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FOREIGN CURRENCY DOMICILIARY ACCOUNT OPENING FORM - CORPORATE GTBank Guaranty Trust Bank Ghana Ltd Name / Company Reg No if Applicable Address Overseas Affiliates if any Industry Classification Passport No Residence Permit No If Applicable Anticipated Sources of Foreign Exchange Please Be Explicit Current Account No with Guaranty Trust Date Opened DD MM YY Type Of Domiciliary Account Please tick as appropriate Us Dollars Pound Sterling Euro CFA Others The undersigned hereby request s you to establish a domiciliary account in the chosen currency and agree s that 1. Cash withdrawals from my / our Account shall be subject to availability. 2. The Bank shall have no responsibility / liability for the following i Any diminution due to taxes charges or depreciation in the value of funds credited to the account which funds may be deposited by you in your name and subject to your name and subject to your control* ii The unavailability of such funds due to restrictions on convertibility requisitions involuntary transfers distrains of any character exercise of military or usurped power or other similar causes beyond your 3. The operation of this account is subject to the laws and regulations at any time existing in the Federal Republic of Nigeria* Authorised Signatories Name Signature FOR OFFICIAL USE ONLY Account officer Head - CIS Relationship Manager Group Head CSU Head CIS Officer - Name 1 Completed Signature Card. 1 Passport Photograph CIS Officer - Signature Identification SPECIMEN SIGNATURES INDIVIDUAL Account No Account Name Tel No Mobile Tel No office/home Photograph Title Mr Mrs etc Authorised Combination For Joint Account Holders. Cash withdrawals from my / our Account shall be subject to availability. 2. The Bank shall have no responsibility / liability for the following i Any diminution due to taxes charges or depreciation in the value of funds credited to the account which funds may be deposited by you in your name and subject to your name and subject to your control* ii The unavailability of such funds due to restrictions on convertibility requisitions involuntary transfers distrains of any character exercise of military or usurped power or other similar causes beyond your 3. The operation of this account is subject to the laws and regulations at any time existing in the Federal Republic of Nigeria* Authorised Signatories Name Signature FOR OFFICIAL USE ONLY Account officer Head - CIS Relationship Manager Group Head CSU Head CIS Officer - Name 1 Completed Signature Card. The operation of this account is subject to the laws and regulations at any time existing in the Federal Republic of Nigeria* Authorised Signatories Name Signature FOR OFFICIAL USE ONLY Account officer Head - CIS Relationship Manager Group Head CSU Head CIS Officer - Name 1 Completed Signature Card. 1 Passport Photograph CIS Officer - Signature Identification SPECIMEN SIGNATURES INDIVIDUAL Account No Account Name Tel No Mobile Tel No office/home Photograph Title Mr Mrs etc Authorised Combination For Joint Account Holders.

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