SECTION A: CORPORATE DETAILSFIXED DEPOSIT INVESTMENT APPLICATION FORM (For Corporate Investors in Nigeria) Company Full Name *RC Number *Date of IncorporationDaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925Nature of Business *Business Email *Company Phone Number *Company Address *CityState/ProvinceCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweWebsite (Optional - URL)Contact Person InformationPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle Name *Last Name *Phone Number *Position/Designation *Preferred Communication Channel *EmailPhoneWhatsAppSECTION B: INVESTMENT DETAILSDeposit Amount (₦) *NGNTenure *90 Days180 Days365 DaysOtherInterest Payment Mode *MonthlyQuarterlyAt MaturityRoll OverInterest Payment AccountBank Name *Account Name *Account Number *Required Document UploadsUpload files - Valid ID of Signatory(ies) *Choose FileNo file chosenDelete uploaded fileUpload files - Certificate of Incorporation *Choose FileNo file chosenDelete uploaded fileUpload files - Board Resolution *Choose FileNo file chosenDelete uploaded fileUpload files - Passport Photograph *Choose FileNo file chosenDelete uploaded file(I) That, We, (Comapany Name:)hereby authorize Networth Portfolio & Asset Management (NP&AM) to open an Investment Account in my name and form me.(II) That Networth Portfolio & Asset Management (NP&AM) is hereby requested and authorized to act on my instructions with regard to any transactions on the Investment Account.(III) That all transactions between Networth Portfolio & Asset Management (NP&AM) and I shall be subject to the articles, rules and regulations of the Nigerian Stock Exchange (NSE), the Securities & Exchange Commission (SEC), the Investments and Securities Act (ISA) of 1999, and all further regulations/directives passed and as amended from time to time to regulate trades between the parties and to regulate broker/dealer activities.(IV) That my mandates shall be sent through written instruction(s) to APL, and/or via a secured e-mail to info@networtham.com.(V) That my mandates will only be executed if delivered to Networth Portfolio & Asset Management (NP&AM) through any of the aforementioned channels by/or before 9:00am on the intended business day of execution.(VI) That in the event that I submit mandates/amendments/cancellations after the deadline stated above, they may not be executed until the next business day.(VII) That my buy and sell mandates will only be executed based on the prevailing market prices of stocks on the Nigerian Stock Exchange at the time of execution and not a price range.(VIII) That my purchase mandates shall not be executed if sufficient funds are not available in my stockbroking account to meet the value of such transaction(s).(IX) That in the event that purchase mandate was erroneously executed in excess of my account balance, Networth Portfolio & Asset Management (NP&AM) has a duty to notify me with a view of regularizing my account without any loss to me.(X) That all sales proceeds of stocks shall bee retained in my investment account except if I advise otherwise in writing, provided that such express instruction(s) is/are not in favor of third parties. (XI) That funds deposited in my investment account with Networth Portfolio & Asset Management (NP&AM) , including retained sales proceeds, are not interest bearing. The fund will remain in my investment account until I give an express instruction/mandate authorizing its utilization.Declaration(i) We hereby authorize Networth Portfolio & Asset Management (NP&AM) to open an investment account on behalf of our company using the above information provided by me in this form. (ii) I hereby authorize Networth Portfolio & Asset Management (NP&AM) to honor all instructions including but not limited to purchases/sales mandates, e-dividends/e-bonuses mandates, etc. emanating from me in writing or through my e-mail address as given in this form. (iii) I hereby confirm that I shall be solely responsible for all orders / transactions done in my name and on my account. Consequently, Networth Portfolio & Asset Management (NP&AM) and its officers, Directors and/or Employees shall have no liability, financial or otherwise, and/or suffer any damages arising from my decision/instruction on this account.(iv) I agree to be bound by the terms and conditions governing the operation of this account.Agreement *We have read and agree to the declaration above.Today's Date *Please upload your signature here *Choose FileNo file chosenDelete uploaded fileSubmitSave as Draft