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No 2 Assumpta Avenue, Opp UBA, Bank Road Owerri, Imo State.
08107148122
info@imostatemfb.com

Online Account Opening Form (Kindly fill out the form)

Surname

First Name

Middle Name

Email

Phone Number

Date of Birth

Place of Birth

Address

Next of Kin Fullname

Next of Kin Phone Number

Next of Kin Address

Gender Male Female

Marital Status Single Married Divorced Widowed

Client Type

BVN

ID Card Type

ID Card Number

ID Card Copy/Scan

Passport Photograph (Jpg, Jpeg, Png, Gif)

I hereby attest the veracity of all above information and authorize Imo State Microfinance Bank Limited to create the related account accordingly.

I Accept the Terms and Conditions

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No 2 Assumpta Avenue, Opp UBA, Bank Road Owerri, Imo State.
08107148122
info@imostatemfb.com

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