Meristem Estate Account

How did you hear about us *

Referred By *

Staff Name *

Meristem strictly prohibits payment of CASH by existing and prospective clients to any representative of the Company, for any reason whatsoever. All payments to the Company shall be by way of cheques or bank drafts issued in the name of the Fund or by direct bank transfers or cash payments to the Company's designated Bank Accounts. The Company shall not be liable for any direct or indirect loss or damage which may arise from failure of the client to adhere to this directive. If you do not receive any investment notification 48 hours after making payment for your investment, please contact our representatives via [email protected]

PERSONAL DETAILS

Name of Account *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Telephone *

Phone *

AUTHORIZED PERSON 1

Title *

Gender *

Surname *

First Name *

Other Names *

Date of Birth *

Residential Address *

Phone *

Email *

Occupation

Employers Name

Employer's Address *

Gross Yearly Income

500,000 - 1 million
1 million - 5 million
5 million - 10 million
10 million above

Identification Document

International Passport
Driver's License
National ID Card
Permanent Voters Card

Signature

Date

AUTHORIZED PERSON 2

Title

Gender

Surname

First Name

Other Names

Date of Birth

Residential Address

Phone

Email

Occupation

Employers Name

Employer's Address

Gross Yearly Income

500,000 - 1 million
1 million - 5 million
5 million - 10 million
10 million above

Identification Document

International Passport
Driver's License
National ID Card
Permanent Voters Card

Signature

Date

AUTHORIZED PERSON 3

Title

Gender

Surname

First Name

Other Names

Date of Birth

Residential Address

Phone

Email

Occupation

Employers Name

Employer's Address

Gross Yearly Income

500,000 - 1 million
1 million - 5 million
5 million - 10 million
10 million above

Identification Document

International Passport
Driver's License
National ID Card
Permanent Voters Card

Signature

Date

Bank Account Information

Bank Name

Account Name *

Account Number *

Account Type

Savings
Current

Date of Opening

BVN *

INVESTMENT DETAILS

Initial Investment

Mode of Payment *

Cheque
Bank Transfer

Mode of Communication *

Email
Letter

Investment Objective *

Income
Growth
Preservation of Capital

KYC Documents (kindly upload files max 1MB in size)

Will or Letter of Administration *

Click or drag a file to this area to upload.

Medical Certificate of Cause of Death and Death certificate

Click or drag a file to this area to upload.

Means of ID of all administrators *

Click or drag a file to this area to upload.

Passport photograph of all the administrator *

Click or drag a file to this area to upload.

Declaration

Terms and Conditions

I guarantee that all information herein is complete and correct.

If this investment is cancelled by me, MWML will have the right to refund the principal amount up to the date of cancellation plus the residue of accrued interest after a penalty charge as MWML may prescribe on the accrued interest.

All amounts relating to this investment in particular payments and benefits will be expressed, calculated and paid in Nigerian currency. Payment will be made in Nigeria.

I accept full responsibility for informing MWML of any changes in current identification information provided (e.g. address change, surname change, contact details, etc.). If any details change, I will provide MWML with new certified proof of identity and a utility bill, not older than 3 months.

In terms of the Anti-money Laundering (Prohibition) Act (2011), I confirm that the funds with which any payment is or will be made to MWML, in terms of this investment, are derived from a lawful source. In addition, I am willing to answer any questions with regard to the origin of such funds and to provide additional information as and when it may be required by MWML or other Regulatory Agencies.

I understand that information in this application may be recorded electronically with MWML in addition to physical records. Such records will form the record of this investment for all purposes and may be used as evidence at any proceedings.

Authorization

I hereby authorize MWML to:

act in accordance with our instructions or that of any person authorized by us in respect of this investment (including those transmitted and received by telephone, fax, electronic mail or the internet), and to do all things necessary to give effect thereto;
deduct sufficient amounts from our chosen investment for the purposes of transaction charges or its fees; provide our details and details in respect of this investment to companies with whom it has business arrangements or MWML’s regulators
to retain interest pro rata across the selected Fixed Term Investments in order to collect charges, including reduction charges.