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Business Information

Required fields are noted with an asterisk.

Please note that value fields do not accept commas or decimal points.

Company Information
Name of Company:
  DBA Company Name:
Company Ownership:
 
 
Total Number of Employees:
 
Registered Address
Address:
 
City/Town:
Country:
State/Region:
Zip/Postal Code:
Registered E-Mail Address:
Confirm E-Mail:  
 
 
Correspondence Address
Address:
 
City/Town:
Country:
State/Region:
Zip/Postal Code:
Remit To E-Mail:
Confirm E-Mail:  
 
Company Phone Number:
Company Fax Number:
Company Web Site (URL):
 
 

Contact Information
Management Contact
First Name of MD/CEO:
Last Name of MD/CEO:
Title/Designation:
Phone Number: Ext.
Mobile Number:
Fax Number:
E-Mail Address:
User Name:
 

Contact Information
Primary Contact
First Name:
Last Name:
Title/Designation:
Phone Number: Ext.
Mobile Number:
Fax Number:
E-Mail Address:
User Name:
 
Secondary Contact
First Name:
Last Name:
Title/Designation:
Phone Number: Ext.
Mobile Number:
Fax Number:
E-Mail Address:
 
Please provide details of Board of Directors/ or Authorized Officers
Director 1 /or Authorized Officer 1
Director's Name:
Title/Designation:
Phone Number:
E-Mail Address:
Director 2 /or Authorized Officer 2
Director's Name:
Title/Designation:
Phone Number:
E-Mail Address:
Director 3 /or Authorized Officer 3
Director's Name:
Title/Designation:
Phone Number:
E-Mail Address:
Director 4 /or Authorized Officer 4
Director's Name:
Title/Designation:
Phone Number:
E-Mail Address:
 
Upload Form C02 - Statement of Share Capital & Return of Allotment Shares:
Upload Form C07 - Particulars of Directors & Any Change Therein:
Upload Organization Chart:
 
Nigerian State where the Company Head Office is located:
 
Other Branches:
 
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