1. Personal InformationName *Date of Birth *Country of Birth *National Registration Number *0 / 11National Insurance Number *TIN/ TAMIS Number *Marital Status *Please select an option-SingleMarriedDivorcedSeparatedWidowed2. Permanent AddressStreet Address *Apartment, suite, etcCity *The Mailing Address is the same. *YesNoMailing Address *Apartment, suite, etcCity *3. Contact InformationEmail Address *Home Phone # *Work Phone # *Cell Phone # *4. Employment StatusI am ... *Select oneEmployedSelf - EmployedUnemployedRetiredStudentYour Current OccupationOccupation Type *Select oneProfessionalSupervisorSenior ExecutiveSkilled WorkerMiddle ManagementName of your Business *Name of your Employer *Industry/ Nature Of Business *Business Address *Apartment, suite, etcCityYears Employed *Annual Salary *5. Document ChecklistLetter of Good Standing from Bank *Choose FileNo file chosenDelete uploaded fileProof of Identification *Choose FileNo file chosenDelete uploaded fileProof of Address: Utility Bill *Choose FileNo file chosenDelete uploaded fileProof of Income: 3 recent payslips *Drag and Drop (or) Choose FilesProof of Employment: Job letter from Employer *Choose FileNo file chosenDelete uploaded fileList of Assets / Liabilities *Choose FileNo file chosenDelete uploaded file6. Customer Declaration & ConsentI/We declare that this information, including any annexes and supporting documents that are attached hereto, is true and correct and Innotech Equipment Inc is entitled to verify the same either directly or through any third-party agent. I/We also agree that, if any such declarations made by me/us are found to be incorrect, Innotech Equipment Inc shall be entitled to terminate the account relationship. I/We confirm having read and understood the account rules ofInnotech Equipment Inc, and hereby agree to be bound by the terms and conditions and amendments governing the account(s) issues by Innotech Equipment Inc from time to time. I/We also agree that Innotech Equipment Inc can disclose this application, any information contained therein, other related confidential information and transactions in this application and on accounts linked to me to law enforcement and regulatory authorities.For Sole Proprietorships – this document shall be signed by the Sole Proprietor. For Partnerships – signed by the persons authorized as per the company’s existing PartnershipResolution. For Companies – signed by persons authorized as per the company’s existing Mandate.I/We confirm that the company has not been or is not in the process of being dissolved, struckoff, wound-up, terminated or placed under receivership or liquidation. Send Message
