As-Is forms

7/31/2019 As-Is forms

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Form Name S.No Field Name

Res/Curr Reserve/Current/Flip/Call Account Opening Form

Res/Curr Branch Details

Res/Curr 1 Branch Name

Res/Curr 2 Branch Code

Res/Curr 3 Sr. No

Res/Curr

8 Existing customer/Serial Number of new app form

Res/Curr Please open My/Our Reserve/Current/Flip/Call Account. Tick below:

Res/Curr 9 Reserve Account

Res/Curr 9a

Res/Curr 9b

Res/Curr 9c

Res/Curr 9d

Res/Curr 10 Current AccountRes/Curr 10a

Res/Curr 10b

Res/Curr 10c

Res/Curr 11 Type: Local

Res/Curr 12 Type: Forex

Res/Curr 13 Type: Foreign

Res/Curr 14 If Forex/Foreign indiacte : US Dollar

Res/Curr 15 If Forex/Foreign indiacte : GBP

Res/Curr 16 If Forex/Foreign indiacte : EURO

Res/Curr 17 Flip Account : Min Period ofpermitted only in GHC

Res/Curr 18 Contribution

Res/Curr 18a

Res/Curr 18b

Res/Curr 18c

Res/Curr 18d

Res/Curr 19 Mode of payment: Cash/Cheque

Res/Curr 20 Mode of payment: Please debit my/our..with you.

Res/Curr 21 Please sign as per specimen With us : Sign

Res/Curr 22 Call account

Res/Curr 22a

Res/Curr 22b

Res/Curr ATM Card (THIS SECTION IS NOT FILLED IN THIS FORM)Res/Curr 23 Please issue me/20 Characters

Res/Curr

Res/Curr

Res/Curr

Res/Curr Internet Banking (THIS SECTION IS NOT FILLED IN THIS FORM)

Res/Curr 24 My/Our e-mail..For: Internet Banking

Res/Curr 25 My/Our e-mail..For: Email Statement

Res/Curr


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Res/Curr

Res/Curr

Res/Curr Mobile Banking (THIS SECTION IS NOT FILLED IN THIS FORM)

Res/Curr 26 Please registeris/are

Res/Curr

Res/Curr

Res/Curr

Res/Curr Intial DepositRes/Curr 27 Amount GHC/GBP/Euro : Cash

Res/Curr 28 Amount GHC/GBP/Euro : Cheque no.

Res/Curr 28a

Res/Curr 28b

Res/Curr 28c

Res/Curr 28d

Res/Curr 29 Periodicity of statement retention : Monthly

Res/Curr 30 Periodicity of statement retention : Quarterly

Res/Curr 31 Periodicity of statement retention : Half Yearly

Res/Curr 32 Periodicity of statement retention : Yearly

Res/Curr Mode of OperationRes/Curr 33 Single

Res/Curr 34 Either/Anyone or survivor

Res/Curr 35 Jointly

Res/Curr 36 Other (Please Specify)

Res/Curr Declaration from Account Holder(s)

Res/Curr Declaration Paraphrase

Res/Curr 37 Sign

Res/Curr 38 Name

Res/Curr 39 Date

Res/Curr For Bank Use only

Res/Curr AT BRANCH

Res/Curr 40 Applicant Interveiwed by

Res/Curr 41 Sign

Res/Curr 42 Date

Res/Curr 43 Account Sourced by

Res/Curr 44 Sign

Res/Curr 45 Date

Res/Curr 46 Name of RM attached

Res/Curr 47 Account Opening Checked & Authorised by

Res/Curr 48 Sign

Res/Curr AT CPU

Res/Curr 49 Documents received and verified by

Res/Curr 50 SignRes/Curr 51 Date

Res/Curr 52 Documents scanned by

Res/Curr 53 Sign

Res/Curr 54 Date

Res/Curr 55 CPU Processing Authorized by

Res/Curr 56 Sign

Res/Curr 57 Date

Res/Curr 58 Cheque Order by


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Res/Curr 59 Sign

Res/Curr 60 Date

Res/Curr 61 ATM

Res/Curr 62 Internet Banking

Res/Curr 63 Mobile Banking

Res/Curr 64 Request Sent by

Res/Curr 65 Sign

Res/Curr 66 DateRes/Curr 67 Reserve Account No. Assigned

Res/Curr 68 Current Account No. Assigned

Res/Curr 69 Flip Account No. Assigned

Res/Curr 70 Call Account No. Assigned

CAF Customer Application Form

CAF 1 Branch Name

CAF 2 Cust ID

CAF 3 Serial No

CAF (A) Personal Details

CAF 4a Name

CAF 4bCAF 4c

CAF 4d

CAF 5 DOB

CAF 6a Gender

CAF 6b

CAF 7 Place & Country of Birth

CAF 8a Marital Status

CAF 8b

CAF 9 No of dependents

CAF 10a Nationality

CAF 10b

CAF 10c

CAF 10d

CAF 11 Passport No/Unique ID

CAF (B) Residence Details

CAF 12 Rented

CAF 13 Self Owned

CAF 14 Family Owned

CAF 15 Company Owned

CAF 16 Flat/House No

CAF 17 Street Name

CAF 18 Landmark

CAF 18 CityCAF 20 Region

CAF 21 Telephone No

CAF 22 Cell/Mob No

CAF Mailing Address

CAF 23 PO Box No

CAF 24 Region

CAF 25 Email Address

CAF (C) Education


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CAF 26 Graduate

CAF 27 Post Graduate

CAF 28 Professional

CAF 29 other(Please Specify)

CAF (D) Ocupation

CAF 30a Salaried

CAF 30b

CAF 30cCAF 30d

CAF 30e

CAF 30f

CAF 31 Student

CAF 32 Retired

CAF 33a Self Employed

CAF 33b

CAF 33c

CAF 33d

CAF 33e

CAF 33fCAF 33g

CAF 33h

CAF 33i

CAF 33j

CAF 33k

CAF (E) Annual Income (GHC)*

CAF 34 0-6,000

CAF 35 6,000-12,000

CAF 36 12,000-25,000

CAF 37 25,000+

CAF 38a Source of Funds

CAF 38b

CAF 38c

CAF 38d

CAF 38e

CAF (F) Other Details

CAF 39a Vehicle use

CAF 39b

CAF 40a Vehicle Type

CAF 40b

CAF 40c

CAF 41a Assets Owned

CAF 41bCAF 41c

CAF 41d

CAF 41e

CAF 41f

CAF 41g

CAF (G) Declaration For Minor

CAF 42 Minor Name

CAF 43 RelationShip with Minor


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CAF 44 Minor DOB

CAF 45 Court Order date

CAF 46a Name of Guardian

CAF 46b

CAF 46c

CAF 46d

CAF 47 Date

CAF 48 Signature of guardianCAF (G) Declaration By Applicant

CAF 49 Signature of applicant

CAF 50 Name of applicant

CAF 51 Date

CAF 52 Photograph

CAF (I) Introduction [Reference By]

CAF 53a Introducer Name

CAF 53b

CAF 53c

CAF 53d

CAF 54 Introducer A/C NoCAF 55 Signature of Introducer

CAF 56 Current Date

CAF (j) Documents Required (Please attach one from category A or one each fr

CAF57a

Category A Documents (Verification of identity & Address)

CAF 57b

CAF57c

CAF 58a Category B1 Documents (Verification of identity)

CAF 58b

CAF 58c

CAF 58d

CAF 58e

CAF59a

Category B2 Documents (Verification of Residential Address

only)

CAF 59b

CAF 59c

CAF 59d

CAF 59e

CAF (K) For Office Use only

CAF At Branch

CAF 60 Applicant Interviewed By

CAF 61 Applicant Interviewed By SignatureCAF 62 Applicant Interviewed on Date

CAF 63 Customer Sourced By Name

CAF 64 Customer Sourced By Sign

CAF 65 Customer Sourced By Date

CAF 66 Name of RM Attached

CAF 67 Account Opening Checked and Autherised By

CAF 68 Introducer's Sign Verified By

CAF 69 Introducer's Sign Verified By person sign


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CAF 70 Introducer's Sign Verified By person on date

CAF At CPU

CAF 71 Documents Received & Verified By

CAF 72 Documents Received & Verified By Sign

CAF 73 Documents Received & Verified on date

CAF 74 Documents Scanned By Name

CAF 75 Documents Scanned By Sign

CAF 76 Documents Scanned on DateCAF 77 CPU Processing authorised by Name

CAF 78 CPU Processing authorised by Sign

CAF 79 CPU Processing authorised on date

CAF 80 Letter of thanks to customer on date

CAF 81 Letter of thanks to introducer on date

ATM ATM Card Application Form

ATM 1 Request Date

ATM 2 Branch

ATM First Applicant

ATM 3a Title

ATM 3bATM 3c

ATM 3d

ATM 3e

ATM 3f

ATM 3g

ATM 4 Last Name

ATM 5 First Name

ATM 6 Postal Address

ATM 7 E-mail Address

ATM 8 Tel/Mobile No.

ATM Second Applicant

ATM 9a Title

ATM 9b

ATM 9c

ATM 9d

ATM 9e

ATM 9f

ATM 9g

ATM 10 Last Name

ATM 11 First Name

ATM 12 Postal Address

ATM 13 E-mail Address

ATM 14 Tel/Mobile No.ATM Bank Information

ATM 15 Account no.

ATM 16a Account Type

ATM 16b

ATM 17 Other accounts to be linked to card

ATM 18 Account Name

ATM 19a Is this your first ATM card?

ATM 19b


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ATM 20 If no, please state why you are applying for a new card

ATM 21 I/We confirm that I/we have read and understood the terms a

ATM 22 First Signature

ATM 23 Second Signature

ATM 24 Date

ATM Bank Use Only

ATM 25a Card Type:

ATM 25bATM Bank Official Details

ATM 26 Name

ATM 27 Signature

ATM 28 Authorized by

ATM 29 Date

Internet Banking Internet Banking Form (Being used currently)

Internet Banking 1 SMS Alert

Internet Banking 2 Email Alert

Internet Banking 3 Internet Banking

Internet Banking 4 SMS Banking

Internet Banking 5 Full NameInternet Banking 6 Date of Birth

Internet Banking 7 Postal Address

Internet Banking 8 Email Address

Internet Banking 9 Mobile Phone Number

Internet Banking Account Information

Internet Banking 10 Account Number 1

Internet Banking 11 Branch







Internet Banking 18 Security question

Internet Banking 19 Answer to security question

Internet Banking Declaration

Internet Banking 20 Authorized Signatory 1

Internet Banking 21 Date

Internet Banking 22 Authorized Signatory 2

Internet Banking 23 Date

Internet Banking Bank Use Only

Internet Banking 24 CSO Name

Internet Banking 25 DateInternet Banking 26 CSO Signature


Ref Form Account Opening - Reference Form

Ref Form 1 Current Date

Ref Form From Referee

Ref Form 2 Name

Ref Form

Ref Form


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Ref Form

Ref Form 3 Address

Ref Form

Ref Form

Ref Form

Ref Form

Ref Form (A) To: Fidelity bank Limited

Ref FormRef Form 4 Name of Applicant

Ref Form 5 Applicant Signature

Ref Form 6 Referee Bank Name

Ref Form 7 Referee Branch Name

Ref Form 8 Referee Account No

Ref Form 9 Referee Signature

Ref Form (B) From: Fidelity bank Limited

Ref Form

Ref Form 10 ToReferee's Bank Name

Ref Form 11 Signed & Stamped by Authorized Signatory

Ref Form (c) From: Reference bankRef Form 12 Reference Bank Name

Ref Form 13 Client Signature Status

Ref Form

Ref Form 14 Signed & Stamped by Authorized Signatory of Reference bank

Ref Form 15 Signed & Stamped by Authorized Signatory date

Foreign Acc Agm Foreign Account Agreement

Foreign Acc Agm Paraphrase

Foreign Acc Agm 1 Current Account Currency

Foreign Acc Agm 2 Signature

Foreign Acc Agm 3 Name in full

Foreign Acc Agm 4 Date

Foreign Acc Agm For office use only

Foreign Acc Agm 5 Account Number

Foreign Acc Agm 6 Signature of CSO

Foreign Acc Agm 7 Date

Staff Acc Staff Account Form

Staff Acc 1 Full Name

Staff Acc 2 DOB

Staff Acc 3 Place of Birth

Staff Acc 4 Postal Address

Staff Acc 5 Residential Address

Staff Acc 6 Mobile NumberStaff Acc 7 Tel Residence

Staff Acc 8 Department/Unit

Staff Acc 9 Department Branch

Staff Acc 10 Position Held

Staff Acc 11a Marital Status

Staff Acc 11b

Staff Acc 11c

Staff Acc 11d


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Staff Acc 11e

Staff Acc 12 Name of Spouse

Staff Acc 13a Account Required

Staff Acc 13b

Staff Acc 13c

Staff Acc 13d

Staff Acc 13e

Staff Acc 14 SignatureStaff Acc 15 Date

Staff Acc 16 HEAD, HUMAN RESOURCE INITIAL

Staff Acc 17 A/O INITIAL

Staff Acc 18 CSO INITIAL

Staff Acc 19 DATE SCANNED

Private Banking Private Banking Form (Not for any accounts related to Minors)

Private Banking 1 Date

Private Banking 1a

Private Banking 1b

Private Banking 1c

Private Banking 2 Reserve AccountPrivate Banking 3 Current Account

Private Banking 3a

Private Banking 3b

Private Banking 3c

Private Banking 4 Others

Private Banking 4a


Private Banking 5a

Private Banking 5b

Private Banking 5c

Private Banking 6 Signature

Private Banking Account Holder

Private Banking 7a

Private Banking 7b

Private Banking 7c

Private Banking 7d

Private Banking 7e

Private Banking 7f

Private Banking 7g

Private Banking 8 Surname

Private Banking 9 First Name

Private Banking 10 Maiden Name

Private Banking 11 Date of BirthPrivate Banking 12 Place & Country of Birth

Private Banking 13 Occupation

Private Banking 14 Employer

Private Banking 15 Position Held

Private Banking Status

Private Banking 16 Nationality

Private Banking 17 Resident

Private Banking 18 Non-Resident


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Private Banking 19 Resident Permit No.

Private Banking Residential Address

Private Banking 20 House No.

Private Banking 21 Street

Private Banking 22 Suburb/Area

Private Banking Postal Address

Private Banking 23 P.O.Box

Private Banking 24 CityPrivate Banking 25 Country

Private Banking 26 E-mail Address

Private Banking 27 Telephone Office

Private Banking 28 Residence

Private Banking 29 Mobile

Private Banking Identification

Private Banking 30 Passport

Private Banking 31 ID Card

Private Banking 32 Other (Please Specify)

Private Banking 33 No.

Private Banking 34 Date of IssuePrivate Banking 35 At

Private Banking 36 By

Private Banking 37 Married

Private Banking 38 Single

Private Banking 39 Separated

Private Banking 40 Divorced

Private Banking 41 Widowed

Private Banking 42 Name of Spouse

Private Banking 43 Applicant Mother's Maiden Name

Private Banking Number Of Children

Private Banking 44 Name

Private Banking 45 Date of Birth

Private Banking If a joint account confirm

Private Banking 46a Instruction Mandate

Private Banking 46b

Private Banking 47a Signatories

Private Banking 47b

Private Banking 48 Date this

Private Banking 49 Day of


Private Banking 51 Signature (Joint a/c)

Private Banking Joint Holder

Private Banking 52aPrivate Banking 52b

Private Banking 52c

Private Banking 52d

Private Banking 52e

Private Banking 52f

Private Banking 52g

Private Banking 53 Surname

Private Banking 54 First Name


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Private Banking 55 Maiden Name

Private Banking 56 Date of Birth

Private Banking 57 Place & Country of Birth

Private Banking 58 Occupation

Private Banking 59 Employer

Private Banking 60 Position Held

Private Banking Status

Private Banking 61 NationalityPrivate Banking 62 Resident

Private Banking 63 Non-Resident

Private Banking 64 Resident Permit No.

Private Banking Residential Address

Private Banking 65 House No.

Private Banking 66 Street

Private Banking 67 Suburb/Area

Private Banking Postal Address

Private Banking 68 P.O.Box

Private Banking 69 City

Private Banking 70 CountryPrivate Banking 71 E-mail Address

Private Banking 72 Telephone Office

Private Banking 73 Residence

Private Banking 74 Mobile

Private Banking Identification

Private Banking 75 Passport

Private Banking 76 ID Card

Private Banking 77 Other (Please Specify)

Private Banking 78 No.

Private Banking 79 Date of Issue

Private Banking 80 At

Private Banking 81 By

Private Banking 82 Married

Private Banking 83 Single

Private Banking 84 Separated

Private Banking 85 Divorced

Private Banking 86 Widowed

Private Banking 87 Name of Spouse

Private Banking 88 Applicant Mother's Maiden Name

Private Banking 89 Number Of Children


Private Banking 91 Date if Birth of Child

Private Banking Foreign Account AgreementPrivate Banking 92 Currency

Private Banking 93 Name in full



Private Banking Alternate Service Channels

Private Banking 96 ATM

Private Banking 97 Internet Banking

Private Banking 98 Fidelity Card


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Private Banking 99 Telephone Banking

Private Banking Currency Required if Foreign/Forex Indicate

Private Banking 100 Dollar

Private Banking 101 GBP

Private Banking 102 Euro

Private Banking 103 Instruction Mandate

Private Banking 103a

Private Banking 103bPrivate Banking 104 Signatories

Private Banking 104a

Private Banking 104b

Private Banking 105 Date this

Private Banking 106 Day of


Private Banking For Bank Use only

Private Banking Document Obtained

Private Banking 108 Completed Signature card

Private Banking 109 Two Recent Passport Photographs

Private Banking 110 Cheque Books DeliveredPrivate Banking 111 Form of ID Establishing Resedential Location

Private Banking 112 Identification

Private Banking 113 Power of Attorney

Private Banking 114 Other Documentation Checked

Private Banking 115 Deferral Documentation

Private Banking 116 Deferral Approved by

Private Banking 117 Account Opening Authorised

Private Banking 118 Account Opening Date

Private Banking 119 Signature Verification

Private Banking Customer Category

Private Banking 120 Royal

Private Banking 121 Premier

Private Banking 122 Silver

Private Banking 123 CSO

Private Banking 124 ARM

Private Banking 125 BM

Private Banking 126 Account Number

Private Banking 127 Date of submission of A/C Opening forms

Private Banking 128 Date Account Opened

Private Banking 129 Primary RM (Name & Contact No.)

Private Banking 130 Secondary RM (Name & Contact No.)

Private Banking CPU Processing

Private Banking Signatures and Pictures ScannedPrivate Banking 131 Head - Account Servicing Officer


Private Banking 133 Head - Domestic Operations


Private Banking Reference Form

Private Banking 135 Name of Applicant(s)

Private Banking 136 The applicant(s) sign(s) thus

Private Banking 137 Name of bank


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Private Banking 138 Address

Private Banking 139 Account Number is




Private Banking 143 Address


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Sub - Field Name Remarks

In case of existing customer,

customer to put in the customerid

in case of new customer, customer

to put the serial number of the CAF

Fidelity Piggy Bank Reserve For kids between 0-13 yrs only

Fidelity Bright Kids Reserve For kids between 13-18 yrs only

Fidelity 24/7

Others

Fidelity Bright Kids Reserve Account For kids between 13-18 yrs only

Fidelity 24/7 Current Account

Others

Foreign a/c agreement required





Monthly

Quarterly

Period

Amount of Contribution

This also has the space to capture

A/c Number

Fidelity Call account

Others (Please Specify)

Space for First Applicant Name

Space for Second Applicant Name

Space for Third Applicant Name

Space for First Applicant E-mail


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Space for Second Applicant E-mail

Space for Third Applicant E-mail

Space for First Applicant Mobile Number

Space for Second Applicant Mobile Number

Space for Third Applicant Mobile Number

Drawn on

Bank

The cheque should..A/c

Customer Name

ATM/Internet Banking not to be issu

Signature will be used/cropped from


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Mr/Mrs/Dr

SurnameFirst Name

Other Name

Male

Female

Single

Married

Ghanaian

Resident Resident Permit No

Non Resident

Others

Valid Till


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Pvt Ltd

Public Ltd

PSUMNC

Govt Co

Other(Please Specify)

Professional

Doctor

Accountant

Architect

Engineer

LaywerBusiness

Manufacturing

Service Provider

Trader/Retailer/Wholesaler


Salary

Business

Inheritance

Investments


Owned

Company Provided

Two Wheeler

Car


Computer

Color TVRefirgerator

Microwave

Air Condtion

Washing Machine



18/50

Mr/Mrs/Dr

Surname

First Name

Other Name

Mr/Mrs/Dr

Surname

First Name

Other Name

om B1 & B2)

Employer Issued ID

employers Letter

Salary Slip (only MNC's & Govt Co's)

Passport copy

National ID

Voter ID

PSU/Govt ID

Driving License

electricity Bill

water/Mun Tax Bill

Life/Med Insurance policy

Physical residence verification

Tenancy Agreement


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If Ao then no needs to be use these

Mr

MrsMiss

Ms

Prof

Hon

Dr.

As per the business rule at CAF form

Mr

Mrs

Miss

Ms

Prof

Hon

Dr.

Savings If new account open then no needs t

Current

Yes

No


20/50

d conditions overleaf

As per the business rule at CAF form

ATM Gold

ATM Orange

As per the account opening already

For AO these fields does not require

For AO this section is not required a

Mr/Mrs/Dr

Surname

First Name


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OtherName

Flat/House No

Street Name

Landmark

City

Region

Correct

irregular

Single

Married

Separated

Divorced


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Widowed

Current Account GHC

Savings Account GHC

FEA USD

FEA GBP

FEA EURO

Day

Month

Year

Local

Forex

Foreign

Please Specify

Day

Month

Year

Mr

Mrs

Miss

Dr.

Prof

Rev.

Other


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Individually

Jointly

Individually

Jointly

These fields are repeated from first

MrMrs

Miss

Dr.

Prof

Rev.

Other


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Individually

Jointly

Individually

Jointly

YES/DEFERRED/WAIVED

YES/DEFERRED/WAIVED

YES/DEFERRED/WAIVEDYES/DEFERRED/WAIVED

YES/DEFERRED/WAIVED

YES/DEFERRED/WAIVED

YES/DEFERRED/WAIVED


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Number of enteries of the field on the form Mandatory Entry in flex Common

y

y

y

3

y y

y y

y y

y y

y y

y y

y yy y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

2 y y

y y

y y

y y


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y

y

y

y

y

y

y

y

y

y

y y

y y

ed y y

y y

the CAF so assume these not be needs.

3 y

3 y

3 y


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y y

y y

y y

y y

y yy y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y yy y

y

y

y y

y


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y

y

y

y

y

y

yy

y

y

y

y

y

y

y

y

y

yy

y

y

y

y

y

y

y

y

y

y

y

y

y

y y

y y


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y y

y y

y y

y y

y y

y y

y y

y y

y y

y y

y

y

y

y

y

y

y

y

y

y

y

y

y

y

y

y

yy

y

y

y

y

y

y

y


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y

y

y

y

y

y

y

yy

y

y

y

y

ields bcz these already are part of CAF y

y

y

yy

y

y

y

y

y

y

y

y

y

that in case of joint account ATM Card will not be issued

y

y

y

y

y

y

y

y

y

y

y

y

y

o mentioned it as this info is already in RES form y

y

y

y

y

y


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y

y

y

that in case of joint account ATM Card will not be i y

y

y

y

AF & RES form is verified by concerned person so y

y

y

y

y

y

y

y

d as these are already in CAF yy

y

y

y

y

y

y

y

y

y

y

y

y

y

per our assumption that Authorised person is already in CAF

y

y

y

y

y

yy

y

y

y

y

y


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y

y

y

y

y

y

y

y

y

y

y

y

y

y

yy

y

y

2 y

2 y

y

2 y

2 y

2 y

y

y

y

y

y

y

y

y

y

yy

y

y

y

y

y

y

y


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y

y

y

y

y

y

y

yy

y

y

y

y

2


36/50

4

4

pplicant info


37/50

4

4

2

2

2


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2


39/50


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Form Name S.No Field Name

ABA AGYAPADIE BUSINESS ACCOUNT Opening Form

ABA 1 Date

ABA 1a

ABA 1b

ABA 1c

ABA 2 Company Certificate Valid Date: Day

ABA 3 MonthABA 4 Year

ABA 5 Yours Faithfully Signature

ABA 6 Name of Company

ABA 7 Registeration Certficate No.

ABA 8 Date Issued

ABA 9 Business Address

ABA 10 Mailing Address

ABA 11 Telephone No.

ABA 12 Fax No.

ABA 13 E-mail Address

ABA 14 Main line of businessABA Other Alternative Services, Please tick as desired

ABA 15 ATM

ABA 16 Internet Banking

ABA 17 Fidelity Card

ABA 18 Telephone Banking

ABA Preferred Mode of Statement

ABA 19 E-mail

ABA 20 Postage

ABA 21 Hold

ABA Account with other Banks (Includind Fidelity Branches)

ABA 22 Banks Name and Address

ABA 23 Account Name

ABA 24 Account Number

ABA 25 Initial Deposit GHC

ABA Cheque Confirmation Form

ABA 26 Authorised Signatory

ABA 27 Date

ABA 28 Confirmation letter duly signed by Signatories

ABA 29 Confirmation done on the reverse side of the cheque

ABA 30 If you are notBelow

ABA 30a

ABA 30b

ABA 30cABA 30d

ABA Indemnity


ABA 32 Date

ABA 33 Date

ABA 34 Company Secretary

ABA Comapany Resolutions (If Applicable)

ABA 35 Company Secretary Name


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ABA 36 Company Name

ABA 37 ..Under the laws of..

ABA 38 ..City of..

ABA 39 Date

ABA 40 Month

ABA 41 Year

ABA Details of Signatories

ABA 42 Mr.ABA 43 Mrs.

ABA 44 Ms.

ABA 45 Dr.

ABA 46 Other

ABA 47 First Name

ABA 48 Surname

ABA 49 Other Names

ABA 50 Sex

ABA 51 Date of Birth

ABA 52 Place of Birth

ABA 53 NationalityABA 54 Residential Address

ABA 55 Postal Address

ABA 56 Identification (Type)

ABA 57 Identification (No)

ABA 58 Occupation

ABA 59 Telephone Number


ABA 61 Date

ABA Details of Next of Kin (For Sole Prorietors Only)

ABA 62 Name and Address of Employers

ABA 63 Residential Address

ABA 64 Occupation

ABA 65 Telephone/Fax No

ABA 66 Name & Postal Address

ABA Details of Signatories

ABA 67 Mr.

ABA 68 Mrs.

ABA 69 Ms.

ABA 70 Dr.

ABA 71 Other

ABA 72 First Name

ABA 73 Surname

ABA 74 Other NamesABA 75 Sex

ABA 76 Date of Birth

ABA 77 Place of Birth

ABA 78 Nationality

ABA 79 Residential Address

ABA 80 Postal Address

ABA 81 Identification (Type)

ABA 82 Identification (No)


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ABA 83 Occupation

ABA 84 Telephone Number


ABA 86 Date

ABA 87 Mandate: Any

ABA 88 To Sign Alone

ABA 89 And Or

ABA 90 To Sign JointlyABA 91 Day

ABA 92 Month

ABA 93 Year

ABA 94 Company Seal

ABA 95 Director of the Company

ABA Terms And Conditions


ABA 97 Date

ABA For Bank Use Only

ABA AGYAPADIE BUSINESS ACCOUNT

ABA Document ObtainedABA 98 Certified Copies of Company Registeration Documents

ABA 99 Company Mandate/Signature Card

ABA 100 Visitation Report

ABA 101 Form of Identification National ID

ABA 102 Waived Document(s)

ABA 103a What Document(s) is/are Deferred

ABA 103b

ABA 103c

ABA 103d

ABA 103e

ABA 103f

ABA 104 Deferral Recommended by (RM)

ABA 105 Deferral Recommended by (BSSM)

ABA 106 Account Number

ABA 107 Date of submission of A/C Opening forms

ABA 108 Date Account Opened

ABA 109 Source/Interviwed By

ABA 110 CSO

ABA 111 RM Attached

ABA 112 Account Opening Checked & Authorised By:

ABA 113 AT CPU: Documents Received Verified & Scanned by

ABA 114 CPU Processing Authorised by

ABAW AGYAPADIE BUSINESS ACCOUNT Opening Form (WELFARE)ABAW 1 Branch Name

ABAW 2 Branch Code

ABAW Business Details

ABAW 3 Business Name & Address

ABAW 4 Business Registeration No

ABAW 5 Date of Registeration

ABAW 6 Business Location

ABAW 7 Telephone No./Fax


43/50

ABAW 8 Mandate On Account

ABAW Details of Signatory

ABAW 9 Surname

ABAW 10 Title

ABAW 11 Other Names

ABAW 12 Nationality

ABAW 13 Sex

ABAW 14 Date of BirthABAW 15a Marital Status

ABAW 15b

ABAW 15c

ABAW 16 Maiden Name (if applicable)

ABAW 17 Name of Spouse

ABAW 18 Identification no.

ABAW 19 Tel no.

ABAW 20 Postal Address

ABAW 21 Initial Deposit GHC

ABAW Details of Next of Kin

ABAW 22 Name & Postal AddressABAW 23 Residential Address

ABAW 24 Occupation

ABAW 25 Telephone/Fax No

ABAW 26 Name & Address of Employers

ABAW ATM Card

ABAW 27 20 Characters

ABAW Mobile banking

ABAW 28 Mobile No.

ABAW Declaration

ABAW 29 Signature/Thumb Print

ABAW 30 Date

ABAW For Bank Use Only

ABAW 31 Account No.

ABAW 32 Source/Interviwed By

ABAW 33 RM Attached

ABAW 34 Account Opening Checked & Authorised By:

ABAW 35 AT CPU: Documents Received Verified & Scanned by

ABAW 36 CPU Processing Authorised by


44/50

Sub - Field Name Remarks

Day

Month

Year

Amount

Please tick one of the By Phone

Please tick one of the Confimation Indicated..ChequeConfirmation by letter signed..signatory(ies)


45/50


46/50

YES/NO/n/a

YES/NO/n/a

YES/NO/n/a

YES/NO/n/a

YES/NO/n/a

1 YES/NO/n/a

2 YES/NO/n/a

3 YES/NO/n/a

4 YES/NO/n/a

5 YES/NO/n/a

6 YES/NO/n/a


47/50

Single

Divorced

Separated


48/50

Number of enteries of the field on the form Mandatory Entry in flex Common

4

4

4

2

2

2

2


49/50

2

2

2

2

2

2

2

22

2

2

2

2

2

2

2


50/50

2

2

2

2