SME Accounts

*Please fill in the form in BLOCK letters and tick the appropriate boxes. Please note that all field are mandatory.
Are you a?*
- New Customer
- Existing Customer
- Agent Banking Operating Account
Preferred Branch*
Date*
DD slash MM slash YYYY
ENTITY DETAILS
Legal Entity Name*
Trading As*
Holding Entity Name*
Company Reg No*
Date of Incorporation*
DD slash MM slash YYYY
Country of Incorporation*
Date of Business Commencement*
DD slash MM slash YYYY
No of Employees*
Email address*
Business Tel. No.*
Residential Physical Address*
Road/Street Name*
Residential Area*
Road/Street Name*
Town*
City*
Province*
ZIP / Postal Code*

ADDITIONAL SERVICES
I would like my statement*
Statement frequency*
I would like a cheque book*
I would like a debit card*
I would like*
- Internet Banking
- E-Tax
- E-Napsa
- E- School
LEGAL ENTITY CONTACT DETAILS
Business Tel. Number*
Fax Number*
Email address*
Other email address*
Physical Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Mailing Address
- Same as physical address

OTHER BANK DETAILS
Bank Name
Branch Code
Applicable Product Type
Please Specify
Average Balance
Date Account Opened
DD slash MM slash YYYY
Years Banked
Please download, read and fill the agent contract application form here and upload it below.
Agent Contract Application Form Upload*
Accepted file types: pdf, Max. file size: 4 MB.
Please download, read and fill the agent appraisal form here and upload it below.
Agent Appraisal Form Upload*
Accepted file types: pdf, Max. file size: 4 MB.
MARKETING CONSENT
Atlas Mara / Partner Products and Services*
- Yes
- No
How did you hear about Atlas Mara?*
- Advertising
- Walk-In
- Campaign
- Referral
I have read and agreed to the terms and conditions.*

View terms and conditions

Nature of Business	Description

Name	ID No / Co Reg No	Share %

Name	ID No / Co Reg No	Share %