Banking-Serice Oromia Bank

TaTaejila Baankiildilee/DgN P0h

Boonddl Orarmly
0ta
ANot/Conventional
Banatan
Unka Herrega Baankii Ittiin Guyyaa/4) Jla/D
/P02h h^n Dh43 6/Bank Account Openina Forrm
TajaajilliYeroo itti Jal

Magaa Damee /C) 69, NgP/Branch Name. Service Start Time

Account
Gosa Herregaa/An 9eit Type ofegotaSharafa Alaatin Banatan
Herrega Sochoaa Herrega Qusanno0 FCY Account
Current Account Saving Account Herrega Dlyaaspooraa ETB USD
Herrega Socho'aa Herrega Qusannaa lditee
FCY Diaspora Account
Current Account Ordinary Saving Account NRFCYHerregaSharafa Alaa EURO GBP
Herrega Daladala Gabaa(ECX) Herrega Qusannaa Addaa
NR FCY Account Kana dura Maamila
ECX Related Account other Saving Account avaf Alaa AddaAddaa
hHU +g pnnBaankil Keeny
PROXNyaati
Herrega SharalegH A0 e) eM¢h)
ARAPPaO-A. Existing Customer
Other FCY Account Lakki
Eee Yes
XeRAD
No

Lakk. Herrega mnaarmilaa

Ta Elektiroonik Baankiingii barbaaddan filadhaa Bank Customer No.
Put "X"in the box, if you need one or more E-payment channels listed here under.
Tajaajila Baankii Intarneetii/StC hT/nternet Banking
Tajaajila Kaardii Kaffaltii /hcg hce/Debit /ATM Card Tajaajila Baankii Moobaayilaa/qone.A n)h9/ Mobile Banking
DZ2/Customer Details
Odeeffannoa Guutuu Maamilaa /PeYnE HCHC

Maqaa/hgP/Name Magaa Abbaa/PMt hg/Fathers' Nane

Koorniyaa
atogoaAkaakayuu /NJT ngMast Name
Guyyaa Dhatootaa
lesee
Magaa Kabajaa Date of Birth
Title
Gender
Bakka Dhalootaa Magaa Haadhaa irital Status
Mother Name
Place of Birth

l_lsclerf
GatiiJiaa
PGE Barnootaa Gatee Hojll DCUC n
Monthly Income
Occupation
Educational Level Gita Hojii
Galii Waggaa Hojechisaa
Position
Annual Income Employer
Ousannaa Jalaabaa
PODEOD9 t096
Initial Deposit
Teessoo eLn/Address
Qaama Kenne -meeyilii
Naannoo
hAA
Region
AA Issued By.
BRA
E-mail

.Gibiraa Addaa
Guyyaa Kenname
Magaalaa
ht9
City
A Issued Date

Lakk, Waraqaa Eenyummaa Biyyoolessaa

Kutaa Magaalaa
National ID Number ate
Sub-city Zone
Lak Moobaayilii
Aanaa/Ganda
Mobile No.
Woreda/Kebele
Bilblla Sararaa (Hoji/Manaa)
Lakkoofsa Manaa ODN DC hah (PDhcg NA/nA)
Telephone (Office/Resident)
House Number

Gosa Waraqaa Eernyurnmaa

Lak Faaksi OromiaBanlk
Fax Nurnber Sdist KiNO Srano
ID Type
Lak Saanduga Poostaa
Lakk.W.Eenyumnga
LNo
ID No.

5345
Sarmuuda Mallattoo

Sarnple Signature

3
1533751 gaaetaaf karnhingeenye tauu minaneessaao
rodeeffarrnoo guddistuu seeraatiin-kan-
AnTlyyataan GuddistuuSeeraa yoonan ta u u l a l abiraa voonan dabarse qofaa dha.
socho'u hanga umrin ishiisaa9 a R e A) RARLO DU H/S) NSON n^ L0) 9h UA
it /Guardian of the following appllant, hearby declare that the applicht isa minor.HisA
barbaachtsutrundaaTkanarr dhiyeessee f herreegn-krang
becomes adult or neccessary information has been furnished above.
Ibeing the lawtul Parent signature being lawful Guardian until the minor anyother
The account will be operated under my
1.1 Kan Gaa'elaaf hin Geenye
/ D )RP /h)AARLAFor Minors decdaration
is given by me.

AARZNT 0g/Narme of the Minor/

Magaa Gaa'elaaf Hin Geenye/AN+D NR9P/ dsP)
Guyyaa Dhalootaa/DAL /Date of Birth
Parernt/Guardian(s)
Magaa Guddistuu/DAE OR)gP PqoAg/Name of
Firummaa Qaban HRS/Relationship

BaankiI Unmatdd PUH00h

PEOPLES'BANK
 PUHOh
Urmafo
aankil
BANK
PEOPLES
Dhihoo Agent
tau
LTee
Yeroo Photo
4Ce
Ho99anaa Kaate
Ka'e AC ogened
Attorney Buaa size
Katalc
passport aCOunt
Aanaa
bank of Bakkaa
banuuhi
withdrawal bobba'e Address Omo
Itti the
PtR)/Dte
requreykn
Herrega fron Suuraa Recent
Damee
and
be
iratt and
NEGVName
Applicant(s)
so
law gochuudhaanshall
account
Hogganao holders
dhaabbatich Mianeessee/
A
witneses Addaa algabaa
Quarnaa
the
Monthly
lncome Aerual
income Fueld
ofBusiness An
e(e
for the account nitial
Depost
Gibiraa
Lakk Gal
Viagaa
Cheth
be. tokko of two hojli ofSignature
may tokkko cpening 04)E aa
Gal
Hojt
Gesa
ase ragaan the
baankii
the
Entity tO ofigrature
razwata.
the
side
tau hecCustomer
of
sigrature
TIN
Busa ariy Malattoo emegni
ADMea
as ogeessa
O0
Sin and use
fulduratti
niolary/judgefrecistrar
witnesses Eriineis Legal Baia
Name ofce and
Mannsh Gyaa
bin the obn joint
)A5A) PMFor Nase
by eeson
kenriameef twooeted
of mirca
Bank Account)
(AD
account by
operated hA/ Full
) by only mirkaneessahub gaalauaudhaaf
taasifama
Wayjinin
banan
k o areplaced
DMe ofecoral nPO
seeraan
maamchaafi withet
ibaanki accounts inin
kaadhaan De
Aom
te and sha. Dhurtatu Ae
diasporanan
mallattockDon D DO
Po2nm0 oresence
ngoonO laaanuu leftno
ase
account
ttMen0)
Kaffalamu / hu
ooeatad
XntrUnn
)
be
vmay n AFFor operate
the Qabeessa Luh
W
Eeryuma erae ti
Gwya f
qofa
the ganga 2.1
AIT
However, Saa Joint Saanduga
Lak
Poostaa Lak
Moobaayll
ajaaj Expired
Date Blbla
Sararaa
Oauma
Kerne
hALThe Itiyoophiyaa
Kabacsuun
QuNA uu pertinert nuuf jchat
A Abbaan toicNDmaarmilaaSn
Seeraa/qaa
in number AOi) Telephone
Offce account ThMO
hA Issued
Date Moble
No Teleghvone Loboca
banne ta directve isued
by
A put nama officer. hundaaee to akka wan30 qATC Saaraa
Babila Gya O
TT
Herrega
Dandeenye
be
epersonseeraAnG
shouldraga der bank hin the Joirthyn
s
Seera Lak
Erhiopia
Mobaayl
Mobile
No Faaka
Lak PORox
Na Fmeey
Galmee
Lak the Comcarce
Etiop hnE
As akka iraetiwith h¯h/ na N
1D
Tajaajla
o0.0biind/nan-iterate
mark ta'u one Diyaaspooraa line the mCNatiojal
yoo UNC in Bivwaalesoa of Qaama De590 arnh
and (ONS
aer
thumbgabu
aarna
hern
side Manage.
qofaat/na
bank in
stricthy qarsh
in Bank
Biyyaalessaa
Baankil
acCOunt Cortrol
buaan stared
and
condition
customer any ATDMegkeessaa
i National
nHin his kanbeaanaan herrega
at ocerated ht07 of
baikaor aangoo
openajoint
Branch Baankii
Account nnát0 ue
Barreessuu
with her n3204 banne the Nane p0 imalattoo
/A0
madebakkathat adhaaf the jiraatan
fromthe Itlyoophiyaa
kessatti
Diaspora
be linewith
Convinced aor
to n34
Herregato danbii
h9/Organization
schgtaie
Name
be Kennamu
has /AAn) you
fDhabeeyyii/Dubbisuu terms
r Manager
one biyya
alaa
kan in /Yld
to account
agreement thebe
opened
FCY fme
sochoosuuf fi strictly
requested
keenyaan seeraa
tSull fiGuutuu
Byyoalessaa
sochoosuuf
well
bankshalService ARhA) 7HereRgichibalhabuaanyap
proposed operated Gvyaa
Dhabbatichi
Hundaa'e
is witness Haala Maanian
Herege
Lakk ha
Lustoaer
Bark
person taaniibaankolee
the Customer didn'tka maqaaand /EC
apeirig
af
signed
lkun qofa Soch¡'u
Herregni
kan be
a°thorized Business Organization
Est.
Date
bg
/Ph
Maqaa
Eeyurmaa
adsigate
Mallartoe
hg
Masah
Herrega The
discretion 3Lamnii
Ityoophiyaa Baname the
walwayin
Gosa
Dhaabbatichaa
Dhaabbataa Mallattoo
Macaa
2galteeiliterate
Qarao walvwajjin shall Kebele.Aareda Magaalaa
Kutaa Lakkoofsa
Manaa
account dura that Kutaa
Magaalaa Guutuu da/Kebeie Nunber
House
Accounit the Sub-city
/rone Ganda/Aanaa alyanaa/Garnda
/zone
alattoon be he
under note 3 hereby acrurt of
form
and
sole Ani
kanaan Herreeani Magaala eneeyi Waragaa
Hiease4HeTega
blind Baankiin theshall
nhy)
Herrega Magaala
Counitry Maraa Naanno0
Region reda Nane
ng Hereenn Maqaa Fmail
thehom Ihe Legal Biyya ht9y hegCity Fub
The one
In Lakk.
 Female
|t 0969137472
06, Full Email: FullSex/PJ: Phone
DateNumber:
hl, of
Address/r- Name/^
Birth:
AA
kn9 1986/03/18
Ng:
hST:
EMEBET

Woreda
WORKU
06, Oromia
BankS.C
Arada, WESENE| e-KYC
Fayda

Addis
Dn+
Ababa
DC*
@A
Dn