Expression of Interest

Vertex City Ltd.

Where excellence meets elegance

EXPRESSION OF INTEREST FORM

INSTRUCTIONS:

Please read this form carefully before filling.
Please supply accurate information only.
All enquiries should be sent to Vertex City Official email: vertex1@outlook.com

Note: (All details will be treated as confidential)

Personal Information

Title:

Surname:

First Name:

Other Name:

Email Address:

Residential Address:

Date of Birth (DD/MM/YYYY):

Phone Number:

Marital Status:

Next of Kin

Full Name:

Mobile Number:

Email:

Address:

Employment Details

Name of Company:

Nature of Business:

Position Held:

Means of Identification

Nationality:

International Passport

National ID Card

Voters Card

Driver's License

Others

Enter Selected Identification Number:

Reason of Purchase

Investment

Residential

Others

Source of Funds

Salary & Allowance

Cooperative Contribution

Savings

Personal income

Business Income

Sales of Personal Property

Loans

Official Payment Details

Please make all payments to the official Vertex City Ltd. account below.

Bank Name: PREMIUM TRUST BANK

Account Name: Vertex City Ltd.

Account Number: 00140171009

PAYER'S DETAILS

Sender's National Identification Number (NIN):

Sender's Account Name:

Sender's Account Number:

Sender's Bank:

Sender's Phone Number:

Acceptance & Undertaking

I/We whose particulars are as stated in the attached expression of interest form do hereby affirm that the information provided is accurate and true.

OFFICIAL USE:

Consultant Name:

Phone No.:

Consultant Email:

I/We Confirm that I/we have read and understood the terms and offer and agreed to be bound by the terms. I/We agree that terms of this offer and application form parts of my/our contract and it shall be read in conjunction with other legal documents executed by me/us during the course of this transition.

Purchaser's Name:

Purchaser's Sign (Type Full Name):

Date:

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