herein is true and accurate, I/We have not withheld any material fact. Any changes will be communicated promptly to Quantum Zenith Securities & Investments Limited for the update of my/our profile.

(b) I/We authorise Quantum Zenith Securities & Investments Limited to carry out relevant checks in relation to my/our personal information that is provided herein for account opening.

c) I/We agree to be contacted by Representative(s) of Quantum Zenith Securities & Investments Limited for verification of my/our personal details to discuss trade instructions which may be time and price sensitive. Quantum Zenith Securities & Investments Limited may use my/our e-mail address(es) to send me/us information such as trade confirmations and other important notifications. My/our failure to provide Quantum Zenith Securities & Investments Limited with valid email address will limit my/our ability to receive the above.

Please select as appropriate

SOLE SIGNATORY BOTH TO SIGN EITHER TO SIGN

Terms and conditions

Please tick this box to accept our terms and conditions

1. Corporate Information

Date of Incorporation/Registration

Place of Incorporation

Company’s Mailing Address

Company’s E-mail Address

Country of Residence

Purpose of Investment

Source of Investment Fund

2. Bank Account Details

4. Initial Investment (N)

Mode of Initial Opening Investment

Cheque/Draft Share Certificates/Demat Intermember Transfer Funds Transfer

Clearing House Number (CHN) (if you have another Stockbroking account)

5. Enhanced Due Diligence

Have any Directors, Signatories, or individual associated with this company or any of their immediate family members held any political post?

Yes No

If yes, please state their names and their relationship with such persons.

6. Online Access & Research/Market Reports

Activate online access Direct Market Access Research Reports Market News

We hereby confirm that:

(a) All information provided by us herein is true and accurate, we have not withheld any material fact. Any changes will be communicated promptly to Quantum Zenith Securities & Investments Limited for the update of our profile.

(b) We authorise Quantum Zenith Securities & Investments Limited to carry out relevant checks in relation to our personal information that is provided herein for account opening.

(c) We agree to be contacted by Representative(s) of Quantum Zenith Securities & Investments Limited for verification of our personal details to discuss trade instructions which may be time and price sensitive. Quantum Zenith Securities & Investments Limited may use our e-mail address(es) to send us information such as trade confirmations and other important notifications. Our failure to provide Quantum Zenith Securities & Investments Limited with valid email address will limit our ability to receive the above.

8. Authorized Signatory & Signature Mandate

CONTACT US

02012781204 - 5
enquiries@quantumzenithsecurities.com.ng

12th Floor, Plot 2, Ajose Adeogun Street,
P.O.Box 75315, Victoria Island, Lagos.

Individual Account Opening Form

CONTACT US

02012781204 - 5
enquiries@quantumzenithsecurities.com.ng

Resource Center

QUICK LINKS

Individual Account Opening Form

CONTACT US

02012781204 - 5 enquiries@quantumzenithsecurities.com.ng

Resource Center

QUICK LINKS

02012781204 - 5
enquiries@quantumzenithsecurities.com.ng