Agency Riders Registration Form

Agency Name (As appear on CAC) *

List Names of Agency Shareholders & Percentages for each *

Agency Registered Date *

Official Agency Phone (Call/WhatsApp) *

Agency Website

Email Address *

Agency Business Address *

City *

State/Province *

Country *

How Many Vehicles Do You have? *

Vehicle Ownership (Select All if Applicable) *OwnedLeased

How Many Riders Do You Have? *

State of Operation (Select All That is Applicable) *

Bank Name

Bank Account Number

Upload Agency Registration Doc. (e.g CAC)

Upload Agency Owners ID (NIN / Intl. Passport / Voter’s Card)

Upload Major Vehicle Documents (Must be on Agency Name)

Upload Passport Photograph of Agency Owners

Select Security Registration Category (Refundable)

Payment MethodPlease make registration payment to (Macver Technology – Union Bank Nig – 0163181524 ) acording to selected registration categories

Upload Payment Proof

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