FEDERAL GOVERNMENT GUARANTOR FORM

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Name: (Surname First)

Date of Birth:

Gender:

Educational Qualification:

Marital Status:

(Tick appropriately)

Local Government Area:

Ward

Are you head of Household?

Number of Dependants:

Place (Community )of Residence:

Telephone

Next of Kin

Relationship

Address of Next of Kin:

Phone of Next of Kin:

Vulnerability (Physically Challenged) people living with HIV/AIDS

Any Natural Disability

If Yes describe

Current Source of Livinng

BANK ACCOUNT NAME:

ACCOUNT NUMBER:

BANK NAME/BRANCH

BANK VERIFICATION NUMBER (BVN)

BENEFICIARY SIGNATIURE/THUMPRINT

Posted on December 31, 2024.

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