Jummai Habila <habilajummaiventures@gmail.

com>

NORTH EAST OUTLET COLLATION FORM

1 message

Google Forms <forms-receipts-noreply@google.com> Mon, Oct 14, 2019 at 10:42 AM

To: HABILAJUMMAIVENTURES@gmail.com

Thanks for filling out NORTH EAST OUTLET COLLATION FORM

Here's what we got from you:

NORTH EAST OUTLET COLLATION FORM

Please fill all fields correctly, make sure it's true, detailed, and verified.

This is your final copy, make no mistakes.

Fill this form in CAPITAL Letters.

This submission must be done by Chairmen/Principal Director of the Outlet.

Follow the guidelines on http://t.me/semnigeria

You can only fill this form once.

The First Field must be Chairman's Email address, make no mistakes with it.

Trying to outsmart the system will lead to outright disqualification.

Check your mail after submission for a copy of what you submitted, make sure you PRINT it

Email address *

HABILAJUMMAIVENTURES@GMAIL.COM

ADDRESS OF COLLATION CENTRE *

MIMI RESORT AND GARDEN-4, ACO FURNITURE CRESENT, BESIDE

ECO BANK, MADALLA, NIGER STATE
LEDGER SORT CODE *

A05858

CERTIFICATE NO *

00217

NAME OF OUTLET AS WRITTEN ON THE CERTIFICATE *

BARAKUS MICRO FINANCE BANK

EMAIL ADDRESS OF OUTLET *

Make sure you know the password to this mail

BARKAKUSIMICROFINANCEOUTLET@GMAIL.COM

NAME OF COORDINATOR'S ORGANISATION/NGO *

ISHIBA EMPOWERMENT AND DEVELOPMENT CENTRE

NAME OF COORDINATOR *

ELIZABETH N. PRAISE

OFFICE ADDRESS OF OUTLET *

GOMBI ROAD

LGA OF OUTLET *

Local Government Area of your Outlet

BIU
STATE OF OUTLET *
State of your Outlet
BORNO

NUMBER OF PROJECTS IN YOUR OUTLET *

3628

TOTAL PROJECT COST *

Total Cost of all Projects in your Outlet

14913670000

TOTAL ASSET WORTH *

14913670000

SUM TOTAL *
SUM TOTAL OF TOTAL PROJECT COST AND ASSET WORTH
29827340000

UPLOAD YOUR LEDGER *

Upload the correct copy of your ledger

Files submitted:
BARKAKUSI NEW TEMPLATE - JUMMAI HABILA.xlsx

INFORMATION OF DIRECTORS

Information about directors of the outlet.

NOTE: AN OUTLET MUST EITHER HAVE 7 DIRECTORS OR 9 DIRECTORS OR 11 DIRECTORS.

DIRECTOR 1 (CHAIRMAN) SURNAME *

HABILA
DIRECTOR 1 (CHAIRMAN) FIRST NAME *

JUMMAI

DIRECTOR 1 (CHAIRMAN) GENDER *

MALE

FEMALE

DIRECTOR 1 (CHAIRMAN) AGE *

46 - 55 YEARS

DIRECTOR 1 (CHAIRMAN) PASSPORT PHOTOGRAPH *

Passport must be on a Plain Background

Files submitted:
jU - JUMMAI HABILA.jpg

DIRECTOR 1 (CHAIRMAN) EMAIL ADDRESS *

Make sure you know the password to this mail

HABILAJUMMAIVENTURES@GMAIL.COM

DIRECTOR 1 (CHAIRMAN) PHONE NUMBER *

Make sure your mobile number is correct
08036176596

DIRECTOR 2 (SECRETARY) SURNAME: *

PINDAR

DIRECTOR 2 (SECRETARY) FIRST NAME: *

HYELDUKU
DIRECTOR 2 (SECRETARY) PHONE NUMBER *

08035934552

DIRECTOR 3 SURNAME *

DAUDA

DIRECTOR 3 FIRST NAME *

ZACHARIAH

DIRECTOR 3 PHONE NUMBER *

08022784342

DIRECTOR 4 SURNAME *

GAMBO

DIRECTOR 4 FIRST NAME *

LIATU

DIRECTOR 4 PHONE NUMBER *

07039277810

DIRECTOR 5 SURNAME *

IBRAHIM

DIRECTOR 5 FIRST NAME *

SAMSON
DIRECTOR 5 PHONE NUMBER *

08064501292

DIRECTOR 6 SURNAME *

BASHAK

DIRECTOR 6 FIRST NAME *

JOSEPH

DIRECTOR 6 PHONE NUMBER *

08069632314

DIRECTOR 7 SURNAME *

AKAWU

DIRECTOR 7 FIRST NAME *

DUNA

DIRECTOR 7 PHONE NUMBER *

08092223037

DIRECTOR 8 SURNAME

DIRECTOR 8 FIRST NAME

DIRECTOR 8 PHONE NUMBER

DIRECTOR 9 SURNAME

DIRECTOR 9 FIRST NAME

DIRECTOR 9 PHONE NUMBER

DIRECTOR 10 SURNAME

DIRECTOR 10 FIRST NAME

DIRECTOR 10 PHONE NUMBER

DIRECTOR 11 SURNAME

DIRECTOR 11 FIRST NAME

DIRECTOR 11 PHONE NUMBER

 HAVE YOU DONE A FINAL CHECKUP ON THE INFORMATION SUPPLIED ABOVE? *

YES

ATTESTATION

ATTESTATION

ATTEST TO THE AUTHENTICITY OF THIS INFORMATION

I Attest That All Information Supplied Is True and Verified by Me *

By Clicking Ticking the box below and Clicking on Next, You Attest to This

TRUE AND VERIFIED

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