UNION BANK OF CAMEROON

PLC

INDIVIDUAL ACCOUNT OPENING FORM

Affix passport
photograph(s)
of
signatory/signat
ories
here

ACCOUNT NUMBER
ACCOUNT OPENING DATE
PLEASE TICK THE DESIRED TYPE OF ACCOUNT (Use or where applicable)
Current

Pearl

ESA

Savings

Domiciliary

QED

Others

Kindly see last page for further information on account types

Account Opening Requirements

1. One Passport Photograph of each signatory
3. Valid means of identification (for each signatory)
2. Two duly completed reference Forms (excluding savings
4. Residence Permit (Foreigners only)

PLEASE FILL IN BLOCK LETTERS

ACCOUNT NAME

(only if joint account)

CUSTOMERS INFORMATION / PARENT OR GUARDIAN INFORMATION (if QED is ticked above)
Name
(Title)

(Surname)

(First Name)

(Middle Name)

Residential Address ................................................................................................................................................................................

...............................................................................................................................................................................................................
Mailing Address
Date of Birth
(DD/MM/YY)

Place of Birth

Sex(M / F)

Division/Sub-division

Region of Origin

Maiden Name

Nationality

Religion

Mothers Maiden name

Phone
Number (1)
Email
Address

Phone
Number (2)

*It is very important that you provide your email address

Marital
Spouses Name
Spouse
Status
Occupation
Employers Address/Business Address ...................................................................................................................................................

...........................................................................................................................................................................................................
Current Position

Total Annual Income (before taxes)

Other sources of Income apart from employer (if any)

Residential Premises Status:

Fully Owned

Education Level:

Primary/Secondary

Car Ownership:

Fully Owned

Means of Identification:

Passport

Loan

Mortgaged

Rent

Polytechnic
Car Brand

National ID

Others
University
Car Model

Drivers License

Masters
Year

Others (Specify)

PhD
Additional Car(s)

For Foreigners Only

Date of Arrival
(DD/MM/YY)

Visa Number

Visa Validity

Resident/Work Permit
Number

Issued (DD/MM/YY) Valid until

(DD/MM/YY)

Next of kin
Surname

Other Names

Relationship:

Residential Address:
Phone Number:

Email Address:

Note: For a joint account, ONLY page 1 of the Account opening

form should be filled by the joint account holders and attached

Customer Specimen Signature

(Please sign within the box)

If Domiciliary is ticked above

Currency Type:
US Dollars
Account Type: Current

Pounds Sterling

Savings

Euro

Others (Please specify)

Fixed Deposit

Estimated sources of Foreign Exchange (please be explicit)

If QED is ticked above

Details of Account (Beneficiary)

Surname
Sex (M/F)

Other Names
Date of Birth
DD/MM/YY

Phone
Number(s)

Address
Current Educational Level: Primary

Secondary

University

Post Graduate

Target Educational Level for Opening Account:

Electronic Banking Services (please tick the additional service required by you)
Card Service required by you
Interswitch debit card

V Pay card

Master Card (Maestro)

Do you already have any of the cards above issued by the bank? Yes
If YES is ticked, fill below
Specify the card type
Card Name
If YES, to which account (s) number is it linked

Visa Intl debit card

No

Acct #1;

Acct #2

Do you wish to have the existing card linked to the new account to be opened? (Y/N)

Internet Banking

T-Alert

Mobile Banking

Etranzact Debit Car

Others (specify)

Other (specify)

If T-Alert is, ticked above, kindly tick the services required by you
Cheque Lodgement Outgoing

Cleared Cheques

Deposit on Current Account

Deposit to Savings Account

ATM Transactions

Cheque Lodgement Incoming

Returned Cheques

Withdrawals from Current Account

Withdrawals on Savings Account

i-bank Transfers

Enter the mobile phone(s) you wish to be linked to the selected services

Phone
Number(1)

Phone
Number (2)
Please note that each alert cost

Account(s) with other Bank(s) (including Union Bank Cameroon Plc)

BANK NAME
BANK ADDRESS

FCFA
ACCOUNT NAME

ACCOUNT NUMBER

CHEQUE CONFIRMATION OF POLICY

It is the policy of Union Bank of Cameroon Plc to confirm all cheques from 2,000,000 (two millions) FCFA and above before payment. This policy has
been adopted to safeguard your account from fraudulent practices.

If you are not in agreement with policy A above, kindly state the minimum amount you require for confirmation

FCFA

Please be notify that confirmation of cheques below 2,000,000 FCFA will attract a service
charge of 1,500 FCFA per cheque if not confirmed in advance (pre-confirmed) to the
respective account officers or branch before presentation of the cheque over the counter or
via clearing. Failure to reach you would cause your cheque to be returned or dishonoured

Tick The Means of confirmation required by you

Confirmation Letter

Reversed side of Cheque

Phone Call/Tex Message

Email

If Confirmation is not required, kindly ignore A and B, tick this box and sign below
Indemnity: I/We hereby instruct Union Bank of Cameroon Plc to pay all cheques duly authorized by me without further confirmation and Fax/ email instructions.
Authorized Signatory & Date

Authorized Co-Signatory & dare(in case of joint-account opening)

Please note that it is extremely important that confirmation should be done in advance and in accordance to mandate chosen above
SIGNING MANDATE( for joint signatories)