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1. Account Holder Information: Details of the account holder including full name, address, phone number, and valid identification details as required by CBN KYC regulations
2. Bank Account Details: Complete banking information including account number, bank name, branch, and BVN (Bank Verification Number)
3. Withdrawal Authorization: Clear statement authorizing the bank to process direct withdrawals, including the purpose of the withdrawal
4. Transaction Details: Specification of withdrawal amount, frequency (one-time or recurring), and timing of withdrawals
5. Beneficiary Information: Details of the party receiving the funds, including their complete banking information
6. Terms and Conditions: Standard terms governing the direct withdrawal arrangement, including the rights and obligations of all parties
7. Cancellation Policy: Clear explanation of how and when the direct withdrawal mandate can be cancelled or modified
8. Declaration: Statement confirming the accuracy of information provided and agreement to the terms and conditions
1. Maximum Withdrawal Limit: Optional section for specifying maximum withdrawal amounts, recommended for variable payment arrangements
2. Third Party Authorization: Required only when the withdrawal is being set up by someone other than the account holder
3. Multiple Account Authorization: Used when withdrawals may be made from multiple accounts
4. Special Instructions: Any specific instructions or conditions for processing the withdrawals
5. Electronic Notification Preferences: Optional section for specifying how the account holder wishes to receive transaction notifications
1. Schedule A - Payment Schedule: Detailed breakdown of payment dates and amounts for recurring withdrawals
2. Schedule B - Required Documentation: List of supporting documents submitted with the form (ID copies, proof of address, etc.)
3. Appendix 1 - Terms and Conditions: Detailed terms and conditions referenced in the main form
4. Appendix 2 - Fee Schedule: Breakdown of any applicable fees and charges related to the direct withdrawal service
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