Subscription Form - Marble Capital Ltd

Fund Type *

Account Category *

INDIVIDUAL APPLICANT

Title *

Surname *

First Name *

Other Name(s)

Residential Address *

Email Address *

Mobile Number *

Phone Number

Mother's Maiden Name *

Marital Status *

Date of Birth *

Gender *

Nationality *

ID Type *

ID Number *

ID Issue Date

ID Expiry Date

Employment Status

Employment Status *

Occupation *

Industry *

Employer/Business Name *

Employer's/Business Address *

Please specify other source(s) of income apart from your occupation

Next of Kin Details

Fullname *

Gender *

Relationship *

Residential Address *

Email Address *

Contact Number *

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JOINT APPLICANT/MINOR'S SPONSOR

Title *

Surname *

First Name *

Other Name(s)

Residential Address *

Email Address *

Mobile Number *

Phone Number

Mother's Maiden Name *

Marital Status *

Date of Birth *

Gender *

Nationality *

ID Type *

ID Number *

ID Issue Date

ID Expiry Date

Employment Status

Employment Status *

Occupation *

Industry *

Employer/Business Name *

Employer's/Business Address *

Please specify other source(s) of income apart from your occupation

Next of Kin Details

Fullname *

Gender *

Relationship *

Residential Address *

Email Address *

Contact Number *

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BANK DETAILS

Bank Account Name *

Bank Name *

Bank Account Number *

BVN *

AUTHENTICATION FOR POLITICALLY EXPOSED PERSON

Have any signatory or any affiliate/relatives occupied any Political Position? *

HOW DID YOU HEAR ABOUT US?

How did you hear about us? *

DOCUMENTS UPLOAD

Passport

Valid ID

Utility Bill

Signature

Accepted file types: PDF, JPEG, JPG, PNG. Maximum file size: 1MB. Maximum passport dimensions: 700px by 700px

DECLARATION

I/We am/are 18 years of age or above.

I/We agree to the amount payable in full on application for the units in the Marble Private Fund.

I/We understand that we will receive our allotted units in either Certificate or E-certificate form.

I/We authorize you to send a Certificate and/or cheque, for any amount overpaid or rejected by registered post at my/our risk to the address given above.

I/We hereby declare that I/We have read, fully understand and accept the data privacy consent

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