GCB Link2Home Account - UnityLink

1 GCB Link2 Home AccountAccount opening form (Individual)GCB/ILKHAF/2014/021 Account NameAccount BankerCustomer ICDate D D M M Y Y Y YAccount opening Requirements One (1) passport-sized photograph Valid Photo ID (Passport / Driver s License / National ) Proof of Address (Utility Bill / Employer s Reference / Income Tax Certificate / Tenancy Agreement): Not Older than six (6) months Trust Deed Vailid of Trustee to be verified against Trust Deed1 General Account InformationPersonal DetailsSurnameFirst NameGenderMaleSingleSeparatedFemaleMarri edDivorcedWidowedMarital StatusNationalityCountry of OriginPurpose of Account (1)TransactionalTransactionalPersonal SavingsPersonal SavingsInvestmentInvestmentFixed DepositNegotiable Certificate of DepositPremium Certificate of DepositOtherPurpose of Account (2)Investment OptionSavings Account (1)Current Account (1) Account typeOther Name(s)Maiden Name (if applicable)Mother s Maiden NameChildrenOthersNo.

2 Of dependantsPlace of BirthDate of Birth D D M M Y Y Y Y $ Currency $$ CurrencyCurrencyTitle Dr. Mr. Miss. Mrs. OtherCountry of ResidenceHome TownProfession / OccupationName of Spouse(s)Spouse EmploymentUndergraduatePost GraduateGraduateEducational StatusNon StudentOthersFor United States (US) NationalsNoYesAre you a US National?NoNoNoNoYesYesYesYesAre you a US Resident Alien?Do you intend to use your Account for investments purposes?Do you have investments / intend to invest in Ghana?If Yes (to any of the above), do you file US Taxes?If No, please explain2 Contact DetailsValid means of Identification (please tick and provide relevant details)National IDDriver s LicencePassportVoter IDOther (specify)NumberNumberNumberNumberNumberI ssue DateIssue DateIssue DateIssue DateIssue DateExp.

3 DateExp. DateExp. DateExp. DateExp. DateHouse AddressPost CodeEmailResidential Address In GhanaStreet NameNearest LandmarkCity / TownSuburbResidential Address (Abroad)Address for CorrespondenceStreet AddressCityStateMobile Tel. NoPermanent residential address (If different from above)3 Title To ResidenceMortgagedOutright OwnershipRentedLeaseOther (please specify)Employment DetailsAccount Service(s) Required (please tick applicable options below)ReadyCash CardVisa ClassicPrepaidOther (specify)Card preferencesMasterCard StandardMasterCard GoldInternet BankingElectronic banking preferencesOnline purchases:Verified by VisaMasterCard SecureCodeOther eBanking ProductsTransaction Alert Preferencese-Alert Address:Collection At BranchStatement PreferenceEmailPostalSemi-AnnuallyStatem ent FrequencyMonthlyQuarterlyAnnuallyCheque / Savings Withdrawal Book Requisition25 Leaves50 LeavesTick as appropriateEmployedRetiredSelf-EmployedS tudentOther (specify)Nature of BusinessNumber of years with Current EmployerEmployer s Email Address Or WebsiteUnemployedEmployer s NameEstimated Net WorthEmployer s AddressNearest LandmarkOffice Phone NumberCity / TownCashChequeDirect CreditMode Of Salary PaymentLess than 1,0001,000 - 5,0005,001 - 10,000 More than 10,000 Wage/Monthly Salary (in stated currency)4 Details Of Next Of Kin (In case of emergency)Details of Next of Kin (In case of emergency)Additional Details (Trust / Minor Account )Full Name of Beneficial owner(s) of the Account (if applicable)

4 (Beneficial owner is a person who enjoys the benefits of ownership even though title is in another name) D D M M Y Y Y YDate of BirthDeposits (Funds Inflow) Account (2) if applicableTransaction typesExpected No. of transactions per monthExpected Amount per month GH 1-56-1011 and above1-20005001 & Above2001-50001-56-1011 and above1-20005001 & Above2001-5000 Withdrawals (Funds Outflow) Account (2) if applicable1-56-1011 and above1-20005001 & Above2001-50001-56-1011 and above1-20005001 & Above2001-5000 Source of FundsSalaryPersonal SavingsInvestmentOther (specify)Expected Account ActivityName Of Associated Business(es) (if applicable)Type Of Associated BusinessLine Of BusinessSurnameFirst NameGenderMaleFemaleOther Name(s)Relationship to Next of KinPhone No.

5 1 Phone No. 2 House AddressCity / TownTitle Dr. Mr. Miss. Mrs. OtherAssociated Business Address% HoldingSuburb5 Internet Banking ApplicationFull Name of CustomerAny Former Name(s)Postal AddressEmailNationalityResidential AddressTelephone Num-ber(s)Please state all your GCB Account numbers you want to be linked to this have carefully read & accepted the GCB Internet Banking Terms & Conditions (Overleaf).(Where the form is submitted at another branch instead of one s branch, an ID - Passport / Voter s / Driver s License will have to be provided)Applicant s SignatureDateProfession/Occupation Account Name Account Number Tick D D M M Y Y Y Y6 Mandate authorisation (please tick as appropriate) Name(s) and mark(s) of signatoriesName _____ Signature _____ Date _____Name _____ Signature _____ Date _____Note: In case of Joint Account , 2nd applicant is required to complete a second Account opening form and attach opening MandateSole SignatoryEither To SignBoth To SignOther (Specify) Account (s) held with GCB and other BanksName and address of Bank / Branch Account Name Account NumberI hereby apply to open Account (s) with _____ branch.

6 I understand that the information given herein and the documents supplied are the basis for opening such Account (s) and I therefore warrant that such information is further undertake to indemnify the Bank for any loss suffered as a result of any false information or error in the information provided to the Bank. Disclosure to Credit Reference BureausThe Bank will obtain information about you from the Credit Reference Bureaus to check your credit status and identity. The bureaus will record our enquiries which may be seen by other institutions that make their own credit enquiries about Bank shall also disclose your credit transactions to credit reference bureaus in accordance with the Credit Reporting Act, 2007 (Act 726)Name _____ Signature _____ Date _____Name _____ Signature _____ Date _____Declaration7 Customer information gathered for and on behalf of GCB by.

7 Name of Agent _____Registered Address of Agent _____Name of Local Supervisor (Regulator) of Agent _____ Signature / Stamp of Agent _____Date _____For GCB Agent (Abroad) only8 CUSTOMER S SPECIMEN SIGNATURE (sign three times in the box below)NAME IN FULLSIGNATURE AND RECENT PASSPORT-SIZED PHOTOGRAPHDOCUMENTS REQUIRED (Original IDs / Documents must be seen)CHECKEDDEFERREDWAIVEDN/A1 Duly Completed Account opening Form2 Specimen Signature Card Duly Completed3 Recent Passport-Sized Photograph4 Proof of Identity: Passport / Driver s Licence / Social Security Card / Other5 Proof of Address: Utility Bill water, electricity6 Agent s endorsementFOR BANK USE ONLY1. REQUIREMENT CHECKLIST2. AUTHENTICATION FOR POLITICALLY EXPOSED PERSONSIs the Applicant a Politically Exposed Person (PEP) or associated with PEP?

8 If customer is closely associated, state relationship _____KYC / Risk Profile:3. INITIAL DEPOSIT Initial Deposit By:4. Account OPENED BY Name _____ Signature _____ Date _____5. DEFERRAL/WAIVER OF DOCUMENT (IF ANY) AUTHORISED BYName _____ Signature _____ Date _____NoYesLow RiskMedium RiskHigh RiskCashTransferAmount: _____96. DOCUMENT VERIFICATION CARRIED OUT BY:Name _____ Signature _____ Date _____Comments _____7. Account opening AUTHORISED/APPROVED BY:Name _____ Signature _____ Date _____8. FOR PEP CUSTOMERS, REFER TO HEAD RISK MGT. DIVISION / COMPLIANCE FOR _____ Name _____Designation _____ Designation _____Signature _____ Signature _____Date _____ Date _____101. The Bank The information on this page (and any further instructions and conditions that may be prescribed by the Bank from time to time) are the terms of the agreement between you and GCB.

9 When you sign the Account opening form you accept these terms as binding on The Account The hours of business will be advertised from time to time. You assume full responsibility for the genuineness, correctness and validity of all endorsements appearing on all cheques, orders, bills, notes, negotiable instruments and receipts or others deposited in the Account . The Account may be debited for any service charge that is set by the Bank from time to time. All notices or letters will be sent to the address supplied by you and will be considered duly delivered and received at the time it is posted. Notices in the press will be deemed sufficient for this purpose. The Bank will not be liable for funds handed over to any person other than the Bank s Cashier/Teller for the credit of your Account .

10 Any anomaly in the entries on your Bank statement must be brought to the attention of the Bank within 21 days of the date thereof and you agree that failure to give such notice absolves the Bank from all liabilities arising there from. The Bank may exercise its general lien or any similar right it is entitled to by or consolidate all or any of my accounts with any liabilities to the Bank and set off or transfer any sum or sums standing to the credit of anyone or more of such accounts or any other E-Alert / SMS Alerts Where requested, the Bank may provide e-Alert / SMS Alerts or other similar service to provide information on transactions. The service is provided As Available and without any warranty of fitness for a specific purpose.