1997 2017 20 YEARS OF ACHIEVEMENT tbl Trust Bank Ltd. ACCOUNT OPENING FORM FOR: INDIVIDUAL ACCOUNT JOINT ACCOUNT MINOR ACCOUNT OTHERS (SPECIFY):... ACCOUNT NAME:......... BRANCH CODE: ACCT. NUMBER: ACCOUNT OPENED: ACCT. UPDATED ON:
ACCOUNT OPENING DOCUMENTATION Trust Bank is under an obligation to request specified information from you that is prescribed by national laws and regulations and /or international standards. In obtaining such information, the Bank is fulfilling its commitment towards global efforts to combat money laundering, terrorist financing and fraudulent activity. We strongly believe that such measures also ensure that adequate safeguards are in place to help in keeping your finances safe and secure at all times. Whilst anticipating your understanding and cooperation in furnishing the required documents, we wish to thank you for taking the time and effort to do so. If you have any questions relating to the Account Opening Form, please contact an Account Opening Officer at any of our branches who will be pleased to assist you. One (1) recent passport size photograph REQUIREMENTS Valid Photo ID for example Biometric ID Card /Current Passport / Biometric Driver s Licence Proof of address; for example Utility Bill From Nawec; Gamtel; Statement from Village Chief / Alkalo; Rent Payment Receipt; Tenancy Agreement and or; Landloard s contact Details Trust Deed (where applicable) Valid ID of each Trustee 1 Birth certificate for Minors Residential/work permit Letters of Probate/Administration (where applicable) Tax Identification Number (TIN) Certificate Note: Original documents must be sighted *If three or more persons are applying for Joint Account, supplementary forms must be filled.
I/We request you to open a Savings/Current/Fixed Deposit/Foreign Currency Denominated and Treasury Bills account in my/our name (s) with your Bank. I/we agree to abide by the Bank s rules governing the conduct of such accounts. CUSTOMER SPECIMEN SIGNATURE / THUMBPRINT (Please insert your name as it appears on your identification document and sign or thumbprint two times in the box bellow) 1 st APPLICANT / TRUSTEE 2 nd APPLICANT / TRUSTEE / MINORS NAME: PHOTO SIGNATURES/THUMBPRINT NAME: PHOTO SIGNATURES/THUMBPRINT 1. 1. 2. 2. 2
PERSONAL DETAILS 1 ST APPLICANT / TRUSTEE Surname(s) Mr. Mrs. Ms:.... Other Name(s):... Sex: MALE FEMALE Date of Birth: Marital status: Single Married Separated Widowed Divorced Name of Spouse... No. of Children... Nationality:... Domicile Country:.. Address/Landmark in vicinity:............... No. of years at current address:... Contact Person:.. Contact Person s No:.. Mobile E-Mail Address.. Relationship:.. 3
IDENTITY DETAILS ID DOCUMENT DOCUMENT NUMBER EXPIRY DATE CURRENT PASSPORT BIOMETRIC NATIONAL ID BIOMETRIC DRIVER S LICENCE BIOMETRIC RESIDENCE / WORK PERMIT OTHERS Is your residence: Owned Mortgage Owned Rented Others (Specify):... Address confirmed by: Utility Bill Cash Power Village Chief /Alkalo Cash Power Meter No. Others (specify):... Date: 4
EMPLOYMENT DETAILS OCCUPATION:... TYPE OF EMPLOYMENT SELF EMPLOYED GOVERNMENT PRIVATE COMPANY MULTINATIONAL PUBLIC COMPANY OTHERS (SPECIFY):... EMPLOYER S NAME:... EMPLOYER S ADDRESS:... JOB TITLE:...TIN NUM.:... YEAR EMPLOYED:... WAGE/MONTHLY SALARY: D... FREQUENCY OF PAYMENT DAILY WEEKLY MONTHLY BI-WEEKLY OTHER (SPECIFY):... MODE OF PAYMENT: CASH DIRECT CREDIT CHEQUE INFLOWS BANK DETAILS Do you currently hold an account with TBL? Yes Account No: No 5
PRODUCT SELECTED Current Savings Fixed Deposit FCD Student Savings Student Current CURRENCY OF ACCOUNT GMD USD GBP EUR PURPOSE OF ACCOUNT Personal Savings Investments Salaries Transactional Other (please specify): SOURCE OF FUNDING Salaries Personal Savings Investments Remittances Other (please specify):. EXPECTED VOLUME & TYPE OF ACTIVITY TRANSACTION TYPE ANTICIPATED NUMBER OF TRANSACTIONS PER MONTH ANTICIPATED AMOUNT PER MONTH DEPOSITS INCLUDING INWARD TRANSFERS 1-5 6-10 11 & above 1-10,000 10,001-50,00 50,001 & above WITHDRAWALS INCLUDING OUTWARD TRANSFERS 1-5 6-10 11 & above 1-10,000 10,001-50,00 50,001 & above STATEMENT FREQUENCY Monthly Quarterly Yearly On Request MODE OF DELIVERY Email E-Statement Pick-up at Branch 6
PERSONAL DETAILS 2 nd APPLICANT / TRUSTEE Surname(s) Mr./Mrs./Ms:... Other Name(s):... Sex: MALE FEMALE Date of birth: Marital Status: Single Married Separated Widowed Divorced Name of Spouse... No. of Children... Nationality:... Domicile Country:... Address/Landmark in Vicinity:......... No. of years at current address:... Contact Person:.. Contact Person s No:.. Mobile E-Mail Address.. Relationship:.. 7
IDENTITY DETAILS ID DOCUMENT DOCUMENT NUMBER EXPIRY DATE CURRENT PASSPORT BIOMETRIC NATIONAL ID BIOMETRIC DRIVER S LICENCE BIOMETRIC RESIDENCE/ WORK PERMIT OTHERS Is your residence: Owned Mortgage Owned Rented Others (Specify):... Address confirmed by: Utility Bill Cash Power Village Chief / Alkalo Cash Power Meter No.: Others (specify):... Date: 8
EMPLOYMENT DETAILS OCCUPATION:... TYPE OF EMPLOYMENT SELF EMPLOYED GOVERNMENT PRIVATE COMPANY MULTINATIONAL PUBLIC COMPANY OTHERS (SPECIFY):... EMPLOYER S NAME:... EMPLOER S ADDRESS:... JOB TITLE:... TIN NUM:... YEAR EMPLOYED:... WAGE/MONTHLY SALARY: D... FREQUENCY OF PAYMENT DAILY WEEKLY MONTHLY BI-WEEKLY OTHERS (SPECIFY):... MODE OF PAYMENT: CASH DIRECT CREDIT CHEQUE INFLOWS 9
BANK DETAILS Do you currently hold an account with TBL? Yes No Account. no: PRODUCT SELECTED Current Savings Fixed Deposit FCD Student Savings Student Current CURRENCY OF ACCOUNT GMD USD GBP EUR PURPOSE OF ACCOUNT Personal Savings Investments Salaries Transactional Others (please specify): SOURCE OF FUNDING Salaries Personal Savings Investments Remittances Other (please specify):. 10
TRANSACTION TYPE EXPECTED VOLUME & TYPE OF ACTIVITY ANTICIPATED NUMBER OF TRANSACTION PER MONTH ANTICIPATED AMOUNT PER MONTH DEPOSITS INCLUDING INWARD TRANSFERS 1-5 6-10 11 & above 1-10,000 10,001-50,00 50,001 & above WITHDRAWALS INCLUDING OUTWARD TRANSFERS 1-5 6-10 11 & above 1-10,000 10,001-50,00 50,001 & above STATEMENT FREQUENCY Monthly Quarterly Yearly On Request MODE OF DELIVERY Email E/Statement Pick-up at Branch CUSTOMER S INSTRUCTION Please debit my/our account with the applicable charges, interest, commission etc. and issue me/us with a cheque book containing...leaflets. DECLARATION I/We understand that the particulars I/We have provided in the document form the basis of opening the account and therefore warrant that the particulars are correct. I/We agree to be bound by the Terms and Conditions governing the operation of the account. In compliance with local regulatory and statutory requirements, the Bank has the right to make information on the account available to the Central Bank of The Gambia, Bankers Association, the GFIU and other law enforcement agencies when required to do so. Name of first applicant:... Signature/thumbprint:... Name of second applicant:... Signature/thumbprint:... Date: 11
PERSONAL DETAILS OF MINOR BENEFICIARY Surname:... Other Name (s):... Guardian (If different from trustee)... Address:... Contact Details:... Sex: Male Female Date Of Birth: (Please insert minor s beneficiary s name as it appears on His or Her Birth Certificate. PHOTO OF MINORS PHOTO OF MINORS PHOTO NAME:... AGE:... PHOTO NAME:... AGE:... PHOTO PHOTO 12 NAME:... AGE:... NAME:... AGE:...
ATTESTATION CLAUSE Marked/Signed by the applicant in the presence of... (member of staff) after the contents of the Account Opening Form had been read, interpreted and explained to him/her in the......dialect/language by...of P.O.Box/House No...;in the...region of The Gambia and Applicant seemed perfectly to understand and approve the same before he/she thumbprinted / signed... WITNESS...staff opening account interpreter...independent person. JOINT ACCOUNT HOLDERS (ONLY) SURVIVORSHIP CLAUSE: any money for the time being standing to the credit of our Joint Account shall be held to the order of the survivors. JOINT AND SEVERAL LIABILITIES: any liability incurred by Joint Account Holders to the Bank, whether in the form of borrowing or otherwise shall be joint and several. Transactional Mandate (Please tick appropriate box); (Please note that this mandates only to transactions. For all other instructions all joint account holders must append their signature to the instrument conveying the instruction) (1) Both to sign (2) Either to sign 13
FATCA DETAILS OF US PERSONS / ENTITIES (Please tick appropriate) Are you a US citizen or permanent resident? Yes No Is your entity a member of a corporation that is incorporated in the US or aliens lawfully admitted for permanent residence? Yes No Does your company intend to use the account for investment purposes? Yes No If Yes( to any of the above), do you file US taxes? Yes If No, Please explain: No 14
DETAILS OF ADDITIONAL SIGNATORIES SIGNATORY 1 SIGNATORY 2 PHOTO PHOTO NAME: SIGNATURES/THUMBPRINT 1. 2. NAME: 1. 2. SIGNATURES/THUMBPRINT Surname(s) Mr. Mrs. Ms:.... Other Name(s):... Sex: M F Date of Birth: Address... Contact Number:... Email Address:... ID DOCUMENT DOCUMENT NUMBER EXPIRY DATE 15
DORMANT ACCOUNT REACTIVATION CUSTOMER INFORMATION UPDATE Account Name Account Number Account Number 2 Branch Branch Phone Number(s) Address / Land Mark in Vicinity Address confirmed DOCUMENT TYPE Email Address Reason for Account Dormancy Transaction Type Withdrawal Deposit Transaction Amount Currency Type: GMD $ Amount in Words Kindly attach Minutes of Board Resolution or duly executed letter authorising reactivation for non-individual accounts. I / We hereby authorise Trust Bank Limited to reactivate this account (s) which has been inactive. I / We confirm that the above information is correct and also agree My / Our above account (s) shall be subject to the terms and conditions applicable by the Bank to such account as may be amended from time to time. Authorised Signature: Date: DOCUMENT NUMBER Authorised Signature: Date: Authorised Signature: FOR BANK USE ONLY Customer Information Updated By: Acct. Opening Officer: Signature Signature verified by: BM / Supervisor: Signature Date: Date: Date: 16
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FOR OFFICIAL USE KYC INFORMATION 1 ST APPLICANT S RISK LEVELS LOW RISK CUSTOMER Ordinary individual resident in The Gambia and not associated with any PEP Does not reside / operates in high risk country Funding is sourced from normal activities MEDIUM RISK CUSTOMER If the applicant or authorized signatories fall into any type of account that is not listed under low risk (above) or high risk (below) HIGH RISK CUSTOMER Customer is a PEP or closely associated with a PEP. Please specify details of PEP position or relationship with the applicant. The applicant resides / operates in a FATF designed Non-Cooperative countries & territories. please specify country. The applicant s source of funds is from high risk jurisdiction. Please specify country... Applicant s business involves transfers / exchange of funds, mineral prospecting / trade, arms and ammunition, game of chance, real estate, dealing in motor vehicles. SOURCE OF FUNDS Applicant s fund is generated from:- Business Ownership Investments Income 18
Inheritance / Gift Donations Others (Please specify)... Estimated annual income or sales turnover: GMD.. FOR OFFICIAL USE KYC INFORMATION 2 nd APPLICANT S RISK LEVELS LOW RISK CUSTOMER Ordinary individual resident in The Gambia and not associated with any PEP Does not reside / operate in high risk country Funding is sourced from normal activities MEDIUM RISK CUSTOMER If the applicant or authorized signatories fall into any type of account that is not listed under low risk (above) or high risk (below) HIGH RISK CUSTOMER Customer is a PEP or closely associated with a PEP. Please specify details of PEP position or relationship with the applicant. The applicant resides/operates in a FATF designed Non-Cooperative countries & territories. Please Specify country. The applicant s source of funds is from high risk jurisdiction. Please specify country.. Applicant s business involves transfers/exchange of funds, mineral prospecting/trade, arms and ammunition, game of chance, real estate, dealing in motor vehicles. 19
SOURCE OF FUNDS Applicant s fund is generated from:- Business Ownership Investments Income Inheritance/Gift Donations Others (Please specify)... Estimated annual income or sales turnover: GMD. FOR OFFICIAL USE CHECKLIST FOR DOCUMENTATION NO DOCUMENTS REQUIRED CHECKED DEFERRED DATE OF RECEIPT OF DEFERRED DOCS. 1 Duly completed Account Opening Form 2 Specimen signature card duly completed 3 One (1) recent passport size photograph 4 Original valid ID card/current passport/biometric Driver s licence sighted 5 Proof of address 6 Trust Deed (where applicable) 7 Original Valid ID of each trustee sighted 8 Reference / Work Permit 9 Original Letter of Probate / Administration (where applicable) sighted 10 TIN certificate 11 Have you sold E-Banking products to the customer? 12 Birth Certificate for Minors 20
E-BANKING PRODUCTS ATM Card to be picked up at Branch ONLINE BANKING I/We would like to select the following facilities (Please Tick): Own Account Funds Transfer Internal Funds Transfer Bill Payment Stop Cheque Payment Stop ATM Card Salary Upload Number of users and their limits for each transaction (Please tick): Make Transaction Verify Transaction Authorize Transaction Email Address User s Name User 1...... User 2...... User 3...... MOBILE BANKING USSD Gamcel Line... Africell Line... TBL APP Gamcel Line... Africell Line... Qcell Line... Comium Line... E-ALERTS 21 SMS ALERT Email Alert E-Statement Frequency: Weekly Quarterly Yearly
FOR OFFICIAL USE ACCOUNT OPENING OFFICER NAME / DESIGNATION / SIGNATURE: COMMENTS: REVIEWING OFFICER: NAME / DESIGNATION / SIGNATURE : COMMENTS: IF APPLICANT FALLS UNDER HIGH RISK CATEGORY ABOVE THE APPROVAL OF THE MANAGING DIRECTOR OR COMPLIANCE OFFICER OR THEIR APPROVED APPOINTEES MUST BE SOUGHT. NAME:... DESIGNATION:... SIGNATURE:... DATE: BRANCH MANAGER S COMMENTS I certify that the information provided conforms to the Bank s laid down policy on the requirements for opening an account. Applicant s Name Screened? Yes No NAME:... SIGNATURE:... DATE: 22
1. At no time and under no circumstance to disclose to any person the pin number/s allotted to me/us. 2. To immediately notify the Bank of the loss or theft of the card. TERMS AND CONDITIONS 10. The Bank will not be responsible for the card not being honored for any reason whatsoever. 11. To return the card for cancellation should it be no longer required or should my/our account with the Bank for any reason be closed. 3. At all time to regard the card as property of the Bank and to surrender it unconditionally and without reservation upon demand by the Bank. 4. At no time to use or attempt to use the card unless there are sufficient funds in my/our account to cover the withdrawal or transfer. 5. To restrict use or attempt to use the card exclusively to the person named overleaf as it is not transferable. 6. Not to use or attempt to use the card after any notification of its cancellation or withdrawal has been given to me/us by the bank or by any person acting on behalf of the Bank. 7. To accept full responsibility for all transactions processed from the use of the card except any transactions occurring after the Bank shall have confirmed to me/us that it has received notice of loss or theft of the card or of unauthorized acquisition of the pin number. 12. That the Bank shall be at liberty to terminate the facility at any time without notice to me/us 13. Cash and/or cheques deposited by use of the card will only be credited or my /our account after verification by the Bank. The statement issued by the automated teller machine/point of sales terminal at the time of deposit will only represent what I / we purport to have deposited and shall not be binding on Bank the Bank is count of the amount contained in the envelope shall be conclusive only and the proceeds will not be available for drawing until the cheques are cleared and realized. 14. Joint account holders are inter alia jointly & by severally bound by these terms and conditions and are liable for all transactions processed the use of card. 15. All rules and regulations governing the operation of current, savings or any other account shall be applicable to card transactions relating to such accounts.. 8. To acknowledge that the amount stated on the ATM/pos terminal screen or a printed inquiry slip or receipt advice shall not for any purpose whatsoever be taken as conclusive of the state of my/our account with the Bank. 9. Not to hold the Bank liable, responsible or accountable in any way whatsoever for any loss or damage however arising, caused by any malfunction or failure of the card or the ATM/ POS Terminal or the insufficiency of funds in the ATM. 16. I / we undertake not to use this card to make payment for purchases of real estate or financial assets overseas. 17. The Bank reserves the right to vary these terms and conditions. Customers signature 23 Date:
tbl Trust Bank Ltd. P R O U D L Y G A M B I A N L A T I V S A R T The Bank may introduce such charges as appropriate 24 D T L G N DI