Nexhange - Sign up Form

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BVN (Biometric Verification Number)

CTP Code

A. Identity Details

username

First Name

Last Name

Gender

Date of Birth

Marital Status

Telephone Number

Father's/Spouse Name

Mother's Name

Occupation

Nationality

Residential Status

Proof of Identity Type

Proof of Identity Number

Proof of Identity

B. Address Details

Step 2

Address Line 1

City

Address Line 2

State

Proof of Address Type

Proof of Address

B. Guardian Details

Guardian Name

Guardian Contact

Guardian Address

Guardian Signature

C. Account Password

password

D. Declaration

I hereby declare that the information provided in this form is accurate and complete. I confirm that any0 information found incorrect and/or incomplete that can lead to violation of regulations may initiate legal actions, and I accept that I am the responsible party for any and all charges, penalties and violations.

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