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ZENITH BANK PLC ONLINE SAVINGS ACCOUNT FORM NAMES FIRST NAME SURNAME MIDDLE NAME DATE OF BIRTH OPTIONAL PLACE OF BIRTH SEX FEMALE MARITAL STATUS SINGLE MALE MARRIED SUFFIX TITLE USUAL NAME MODE OF IDENTIFICATION NUMBER COUNTRY OF ORIGIN STATE LOCAL GOVERNMENT AREA WIDOWED -2 - CONTACT ADDRESS MAILING ADDRESS BUSINESS PHONE HOME PHONE FAX MOTHER S MAIDEN NAME OPTIONAL ACCOUNT TITLE DATE SIGNATURE BANK USE ONLY VERIFIED BY ------------------------------------------------------------------- -3- SAVINGS ACCOUNT FORM ACCOUNT NUMBER ADDRESS POST OFFICE BOX TELEPHONE NO NAME AND ADDRESS OF EMPLOYER PROFESSION SPECIMEN SIGNATURE OF CLIENT Zenith Bank. Plot 84 Ajose Adeogun Street. Victoria Island. Lagos Nigeria* Tel 234 1 4618301 4618321 4618311. Fax 234 1 2618212. Website www. zentbank. com -4- READ AND APPROVED BY PASSPORT PHOTOGRAPH PHOTOCOPY OF PASSPORT OR ID PASSPORT NO OR ID APPROVED BY www. zentbank. com -5- NAME OF ACCOUNT AUTHORISED PERSON TO SIGN SIGNATURE SPECIMEN S SIGNATURE VERIFIED BY Please note that 2 of this form are required for processing* So you are required to print out 2 copies of this form*. Plot 84 Ajose Adeogun Street. Victoria Island. Lagos Nigeria* Tel 234 1 4618301 4618321 4618311. Fax 234 1 2618212. Website www. zentbank. com -4- READ AND APPROVED BY PASSPORT PHOTOGRAPH PHOTOCOPY OF PASSPORT OR ID PASSPORT NO OR ID APPROVED BY www. Website www. zentbank. com -4- READ AND APPROVED BY PASSPORT PHOTOGRAPH PHOTOCOPY OF PASSPORT OR ID PASSPORT NO OR ID APPROVED BY www. zentbank. com -5- NAME OF ACCOUNT AUTHORISED PERSON TO SIGN SIGNATURE SPECIMEN S SIGNATURE VERIFIED BY Please note that 2 of this form are required for processing* So you are required to print out 2 copies of this form*. Plot 84 Ajose Adeogun Street. Victoria Island. Lagos Nigeria* Tel 234 1 4618301 4618321 4618311. Fax 234 1 2618212. Website www. zentbank. com -4- READ AND APPROVED BY PASSPORT PHOTOGRAPH PHOTOCOPY OF PASSPORT OR ID PASSPORT NO OR ID APPROVED BY www. zentbank. com -5- NAME OF ACCOUNT AUTHORISED PERSON TO SIGN SIGNATURE SPECIMEN S SIGNATURE VERIFIED BY Please note that 2 of this form are required for processing* So you are required to print out 2 copies of this form*.

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