Page 1 of 2
Form 121 (Rev. 12/2019)
BUSINESS ONLINE BANKING APPLICATION - Phase 1
.../Specify More Accounts Over (as needed)
Customer No. (CIF#): (Bank Use Only)
Business (Legal) Name:
Business Type:
Corporation /
Company
Partnership
Sole Proprietorship /
Trading As
Charity, Lodge, Unincorporated
Church, Association, Club, etc.
Business (Trading As / Doing Business As) Name:
Business Address:
City: Island/State (Zip):
Country: P.O. Box
Main Telephone Number: ( )
Sector:
(Select One):
9410-Private
Financial Institution
9584-Other Private
Non-Financial Institution.
9101-Central
Gov’t/Public Corp.
BOB Express Online Banking - Service Request Details: Phase 1
The following online banking functions will be made available during the Phase 1 roll-out of BOB Express Online Banking for the designated Business Accounts
selected for Online Banking access (current and any additional identified):
Information: Account Information; Account Transactions; Account Turnovers; Loans & Term Deposits Inquiry; Account Statements; Cheque Images
Inbox: View System Messages; Settings: View User Profile; Change password; Change PIN; Login & Logout
When Available We want to perform foreign currency transactions online (e.g. Foreign Wires and Transfers, Amex Pmts., Request Foreign Drafts)
Online Banking Administrator Information:
The Business Online Banking Administrator is designated by the business’ delegated signatories, and will serve as the Point of Contact to assist with the coordination
of administering the business’ online access to accounts and users. All online banking change requests must be summarily approved by the business’ delegated
signatories. I / We confirm the Business’ Online Banking Administrator role is delegated to:
Administrator Name:
Work Phone Number: ( )
Work Email Address:
Work Mobile Number: ( )
Account Information:
Specify whether to Add or Remove the Accounts accessible to the Business’ online banking registration. For each Business Account specified, only View Access
will be provided during Phase 1
Action
Account Number
Signing Authority: Phase 1
CIF # S/C/CA
(Internal Use Only)
ADD
REMOVE
View Only
ADD
REMOVE
View Only
ADD
REMOVE
View Only
ADD
REMOVE
View Only
ADD
REMOVE
View Only
ADD
REMOVE
View Only
ADD
REMOVE
View Only
ADD
REMOVE
View Only
BUSINESS ONLINE BANKING APPLICATION Page 2 of 1
Form 121 (Rev. 12/2019)
.../Specify Authorised User Information on Additional Sheets Provided (copy as needed)
Authorised User Information::
See the Addendum Page Provided. Make copies as required and provide the details required for the setup of each User that is duly authorised to access the Business’ Accounts online
DECLARATION
I / We hereby declare that the information provided by me/us in this application is correct and complete to the best of my/our knowledge and that I/we have read,
understood and accepted the Terms and Conditions outlined in the BOB Accounts Terms and Conditions Agreement, Telephone, Fax and Email Agreement and
Online Banking Agreement and shall be bound by the terms and conditions therein. I/We agree that the information provided may be used to establish and maintain
the services specified with the Bank, and the Bank may offer me/us any services from time to time, as permitted by law, regulatory and / or statutory body and / or
government organization.
---------------------------------------------------------------------------------------------------------------------
Authorised Signature Date
---------------------------------------------------------------------------------------------------------------------
Name of Signing Officer
---------------------------------------------------------------------------------------------------------------------
Title of Signing Officer
-------------------------------------------------------------------------------------------------------------------------
Authorised Signature Date
-------------------------------------------------------------------------------------------------------------------------
Name of Signing Officer
-------------------------------------------------------------------------------------------------------------------------
Title of Signing Officer
---------------------------------------------------------------------------------------------------------------------
Authorised Signature Date
---------------------------------------------------------------------------------------------------------------------
Name of Signing Officer
---------------------------------------------------------------------------------------------------------------------
Title of Signing Officer
-------------------------------------------------------------------------------------------------------------------------
Authorised Signature Date
-------------------------------------------------------------------------------------------------------------------------
Name of Signing Officer
-------------------------------------------------------------------------------------------------------------------------
Title of Signing Officer
---------------------------------------------------------------------------------------------------------------------
Authorised Signature Date
---------------------------------------------------------------------------------------------------------------------
Name of Signing Officer
---------------------------------------------------------------------------------------------------------------------
Title of Signing Officer
-------------------------------------------------------------------------------------------------------------------------
Authorised Signature Date
-------------------------------------------------------------------------------------------------------------------------
Name of Signing Officer
-------------------------------------------------------------------------------------------------------------------------
Title of Signing Officer
-- BANK USE ONLY --
1. Customer Application Reviewed with ALL Supporting Documents
2. Customer User Callbacks Completed
3. Customer Signature(s) Verified to Bank Records
4. Customer CIF, CASA Records created / updated:
5. Auth. Users CIF, CASA Records created / updated
6. Online IDs Generated and logged
7. Online Registration Completed
Relationship Manager:
(Name)_______________________________________________________________
Verified By:
(Name/Signature/Date)___________________________________________________
Core Banking Setup
Input By:
(Name/Signature/Date)___________________________________________________
Reviewed By:
(Name/Signature/Date)___________________________________________________
eBank Setup – Phase 1
Input By:
(Name/Signature/Date)___________________________________________________
Reviewed By:
(Name/Signature/Date)___________________________________________________
BUSINESS ONLINE BANKING APPLICATION Addendum Page
Form 121 (Rev. 12/2019)
Authorised User Information:
COPY THIS PAGE AS REQUIRED Phase 1
Provide the details required for the setup of each User that is duly authorised to access the Business’ Accounts online. Provide copies of the Know Your Customer (KYC) Document
and NIB / SSN referenced for identification. Confirm the Type of View Access required and which registered Accounts should be made available for each Authorised User to View.
Each Authorised User will receive 3 (time-sensitive) emails with their unique credentials to facilitate their login once Registration is completed.
User (# ) Phase 1
Action
Authorised User Details
ADD
CHANGE
REMOVE
Name:
Existing BOB
Customer?
Job Title:
CIF # (Internal Use Only)
Birth Date: D D M M M Y Y Y Y
NIB / SSN Number:
KYC Document Type
KYC Document Number
KYC Doc. Issuing Country
KYC Doc. Expiry Date
Work Email:
Work Mobile Number: ( )
Work Phone Number: ( )
User Access Type:
(Select as Required)
View Accounts
View Loans and Term Deposits
Specify A/Cs
to View:
#
#
#
#
#
#
#
#
Bank Use
Only:
New Br-CIF# Online ID: Response:
User (# ) Phase 1
Action
Authorised User Details
ADD
CHANGE
REMOVE
Name:
Existing BOB
Customer?
Job Title:
CIF # (Internal Use Only)
Birth Date: D D M M M Y Y Y Y
NIB / SSN Number:
KYC Document Type
KYC Document Number
KYC Doc. Issuing Country
KYC Doc. Expiry Date
Work Email:
Work Mobile Number: ( )
Work Phone Number: ( )
User Access Type:
(Select as Required)
View Accounts
View Loans and Term Deposits
Specify A/Cs
to View:
#
#
#
#
#
#
#
#
Bank Use
Only:
New Br-CIF# Online ID: Response:
