client-update-form – Lotus capital limited form portal

Client Update Form

Conversational Form (#3)

KYC DATA UPDATE FORM

Dear Sir/ Madam, kindly amend my records with respect to my investment(s) in

CONT-No

A. INVESTMENT DETAILS

INVESTMENT TYPE

Halal Investment Fund

Halal Fixed Income Fund

Lotus Waqf Endowment Fund

Mudaraba Investment Plan

B. PERSONAL INFORMATION

Title

Mrs

Name

Gender

Male

Female

Religion

Christianity

Islam

None

Country of Birth

City of Birth

Date of Birth

Phone Number

BVN

NIN

C. INFORMATION TO BE UPDATED

Tick and complete the change request option required

CHANGE OF NAME

New Name

Surname

Firstname

Previous Name

Surname

Firstname

Original investment certificate | indemnity form (for Halal Investment Fund)

CHANGE OF CONTACT DETAILS

Mobile Number

Address

City

State

Country

CORRESPONDENCE PREFERENCE

Would you like to receive sms in addition to mail

Yes

CHANGE OF DIVIDEND MANDATE

Change of dividend mandate

Re-invest

Pay to my bank account

CHANGE OF BANK DETAILS

Account Name

Bank Name

Account Number

D. TAX RESIDENCY SELF CERTFICATION

Country of residence

Tax payer ID | Functional Equivalent

If Taxpayer ID | TIN is unavailable , please select a reason

Reason A - My country of residence does not issue Taxpayer ID or Functional equivalent to its residents

Reason B - I am unable to obtain a Taxpayer ID or functional equivalent (please explain why in the box below )

Reason C - local laws in my country of residence do not require the collection of the Taxpayer ID or functional equivalent

Please explain in the box below why you are unable to obtain a Taxpayer ID or functional equivalent if you selected Reason B above

E. SIGNATORY AUTHORIZATION

Tend to the fields in the individual applicant section if it is an individual application and to the fields in the joint applicant section if it is a joint application.

INDIVIDUAL APPLICANT

Upload your signature image:

First Name

Last Name

JOINT APPLICANTS

Upload your signature images:

First Name

Last Name

Tend to the fields in the change of name section if it is for change of name and the change of address section if it is for change of address.

CHANGE OF NAME

Upload the following documents :

Banker's confirmation of signature letter issued by your bank

Marriage certificate (if applicable)

Newspaper publication

CHANGE OF ADDRESS

Government issued ID card

Proof of address (utility bill with matching address not holder than 3 months)