FULL LIQUIDATION FORMPlease enable JavaScript in your browser to complete this form.12LayoutDate of Liquidation (DD/MM/YY)Customer IDDate of Maturity (DD/MM/YY)BVNCorporate Name (if applicable)NameFirstLastPhonePAYMENT INSTRUCTIONLayoutAmount (Word)Account NameAmount (Figure) Account Number BankLayoutAccount Holder Signature Click or drag a file to this area to upload. Joint Signatory (if applicable) Click or drag a file to this area to upload. THIRD PARTY INDEMNITY (for Third Party Payment Requests Only) I/We are investors in the Centrum Finance Company Limited Investment Product Fund and request that you issue the proceeds of the redemption as set out above, in favour of the beneficiary whose details appear on the payment instruction set out above. In consideration of Centrum Finance Company Limited honouring the request, I/We hereby for myself /ourselves and my/our legal representatives, agree to keep Centrum Finance Company Limited indemnified against all actions, proceedings, claims and demands which may be brought or made against Centrum Finance Company Limited or any of its Authorized Representatives in consequence of complying with My/Our request to pay the proceeds to the above -named Beneficiary. I/We further agree to pay on demand all payments, losses and expenses suffered or incurred by Centrum Finance Company Limited in consequence thereof or arising therefrom. LayoutName of InvestorSignature of Investor Click or drag a file to this area to upload. Name of Witness Signature of Witness Click or drag a file to this area to upload. NextFOR OFFICIAL USE ONLYLayoutRelationship Manager's NameCustomer Service Name & SignatureHead, Business Development Name & SignatureInternal Control Name & SignaturePAYMENT APPROVAL:LayoutFinal Amount PayableOperations Name & SignaturePenalty Rate:(If Applicable)Account Officer's Name & Signature Submit