...Invest with confidence INVESTMENT ACCOUNT (CORPORATE) APPLICATION FORM BUSINESS NAME: ACCOUNT NUMBER:

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1 ...Invest with confidence INVESTMENT ACCOUNT APPLICATION FORM (CORPORATE) BUSINESS NAME: ACCOUNT NUMBER:

2 LIBERTY ASSET MANAGEMENT LIMITED Corporate Clubs and Society Other, please specify Requirement a. Duly completed Account Opening and KYC form b. Business Registration Certificate c. Certificate to Commence Business d. Tax Identification Number & Registration Number e. Copy of Constitution, Regulation, Act and/or Board Resolution f. Copy of Operating License (if necessary) g. Valid National Photo Identification Card (National ID, Passport, Driver s License, NHIS, Voter s ID) h. Valid International Identification Card, proof of residence/valid residential permit & Address confirmation letter from Embassy (applies to Non-Ghanaian company representative) NB. Please refer to last page for guidelines for completing this form 2

3 MANAGED INVESTMENT ACCOUNT APPLICATION FORM (CORPORATE) BUSINESS INFORMATION Name of Institution: Personal Name (in case of sole proprietorship): Nature of Business Registered Office Address: Postal/Mailing Address: Tax Identification number (TIN) Country of Registration: Address: Registration number Date of Registration: Business contact number(s) Web Address: AUTHORIZE PERSON TO OPERATE ACCOUNT (person(s) with the mandate to operate this investment account) Surname: First Name: Other name(s): Surname: First Name: Other name(s): Gender: Male Female Gender: Male Female Country of Residence: Nationality: Residential Permit number: Identification Document (Please Tick Relevant Box) National ID Passport Driver s License Country of Residence: Nationality: Residential Permit number: Identification Document (Please Tick Relevant Box) National ID Passport Driver s License NHIS Voter s ID NHIS Voter s ID ID Number: Place of Issue:... ID Number: Place of Issue:... Date Of Issue:.../.../...DD/MM/YY Date Of Issue:.../.../...DD/MM/YY Date of expiration:.../.../...dd/mm/yy Occupation: Date of expiration:.../.../...dd/mm/yy Occupation: 3

4 LIBERTY ASSET MANAGEMENT LIMITED Position/Job Title: Residential address: City/Town: Tel number: address: Signature: Position/Job Title: Residential address: City/Town: Tel number: address: Signature: Date:.../.../... DD/MM/YY Date:.../.../... DD/MM/YY INVESTMENT DURATION AND PAYMENT MODE Duration: 182 Days 1 Year 2 Years Other (please specify) Initial Deposit in Words: Initial Deposit in Figures: GH Payment Type: Cash Cheque Wire Transfer Standing order INVESTMENT POLICY STATEMENT Source of Funds: (Please tick choice) Investment Knowledge: ( Please tick choice) Employment retirement income Professional Sophisticated Good Inheritance/Trust Investment Income Fair Limited Novice household/family income Annual turnover Risk Tolerance Level (Please tick choice) Conservative Moderate High Investment objective: (Please tick choice) Safety Income Growth Income and Growth Speculation 4

5 MANAGED INVESTMENT ACCOUNT APPLICATION FORM (CORPORATE) LIBERTY ASSET MANAGEMENT LIMITED GENERAL TERMS AND CONDITIONS The effective date or value date* of your investment product shall be the date on which these funds are reflective in the Company s account. This is usually the next business day if monies are paid by cash and four business days if paid by cheque. Returns on your investment accounts will be paid at periodic intervals, at the rates applicable at the time of acceptance as the case may be. Rates are subject to change or renegotiation upon the request of the asset manager or as initial investments mature and funds are reinvested; subject to the prevailing economic and investment climate. Clients agree to give Liberty Asset Management Limited Power of Attorney (stated below). In the event of the investment account being closed before completing the original term of deposit, interest will be paid at the rate applicable on the date of deposit for the period for which the deposit has remained with us. The deposit may be subject to penal rate of interest as prescribed by Liberty Asset Management Limited on the date of deposit. Payments at maturity shall be made to the customer by cheque. Payments of GH 5,000 and above shall be made by cross cheque. Cheques shall be made available to clients three business day after their investments have matured. This Agreement may be modified or amended by the Providers from time to time without notice, except as may be required by law. You may terminate your use of the Service if you do not agree with any modification or amendment. If you use the Service after the effective date of an amendment or modification, you will be deemed to have accepted that amendment or modification. You agree that you will not modify this Agreement and acknowledge that any attempts by you to modify this Agreement shall be void. You may not assign this Agreement to any other party. You represent and warrant that all information you supply to us in connection with the Service, including but not limited to your application information and all data entered in connection with any transaction, will be complete and accurate in all respects. We are entitled to rely on any information you provide, and you agree to update your personal information if it changes. We also reserve the right to take steps to verify the information you provided. IF YOU PROVIDE INACCURATE INFORMATION, YOUR ABILITY TO USE THE SERVICE MAY BE TERMINATED. *value date: - the day on which your investment begins to earn interest Kindly insist on the following after successfully completing your Managed Investment Account form: Receipt of payment Investment certificate 5

6 LIBERTY ASSET MANAGEMENT LIMITED LIMITED POWER OF ATTORNEY NB: The Limited Power of Attorney gives your Asset Manager, Liberty Asset Management Limited, the power to manage your investment account. Please read carefully before signing. I hereby authorize Liberty Asset Management Limited to discretionarily serve my interests by acting on my behalf, as my asset manager, in any transaction that will optimize returns on my Investment Account. In so doing, other persons to whom Liberty Asset Management Limited has given instructions in order to implement my instructions, may rely on Liberty Asset Management Limited s instructions without obtaining my approval, counter-signature or co-signature. In this regard, Liberty Asset Management Limited s authority will include, without limitation: The authority to invest in or to give instructions for transactions in securities and financial instruments, including the buying and selling of stocks, bonds, notes, debentures, shares, units (from trust schemes) and without limitation to industry, sector, asset class and region or any other securities instructions or contracts relating to securities; and the authority to complete transactions, transfer, convert, endorse, sell, assign and deliver any assets held in my Investment Account and to make, execute, and deliver any and all written instruments of assignments and transfers. BENEFICIAL OWNERS Full name of beneficial owner(s)

7 MANAGED INVESTMENT ACCOUNT APPLICATION FORM (CORPORATE) DECLARATION By signing this form, I/we hereby: (i) Declare that I/we have read and understood the Investment Management Agreement overleaf and that we hereby agree to it. (ii) Declare that all information provided is true, accurate and correct as at the date given below. (iii) Instruct Liberty Asset Management Ltd. to act based on this information, unless otherwise notified in writing by me/us. (iv) Authorize Liberty Asset Management Ltd. to act on instructions relating to my/ our account(s) received from the Authorised Signatory(ies) Name:... Signature:... Date:.../.../... DD/MM/YY Name:... Signature:... Date:.../.../... DD/MM/YY 7

8 LIBERTY ASSET MANAGEMENT LIMITED OFFICE USE ONLY Document required (NB: original IDs & documents must be sighted) Checked Deferred Waived N/A 1 Duly completed Account Opening form 2 Copy business registration certificate 3 Copy of Rules and Regulations 4 TIN Registration No 5 Partnership Deed 6 Trust Deed 7 Act/Gazette (for Government Agency) 8 One recent passport-sized photograph of each authorized person(s) 9 Copy of Identification card of authorized person(s) 10 Resident Permit and Non-Citizen Ghanaian National ID Card (for non- Ghanaians) 11 Copy of business license (if necessary) 12 Copy of Constitution, Bye laws, Regulations 13 Others (please specify) KYC PROFILE Low risk Medium risk High risk Indicate which of the director, executive, trustee, promoter, executor or administrator is PEP Name: position Name: position Name: position 8

9 MANAGED INVESTMENT ACCOUNT APPLICATION FORM (CORPORATE) Initial deposit Was done by Cash Cheque Draft Wire Transfer Account opened by DD / MM / YY Name: Signature: Date: / / Deferral/Waiver of document (if any) authorized by DD / MM / YY Name: Signature: Date: / / Account opening authorized/approved by DD / MM / YY Name: Signature: Date: / / For high risk customer refer to the AML/CFT Compliance & Reporting Officer for approval Name: Designation: Signature: Date: / / DD / MM / YY 9

10 LIBERTY ASSET MANAGEMENT LIMITED GUIDELINES FOR FILLING THE ACCOUNT OPENING AND KYC FORM 1. The Application form should be completed in ENGLISH and in BLOCK LETTERS 2. Please tick in the appropriate box whenever applicable 3. Please fill the form in legible handwriting so as to avoid errors in your application processing. Please do not overwrite. Corrections should be made by canceling and re-writing and such corrections should be counter-signed by the applicant 4. Application forms that are incomplete in all respects and/ or not accompanied by required documents are liable to be rejected 5. Completed application forms with the necessary documentary attachments should be submitted to our Client Relations Officers in any of our branch offices 6. You are to submit a proof of Identity document (any valid national photo identification card). The Officer receiving your application will have to inspect the original valid national photo identification card plus a Self-attested photocopy 7. The Officer receiving your application will inspect the original copies of the required documentary attachments CORPORATE INFORMATION 1. Name of Institution: The registered name of the organization or the recognize name of the organization 2. Personal Name (in case of sole proprietorship): Sole proprietorship is a type of business entity that is owned and run by one individual or one legal person and in which there is no legal distinction between the owner and the business. Kindly provide the full name of the business owner 3. Nature of Business: The type or general category of business or commerce of your organization 4. Registered Office Address: The official address of your organization 5. Postal Address: The address where we can communicate with your organization/mailing address 6. Registration Number: The unique number assigned to your organization 7. Tax Identification Number: An identifying number used for tax purposes 8. Date of Registration: The day, month and year of registration quoted on the company registration certificate 9. Country of Registration: The country under whose law your organization is registered 10. Business Contact Number(s): The contact telephone number of your organization 11. Address: The electronic post office box on a network of your organization 12. Web Address: The location address on the internet of your organization 13. Authorized Person to operate account: A person who has been formally and properly empowered to operate (fill account opening form, sign account opening documents, provide necessary documents in relation to the account opening, request for withdrawal and closure of account) this account a. Surname b. First/Other names c. Gender d. Country of Residence e. Nationality f. Residential Permit number g. Identification Document i. Kindly tick the appropriate box ii. ID number iii. Place of issue iv. Date of issue v. Date of expiration h. Occupation i. Position/Job Title j. Residential address k. City/Town l. Tel number m. address n. Signature o. Date 14. Investment Duration and Payment Mode: Please tick the appropriate box 15. Investment Policy Statement: Please tick the appropriate box a. Annual Turnover/Gross Income: A numeric value representing the total sales for the past 12 months period 16. Investment Objective: Please tick the appropriate box 17. Please read the General Terms & Conditions and the Limited Power of Attorney carefully 18. Beneficial owner: A person who enjoys the benefits of ownership even though title is in another name or any individual or group of individuals that, either directly or indirectly, has the power to vote or influence the transaction decisions regarding this investment 19. Declaration: Kindly append your signature(s) 10

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