SCUML REGISTRATION FORM Registration Incorporation/Registration/Business Name * Company name must be exactly how it is captured on your company Certificate CAC Type * RC BN CAC/IT Other CAC Type RC No or BN Number * Date of Company's Registration * TIN Number * Company's Trade Name DNFI Category * Audit Firms Cars & Vehicles Chartered Accountants Clearing and Settlement Construction Company Consultants and Consulting Company Dealers in Jewelries and Luxury Dealers in Real Estate Estate Surveyor & Valuers Hotel & Hospitality Legal Practitioners Mechanized Farming Mortgage Brokers NPOs Pool, Betting, Lottery and Casino Precious Stones & Metals Supermarket Tax Consultants Trust and Company Services BVN * Company Account Number * Bank Name * Access Bank Plc Fidelity Bank Plc First City Monument Bank Plc First Bank of Nigeria Limited Guaranty Trust Bank Plc Union Bank of Nigeria Plc United Bank for Africa Plc Zenith Bank Plc Diamond Bank Plc Ecobank Nigeria Plc Heritage Banking Company Limited Keystone Bank Limited Polaris Bank Limited Stanbic IBTC Bank Plc Standard Chartered Sterling Bank Plc Unity Bank Plc Wema Bank Plc SunTrust Bank Nigeria Limited Providus Bank Limited Jaiz Bank Plc Abu Microfinance Bank Abbey Mortgage Bank Addosser Microfinance Bank Bc Kash Microfinance Bank Cemcs Microfinance Bank Daylight Microfinance Bank Enterprise Bank Eso-E Microfinance Bank FBN Merchant Bank CitiBank Nigeria Limited TAJ Bank Limited Titan Trust Bank Ltd Globus Bank Limited SunTrust Bank Imperial Homes Mortgage Bank Parallex Bank Ltd FSDH Merchant Bank Limited LOTUS Bank Brief Description of Business Head Office Address (Physical Address) * State * Abia State Adamawa State Akwa Ibom State Anambra State Bauchi State Bayelsa State Bayelsa State_Old Benue State Borno State Cross River State Delta State Ebonyi State Edo State Ekiti State Enugu State FCT Gombe State Imo State Jigawa State Kaduna State Kano State Katsina State Kebbi State Kogi State Kwara State Lagos State Nasarawa State Niger State Ogun State Ondo State Osun State Oyo State Plateau State Rivers State Sokoto State Taraba State Yobe State Zamfara State Phone Number * JTB No (Taxpayer ID No) Branch Office(s) Address (Physical Address) Website/URL Director's Name * Director's Name (2) Director's Name (3) File Upload * Drop a file here or click to upload Choose File Maximum upload size: 2MB Please scan all your documents as one PDF file - The file should not exceed 2MB please. Indicate Preferred Nearest SCUML Office to pick your certificate * Abuja FCT Enugu Gombe Kano Lagos Rivers Maiduguri Ibadan Kaduna Benin Sokoto Ilorin Uyo Makurdi Email Address * Your Email Address (You will need this to login to your account if necessary) Password * Create your SCUML Account Password Contact Person For The Organization Name of Contact Person * Must be one of the management staff of the organization Email Address * Contact Phone Number * Checkboxes * I read and understood the registration guideline on the home page