AFFIX PHOTO AFFIX PHOTO

A. ACCOUNT OPENING FORM Date D D M M Y Y Y Y

Branch Name Account No.

Segment
Account Name First Name Surname Middle Name
Currency (Please Tick where Applicable) UGX USD GBP EURO Others
Account Category: Personal Joint
Type of Account (Please Tick where Applicable)
Ordinary Savings Current Child Savings Others Please Specify........................

B. PERSONAL DETAILS
Mr. Mrs. Ms. Date of Birth D D M M Y Y Y Y Gender: Male Female

Name First Name Surname Middle Name

Nationality National ID Refugee Card Passport ID No...........................

Place of Birth Country of Residence

Marital status: Married Single Separated Divorced

Are you registered with any taxation authority? If YES,
No Yes Country of Registration TIN

C. PHYSICAL ADDRESS
Tel No. Office No. Personal E-mail Address
Village Zone Parish Sub-country
Region County District
Street/Plot No. Period at Current Address (Months)
P.O.Box

i. Are you a Politically Exposed Person (PEP)? Yes No

ii. Are you related to any Politically Exposed Person Yes No

Home ownership Owned Renting Living with relatives
Educational Level
Primary Secondary University Post Graduate

Others (Specify)

NEXT OF KIN DETAILS

Name First Name Surname Middle Name

Tel No. E-mail Address Relationship

Place of Residence: Village Sub-County District
NATURE OF BUSINESS / OCCUPATION
Employed Self-Employed Nature of Business....................................... Student Others .........................
Name of Employer Job Title Employee No. Physical Address

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Duration of Employment Tel: Number E-mail Address
Expected monthly income________________________________________________________
Annual Income: ≤Ugx 2.4M >Ugx 2.4M ≤10M >10M
Total Assets: ≤Ugx 10M 10M≥TA ≤100M >100M
STUDENT
Name of Institution Duration at Institution
Contact Address Tel: Number
E-mail Address Annual Income

D. OTHER INFORMATION:
1. Bank Account currently held:
Bank Name Type of Account Account Names Account Numbers DPF (tick One)
1.
2.
2. Registered Mobile Money Numbers
Mobile Numbes Registered Names DPF (tick One)
1.
2.

3. Preffered model of Deposit Protection Fund (DPF) payments (Tick one in either (1) or (2) above.
E. ACCOUNT SERVICES (Please Tick where prefered choice(s) is / are appicable)
1. ATM CARD (To be collected from Branch) Yes No If No, Specify Branch
2. Mobile banking (Ku Siimu) Yes No Tel No.
3. SMS Alert 50 100 100>

4. Internet Banking Yes No

5. Cheque book Yes No 25 Leaves 50 Leaves 100 Leaves

6. Statements (Frequently) Yes No Monthly Quartely Annually

E-mail Address
F. SOCIAL PERFORMANCE & PERSONS WITH DISABILITIES
The bank would like to serve you better. Do you have difficulties in doing the following? (Tick where applicable)
(a) Seeing, even if wearing glasses (b) Hearing, even if using a hearing aid (c) Walking or climbing steps

(d) Remembering or concentrating (e) Communicating for example understanding or being understood
(f) No difficulties with any of the above (g) I would rather not disclose

SIGNATURE CARD

Customer Name
Customer Signature

I/We request you to open the following account(s) with Opportunity Bank as per the following details.
I/We have been advised about the available products and have selected this product as appropriate.
Customer (SIGNATURE(s): ____________________________________________________________________________
OFFICIAL BANK USE
Opened by:
Names_______________________________________Position__________________________________Signature___________________
Approved by:
Names_______________________________________Position__________________________________Signature___________________

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Credit Reference Bureau Consent:

For as long as I/WE/the Company/entity holds an account with Opportunity Bank, I/WE/the Company/entity gives consent to
Opportunity Bank the right to remit/ give/access/check any relevant information to and/or with the Credit Reference Bureau about
me/us/the entity/Company supplied to it or it may require at any time for any purpose whatsoever. Any failure or delay by
Opportunity Bank to exercise any right, power or privilege granted by law shall not be deemed to be a waiver by the Bank except
as to the extent or the scope and breath permitted by law.

Customer Signature: ____________________________ Date: _________________________________________

Terms and Conditions for Bank’s products/account services and/or facilities:

Acceptance of Terms and Conditions:

a) I take full responsibility for any consequences that may arise out of false/incomplete information provided to Opportunity Bank and
the Bank reserves the right to verify any information provided at any time for as long as I hold the account with Opportunity Bank.

b) I agree to be bound by any additional terms and conditions governing any facilities, products and/or services offered by the Bank as
may apply from time to time. I undertake to indemnify the Bank against any loss caused for breach of the terms and conditions.

c) Any communication to the Customers on the Bank’s facilities, products and/or services shall be deemed to have been done effectively
if communicated to the Customer by mail, posting, fax, using any media platforms including social media, display in the Bank’s
premises, verbal explanation by Bank staff, Bank’s website, SMS alerts, correspondence to the destined customer, one account holder
for joint account holders or through all other appropriate means.

d) Opportunity Bank reserves the right to impose charges or fees or levies or taxes or debit my account at any one time for breach of any
terms and conditions governing any facilities, products and/or services offered by the Bank from time to time.
e) Any request for a change or amendment or variation of information supplied to the Bank shall be done in writing or in any way that
the Bank may deem appropriate from time to time. The Bank reserves the right to accept or decline the change or amendment or
variation.

f) I agree to supply any information to the Bank upon request by the Bank including all statements, information, material, and
explanations as may be reasonably required by the Bank from time to time. Without prejudice to the data protection laws applicable
in Uganda including but not limited to the EU General Data Protection Laws, any information supplied to Opportunity Bank shall be
held and used for a period stipulated, required and allowed by the laws of Uganda.

g) Any information supplied by the Customer shall be held and used for commercial, financial, regulatory or any other purpose and in a
manner permitted by the laws of Uganda. All information shall be held in strict confidentiality unless otherwise as permitted by law
or compulsion by court to be issued out.

h) Opportunity Bank shall have the option to ask to be informed in advance of the intended withdrawal by any Customer of large sums
of money so as to be able to make appropriate arrangements to have the funds available.

i) The Bank shall be entitled at any time and without notice to the Customer combine, consolidate or merge all or any of the Customer’s
account(s) and liabilities held with the Bank or anywhere whether in or outside the Republic of Uganda and may transfer or set off
any sums in credit in such accounts in or towards the satisfaction of any of the Customer’s debt liabilities whether actual or
contingent, primary or collateral notwithstanding that the credit balances on such accounts and the liabilities on any other accounts
may not be expressed in the same currency at the Bank’s own rate of exchange then prevailing.

j) Opportunity Bank will not be held liable for any loss/ damage to its customers or delay or failure to perform any of its obligations
occasioned due to unforeseen events caused by events beyond its reasonable control (‘Force Majeure event”) including but not
limited to technological interruptions.

k) I agree and accept that I am liable for all the charges, fees, taxes, commissions and others incurred through use and access of the
Bank’s facilities, products and services.

l) These terms and conditions may be changed, varied, amended, complemented from time to time and shall not be exhaustive of all
terms and conditions governing the Bank’s facilities/ products and/or services.

m) The terms and conditions of Opportunity Bank facilities, products and/or services shall be regulated and governed in accordance with
the Laws of Uganda and the parties submit to the exclusive jurisdiction of the Ugandan courts.

I/WE/the directors/representatives of the Company/entity have read and/or been explained to the terms and conditions governing the
Bank’s facilities, products and or services. I/WE/the directors/representatives of the entity/Company have fully appreciated the same
and agree to be bound by the terms and conditions.

Customer Name: ______________________________________________________ Signature: ________________________________________________

Date: __________________________________________________________________

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