If you hold or have held a prominent public function or you are a senior public officer in government or the military within the Federation or abroad, or you are related to such a person, please provide the position (present or past) or the name of the senior public officer you are connected to, associated with or a family member of:
(N.B. Consent refusal may result in us not being able to perform or continue to perform our contractual obligation with you.)
Where I have provided to the Bank, Personal Data of any person other than myself, I hereby represent and warrant that I have informed him/her of the purposes for which his/her Personal Data is collected, used and disclosed and obtained his/her necessary consent.
By signing below, you agree to the Terms and Conditions stated on the Application Form of the Bank’s products/ services and provide consent to the Company to obtain your Personal Data from other sources, including service providers and/or business partners who are third parties, and other persons such as your referrals, former employers, and other publicly available sources.
I, {name} of, {residentialAddress} hereby declare under penalty of perjury, that all information provided in support of this application is true and correct to the best of my knowledge and belief, and confirm that the Bank is entitled to verify same directly or through any third party. I also agree that, if any such declaration made by me is found to be incorrect, the Bank is not bound to pay any interest on the account(s) opened by me, and is entitled to terminate the account relationship.I confer authority on the Bank to disclose information and data relating to my account as part of relevant statutory and regulatory mandates on a confidential basis to any agency duly authorized by law, rule or regulation without any further consent or authorization from me.
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