Government of Ghana Treasury Bills and Bonds Application Form
Government of Ghana Treasury Bills and Bonds Application Form
1. A/C Name
3. Branch Name
(A/C Domiciled)
4. Address
7. National ID No.
61 to 91 Days Up to 2 Years
9. Pursuant to the issuance of Treasury Bills and Bonds by Bank of Ghana, the undersigned here offers to purchase security as indicated
below:
a. Investment Amount GHS / USD
•
Cancel One
b) Re-invest principal + interest on maturity until further notice (Applicable only to investments up to 182 Days)
c) Do not Re-invest
vi. Any non-discretionary account or similar account (other than an estate or trust) held by a dealer or other fiduciary for the benefit
or account of a U.S. Person;
vii. Any discretionary account or similar account (other than an estate or trust) held by a dealer or other fiduciary organized,
incorporated, or (if an individual) resident in the United States; and
b. Formed by a U.S. person principally for the purpose of investing in securities not registered under the Act or for
otherwise evading the application of U.S. securities laws
2. ‘Resident’ in the United States will mean you are physically located in the US for 3 months or longer in a 12 month period or you want
correspondence / communications to be sent to you / made via :-
i. A US mailing address; or
i. Any discretionary account or similar account (other than an estate or trust) held for the benefit or account of a non-U.S. person
by a dealer or other professional fiduciary organized, incorporated, or (if an individual) resident in the United States;
ii. Any estate of which any professional fiduciary acting as executor or administrator is a U.S. person if:
a. An executor or administrator of the estate who is not a U.S. person has sole or shared investment discretion with respect to
the assets of the estate; and
iii. Any trust of which any professional fiduciary acting as trustee is a U.S. person, if a trustee who is not a U.S. person has sole or
shared investment discretion with respect to the trust assets, and no beneficiary of the trust (and no settlor if the trust is
revocable) is a U.S. person;
iv. An employee benefit plan established and administered in accordance with the law of a country other than the United States
and customary practices and documentation of such country;
v. Any agency or branch of a U.S. person located outside the United States if:
B. The agency or branch is engaged in the business of insurance or banking and is subject to substantive insurance or banking
regulation, respectively, in the jurisdiction where located; and
vi. The International Monetary Fund, the International Bank for Reconstruction and Development, the Inter-American Development
Bank, the Asian Development Bank, the African Development Bank, the United Nations, and their agencies, affiliates and
pension plans, and any other similar international organizations, their agencies, affiliates and pension plans.
“United States” means the United States of America, its territories and possessions, any State of the
United States, and the District of Columbia.
Govt T-Bill Form version 8
24/05/2016
13. DECLARATION
I declare that in the event that my status and personal details change to meet the definition of a US person, I confirm that I will inform the Bank
immediately. Furthermore, I confirm that no information and / or advice have been received with respect to this purchase from any employee of
Barclays Bank and that I understand the risks associated with such an investment.
b. Is customer a US Person? (ie. per definition above) YES NO d. Customer KYC Compliant? YES NO
_______________________________________________________________________________________________________________________