Registered under the Financial Services Act 2010
CHECKLIST
□ KYC
□ Biometrics
□ Source of funds
Customer’s Name & Address
Cell :
Date :
VISA CARD ACTIVATION/EXTENSION FOR FOREIGN TRANSACTIONS
Account Name :
Account Number :
Card Number : * * * * * *
Destination / Country :
Purpose :
Amount :
Duration : From To
Signature :
For Bank Use Only
Checker’s Name ………………………………………… Signature…………………………………..
Authoriser’s Name ………………………………………. Signature………………………………….
Manager …………………………………..