AFFIX RECENT
PASSPORT
PHOTOGRAPH OF
CUSTOMER FORM OCCUPANT
(INDIVIDUAL)
A. PERSONAL INFORMATION:
1. NAME OF OCCUPANT:
2. AGE:
3. SEX:
4. PRESENT RESIDENTIAL ADDRESS:
5. MOBILE PHONE NUMBER:
6. EMAIL ADDRESS:
7. STATE OF ORIGIN:
8. LOCAL GOVERNMENT AREA:
B.CURRENT RESIDENCE - HISTORY:
9. CURRENT RESIDENTIAL ADDRESS:
10. DATE OF TERMINATION OF CURRENT LEASE:
11. REASON(S) FOR VACATING PRESENT ACCOMODATION:
C.EMPLOYMENT INFORMATION:
12. OCCUPATION:
13. PLACE OF WORK:
14. OFFICE ADDRESS:
D. OTHER INFORMATION
15. MARITAL STATUS:
16. NAME OF SPOUSE:
17. OCCUPATION:
18. ADDRESS:
19. PLACE OF WORK:
20. OFFICE ADDRESS:
21. NUMBER OF CHILDREN:
AFFIX RECENT
PASSPORT
PHOTOGRAPH OF
CUSTOMER FORM OCCUPANT
(INDIVIDUAL)
22. PROPOSED USE OF PROPERTY:
23. NUMBER OF OCCUPANTS:
E. NEXT OF KIN INFORMATION
24. NAME:
25. RELATIONSHIP:
26. ADDRESS:
27. PHONE NUMBER:
28. EMAIL:
F. GUARANTOR INFORMATION
S/N NAME TELEPHONE N0. RELATIONSHIP
1.
2.
Please attach letter of guarantee from at least one guarantor
DECLARATION: I hereby declare that the information given above is correct to the best of my knowledge
and I believe same to be true
Subscriber’s Signature Date
Completed form is to be returned to:
Joe Akhigbe & Associates
5th Floor, 19 Tinubu Street, Lagos Island
Telephone: 01-4532771, 01-4532772
Email:
[email protected]
