Investor’s Bank Account Update Form for Direct Settlement

INVESTOR’S BANK ACCOUNT UPDATE FORM FOR DIRECT SETTLEMENT CSCS Plc, Stock Exchange House (Floors 1, 12, 13, 14 & 15), 2/4, Customs Street, P.O.BOX 3168, Marina, Lagos State. E-Mail: info@cscsnigeriaplc.com Website: www.cscsnigeriaplc.com Telephone Number: + 234 (1) 9033551 (FORM 001)

ACCOUNT TYPE: PERSONAL [ ] CORPORATE [ ]
(Please Tick appropriately)

CLIENT’S DETAILS
NAME OF CLIENT (surname first) OR COMPANY’S NAME: …………………………………………………………………………………………………………………………………………… DATE OF BIRTH/CAC NO:………………………………………..……………………………………………………….. MOTHER’S MAIDEN NAME (where applicable)……..………………………………………………………….. ADDRESS…………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………………

CSCS ACCOUNT NUMBER | CLEARING HOUSE NUMBER
[ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] | [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ]

TEL. NUMBER: (1).………………………………………………………….. (2)……………………………………………………………………..
E-MAIL ADDRESS :( 1).………………………………………………………. (2)……………………………………………………………………..

SIGNATURE: (1)…….…………………….…………………………………. (2)…………………………………………………………………….
(For Corporate accounts, two authorized signatories must sign with their passports photographs affixed and company’s Seal appended on this form).

CLIENT’S BANK DETAILS (SETTLEMENT BANKS ONLY)
BANK NAME:……………………………………………………………………………………………………………………………………………….
BANK BRANCH……………………………………………………………………………………………………………………….…………………… ACCOUNT NUMBER: [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] | BANK VERIFICATION NUMBER (BVN): [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] TYPE OF ACCOUNT (Please tick the type of account) Current [ ] Savings [ ]

STOCKBROKING FIRM DETAILS.
MEMBER CODE: [ ] [ ] [ ] [ ]
STOCKBROKING FIRM:………………………………………………………………………………………………………………………………….

AUTHORISED SIGNATORIES & COMPANY’S STAMP (1).………………………….……………………………………….…………..
(2)………………………………………………………………………………..