Scribd Logo
Upload

Welcome to Scribd!

  • 52 views

    Indemnity Form

    Uploaded by

    Hlelolwenkosi Isaac
    This indemnity form summarizes an agreement between an individual and Innbucks Microbank Limited. The individual agrees to indemnify and hold Innbucks harmless from any legal actions, costs or expenses resulting from a special event. The individual acknowledges they accept all risks related to the event. The individual also releases Innbucks from any liability and agrees that Zimbabwean law will govern any disputes arising from the agreement.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Indemnity Form

    Uploaded by

    Hlelolwenkosi Isaac
    52 views2 pages
    This indemnity form summarizes an agreement between an individual and Innbucks Microbank Limited. The individual agrees to indemnify and hold Innbucks harmless from any legal actions, costs or expenses resulting from a special event. The individual acknowledges they accept all risks related to the event. The individual also releases Innbucks from any liability and agrees that Zimbabwean law will govern any disputes arising from the agreement.

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This indemnity form summarizes an agreement between an individual and Innbucks Microbank Limited. The individual agrees to indemnify and hold Innbucks harmless from any legal actions, costs or expenses resulting from a special event. The individual acknowledges they accept all risks related to the event. The individual also releases Innbucks from any liability and agrees that Zimbabwean law will govern any disputes arising from the agreement.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    52 views2 pages

    Indemnity Form

    Uploaded by

    Hlelolwenkosi Isaac
    This indemnity form summarizes an agreement between an individual and Innbucks Microbank Limited. The individual agrees to indemnify and hold Innbucks harmless from any legal actions, costs or expenses resulting from a special event. The individual acknowledges they accept all risks related to the event. The individual also releases Innbucks from any liability and agrees that Zimbabwean law will govern any disputes arising from the agreement.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    INDEMNITY FORM

    Date & Time: _____________________ Branch Submitted: ______________________________

    I___________________________________________________________________________ (Full Name)

    Identity Card Number: ________________________________ Cellphone Number: _________________

    For Internal Use

    Kineto Account Number (Where Funds Are being Transferred from): ____________________________

    Kineto Account Number (Where Funds Are being Transferred To): _____________________________

    Actioned by (Name)_______________________Date &Time: _____________ Signature: ____________

    Authorized by: (Name)_____________________________________ Signature: ____________________

    Items to attach on document


    Items to attach on document
    1. Copy of Identification e.g. (ID, passport or driver’s license)
    1. 2. Copy of Identification
    Attach valid proof ofe.g. (ID, passport
    residence (at leastorthree
    driver’s license)
    months old)
    2. 3. Attach valid
    Attach proof
    image of residence
    showing (at least three months old)
    face (Selfie)
    3. 4. Attach image
    Attach showing
    source face
    of funds (Selfie)
    form.
    4. Attach source of funds form.
    INDEMNITY AGREEMENT

    Note: Please ensure that you obtain legal advice from your attorneys or risk management advisors. This
    document does not constitute legal advice.

    I, the undersigned:

    ____________________________________

    (INSERT FULL NAME)

    Identity Number:

    (the "permittee")

    do hereby irrevocably indemnify and hold harmless:

    INNBUCKS MICROBANK LIMITED

    against all and any actions, suits, proceedings, claims, demands, costs and expenses of whatsoever nature and
    howsoever incurred which may be taken or made against them or be incurred or become payable by them arising out of
    my _____________________________________________ ("the special event") (as
    noted or reported in the attached)

    Location of special event:- ____________________________________

    ASSUMPTION OF RISKS

    I am aware that my action to


    ……………………………………………………………………………………………………………………………………………..
    may result in Innbucks facing lawsuits and other risks which include but not limited to reputational risk, financial lose, fraud
    etc.
    I therefore freely accept and fully assume all such risks and loss resulting therefrom.

    RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

    1. I freely and voluntarily agree to indemnify and hold Innbucks, and all of the officials, officers, agents and
    employees harmless from any liability whatsoever from any and all claims, demands, actions or causes of action
    arising from or in any way connected to this special event.
    2. This Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and
    representatives, in the event of my death or incapacity;
    3. This Agreement and any rights, duties and obligations as between the parties to this Agreement shall be
    governed by and interpreted solely in accordance with the laws of Zimbabwe and no other jurisdiction; and
    4. In entering into this Agreement, I am not relying upon any oral or written representations or statements made by
    Innbucks or its agents with respect to the safety of this event other than what is set forth in this Agreement.

    I have read and understand this agreement and i am aware that by signing this agreement I am waiving certain
    legal rights which I or my heirs, next of kin, executors, administrators, assigns and representatives may have.

    DATED at .......................... this .............. day of ............................20......

    ____________________________________(signature)
    Date:
    Place:
    ____________________________________(signature)

    Date
    Place:

    You might also like