Product InformationWhat Product Are You Applying For? DLM Fixed Income Fund Are you an existing client of DLM Fixed Income Fund?(Required) Yes No Postal address Amount (₦) (that you want to invest) Write it in words Company InformationCompany/Business Name(Required) Certificate of Incorporation Registration No.:(Required)Business Type/Nature Sector/Industry(Required) Corporate / Operating Address Street Address Address Line 2 City State / Province / Region Tax Identification Number (TIN) BVN(Required) Average Annual Turnover: Less than 50M 50M – Less than 500M 500M – Less than 5B Above 5B Preferred mode of communication:(Required) Email Telephone Letter Visit Special Control Unit Against Money Laundering (Scuml) Reg. No Bank Account InformationAccount Name(Required) Account Number(Required) Bank Name(Required) INTEREST/DIVIDEND RE-INVESTMENT: * Yes No Details of Account SignatoryName(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Title First Last Nationality Nigerian Others Marital status Single Married Widowed Date of BirthDD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address Postal address Residential address Applicant’s Email address(Required) Telephone Number(Required) Mobile Number Means of Identification(Required) National ID Card National Driver’s License International Passport INEC Voters Card ID Card Number(Required) ID Card Issue DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ID Card Expiry DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Tax Identification Number (TIN) BVN Date of EmploymentMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Employer’s Name First Last Employer’s/Employment Address(Required) Nature of Business/Occupation Authorized SignatureMax. file size: 512 MB.KYC DocumentGovt. ID Card(Required)Max. file size: 20 MB.Utility bill (not later than 3 months)(Required)Max. file size: 20 MB.Passport Photograph(Required)Max. file size: 20 MB.Details of Account Signatory 2Name Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Title First Last Date of Birth:MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Nationality (copy) Nigerian Other Marital status Single Married Widowed Address Residential address Applicant’s Email address Telephone Number Mobile Number Means of Identification National ID Card National Driver’s License International Passport INEC Voters Card ID Card Number ID Card Issue DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ID Card Expiry DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Tax Identification Number (TIN) BVN Date of EmploymentMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Employer’s Name First Last Employer’s/Employment Address Nature of Business/Occupation FileMax. file size: 512 MB.KYC Document 2Govt ID CardMax. file size: 512 MB.Passport PhotographMax. file size: 512 MB.Utility Bill (Not Less than 3 months)Max. file size: 512 MB.Details of Account Signatory 3Name Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Title First Last Nationality Nigerian Other Date of Birth:MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Marital status Single Married Widowed Address Residential address Applicant’s Email address Mobile Number Telephone Number ID Card Number Means of Identification National ID Card National Driver’s License International Passport INEC Voters Card ID Card Issue DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ID Card Expiry DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Tax Identification Number (TIN) BVN Date of EmploymentMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Employer’s Name Employer’s/Employment Address Nature of Business/Occupation Authorized SignatureMax. file size: 512 MB.KYC Document 3Govt. ID CardMax. file size: 512 MB.Utility bill (not later than 3 months)Max. file size: 512 MB.Passport PhotographMax. file size: 512 MB.Declaration By ApplicantsConsent(Required) I have attached a cheque, bank draft, or evidence of fund transfer payment made payable in the name of my chosen fund to DLM Asset Management. I/We understand that as with all stock market investment, the prices of Money market Funds (DLM Fixed Income Funds) invested in quoted securities may go down or up. I understand that past performance is not an indication of future performance. I agree to comply with the minimum investment period specified for any of the Mutual Funds, failing which I accept any losses, charges or costs that may arise at the point of redemption of my investment. I/We agree that my e-statement can be sent at my risk to the correspondence address/email address I have provided. I/We hereby authorize the Fund Manager to honour redemption requests and instructions sent by electronic mail in respect of my investment holdings in the Fund. I/We declare that the above information is true. Indemnity For Redemption Requests/Instructions Sent by DLM Fixed Income Fund Clients Through Electronic Mail(Required) I/We hereby authorize the Fund Manager to honour redemption requests and instructions sent by electronic mail in respect of my investment holdings in the Fund and in this regard confirm the email address captured as designated one for this purpose. Upload Unit Holder's SignatureMax. file size: 512 MB.Date of ApplicationMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920
