Mandate authorization (Please tick as appropriate)
Sole Signatory
Either to Sign
Both to Sign
Name
Surname
Other Name
Class of Signatory
Identification Type
Identification No.
Telephone Number
Date
For Bank use only
For Bank use only
9
ACCOUNT SERVICES(S) REQUIRED (Please tick the applicable option below)
Card Preferences
ATM Card
E-zwich
Electronic Banking perferences
Mobile Banking
GnahaPay
Transaction Alert Preference
Email Alert
SMS Alert
Statements to be collected at the Branch/Agency
Semi-Annually
Annually
10
DECLARATION / DISCLOSURE
DECLARATION
I/We hereby apply for the opening of account(s) with OKOMFO
ANOKYE RURAL Bank plc.
I/We understand that the information
given herein and the documents supplied are the basis for opening such account(s)
I/We therefore confirm that such information is correct.
I/We further undertake to indemnify the Bank for any loss suffered as a result of
any false information provided to the Bank.
DISCLOSURE TO CREDIT REFERENCE BUREAUX
The Bank will obtain any information about you from the credit reference bureaux to
check your credit status and identity. The bureaux will record our enquiries which
may be seen by other institutions that make their own credit enquiries about you.
The Bank shall also disclose your credit transactions to credit reference bureaux in
accordance with the Credit Reporting Act, 2007 (Act 726).
Name:
Date
Name:
Date
11
(THIS SHOULD BE
ADOPTED WHERE THE APPLICANT IS NOT LITERATE AND THE FORM IS READ TO HIM OR HER BY A
THIRD PARTY
I agree to abide by the content of this agreement and acknowledge that it has been
truly and audibly read over and explained to me by an interpreter.
Date:
Name And Address Of Interpreter:
Language of Interpretation:
1 REQUIREMENT
CHECKLIST
#
DOCUMENTS REQUIRED
CHECKED
DEFERRED
WAIVED
1
Duly completed Account opening form.
2
Specimen signature card duly completed
3
Recent passport photograph
4
Proof of identity: International passport, Driver’s license or
National Health card, Valid Ghanaian Voters ID (original must be
signed)
5
Resident Permit (for non-Ghanaian)
6
Proof of Address: Utility bills etc. (Certified true copy is
acceptable if the original is not held)
7
Letter from Employer / School (for salary account and or student
only)
Fixed/Current/Fixed Investment Other Type Of Account
#
DOCUMENTS REQUIRED
CHECKED
DEFERRED
WAIVED
1
2
3
4
5
6
7
AUTHENTICATION FOR
FINANCIAL INCLUSION
Is the customer socially or financially disadvantaged
Yes
No
if answer to the question (i) above is YES, state other documents obtained
in line with the Bank’s policy on social/financially disadvantaged customer
in compliance with paragraph
of AML/CFT
Regulation,
Does the Customer enjoy tiered KYC requirement?
Yes
No
If answer to question (iii) above is YES, identify the
customer risk category
Low Risk
Medium Risk
High Risk
3 AUTHENTICATION FOR
POLITICALLY EXPOSED PERSONS
Is the Applicant a Politically Exposed Person?
Yes
No
A. ACCOUNT OPENED
BY:
Name
Date
B. DEFERRAL/WAIVER OF
DOCUMENT (IF ANY) AUTHORISED BY: :