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Broker Account Creation
Member Name
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CHN (cscsno)
Name
Date of Birthdd/mm/yy
Phone no
Guardian / Next of kin
Guardian / Next of kin Phone
Guardian / Next of kin CHN
Madien Name
Address Line 1
Address Line 2
Address Line 3
City
Bank Sort Code
Bank Account no
Confirm Bank account no
Bank Account name
Date of creation (of bank acct
Token value
Request datedd/mmyy
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