Applying for a rental service licence

Size: px
Start display at page:

Download "Applying for a rental service licence"

Transcription

1 Applying for a rental service licence To operate a goods, passenger, vehicle recovery or rental service the law requires individuals or copanies to hold the appropriate transport service licence. This pack includes: application checklist inforation regarding requireents for a rental service licence Application for transport service licence for (TL01) Personal details for (TL02) The inforation contained in this pack is of a general nature and should be used as a guide only. For further inforation, the NZ Transport Agency publishes a nuber of factsheets on various topics that ay be of assistance to you. In particular: Transport service licences (Factsheet 47) Passenger service vehicles (Factsheet 15) If you are not sure whether you require a transport service licence, or have any other questions, please refer to our website or call our contact centre on October 2017 NZ Transport Agency Palerston North Office Private Bag Palerston North 4442 Page 1

2 Rental service licence checklist When returning your application, please ensure you have copleted and enclosed the following: Application for transport service licence for (TL01) Personal details for(s) (TL02) For each person in control of the Transport Service. This includes all partners in a partnership application and for a copany application all directors and any shareholders that have 20% or ore shares. Application fee of $ (Cheques are to be ade payable to the NZ Transport Agency) NOTE: a $9.70 per person police vetting fee is also required. Each person naed as being in a position of control of the service will be vetted by the Police, unless a person has previously been vetted through the NZ Transport Agency within the last 12 onths. Periodic vetting ay also be conducted at the Transport Agency s discretion. Certificate of incorporation and a list of official directors If the application is for a copany or other incorporated body. This inforation is available fro Copy of proof of identity (passport or birth certificate) if you don t hold a New Zealand licence. Must be certified copy eg JP. Copy of passport and iigration status (New Zealand resident, work perit, student perit etc) If not born in New Zealand (ust be a certified copy eg JP). The registration nubers of the vehicles being used by the proposed service NOTE: applications received without the correct inforation will be returned to the applicant to be resubitted with all the required docuentation. Page 2

3 Rental service licence What does the holder of a rental service licence do? A Rental Service eans the letting of a otor vehicle on hire for the carriage of passengers (including the driver) or of goods, or both, to a person who drives a vehicle or provides a driver for the vehicle. Penalties for operating an unlicensed service It s illegal to operate an unlicensed transport service. If you re convicted you ay face a fine of up to $10,000. The fine increases to a axiu of $25,000 for subsequent convictions. In addition to the fine, the court ay ipound vehicles used in an unlicensed service for up to 90 days (no atter who owns the). How do I apply for a rental service licence? In order to obtain a Rental service licence you ust subit the following docuents to the Transport Agency: 1. A copleted Application for transport service licence for (TL01). 2. A copleted Personal details for (TL02) for each person in control of the transport service. This includes all partners in a partnership application and all Directors and substantial shareholders (20% or ore of shares held) for copany applicants. If you are not a New Zealand resident (the holder of a resident perit) then you will need to have either a work perit or soe other teporary perit with conditions to allow you to work in New Zealand. 3. A copy of proof of identity (passport or birth certificate) if you do not hold a New Zealand licence (ust be certified copy eg JP). 4. If the applicant is a copany or other incorporated body, a Certificate of Incorporation and an official list of Directors. 5. A $ application fee. 6. A $9.70 fee, per person, for Police vetting. (Each person naed as being in control of the licence will be vetted by the Police. There is no vetting charge if the person has been vetted in the past twelve onths). Send all of the above to: Licensing Assesents Tea NZ Transport Agency Private Bag Palerston North 4442 You should allow up to 20 working days for your application to be processed. Rental service agreeent You ust also hold a rental service agreeent which eets the requireents specified in Section 9 of the Land Transport Rule: Operator Licensing How uch will the application cost? The application fee is $ You can include a cheque or oney order with your application, or coplete the credit card details section on the TL01 for for the fee to be paid by credit card. Page 3

4 What is the vetting fee for? The Transport Agency is legally obliged to ensure that holders of a rental service licence are fit and proper people. Soe of the factors which ay be taken into account when deterining if a person eets the fit and proper person criteria are: criinal conviction history, including charges or convictions relating to violent or sexual offences; drug or firear offences, or offences involving organised criinal activity; any transport-related offending, especially offences related to safety; any history of behavioural probles; any past coplaints about a transport service provided by the person; any history of persistent failure to pay fines for transport-related offences. Note: the Transport Agency ay take into account any other relevant atter which they consider is in the public interest when deterining a person s fitness to hold any licence. Even if you are not required to pay the vetting fee, you ay still be vetted. Page 4

5 Application for Transport Service Licence TL01 Applicant details Please coplete A, B or C as applicable. A. If application is by an individual: Nae of individual (Surnae or faily nae) (Full first naes) B. If application is by a Partnership or Trust: Nae of Partner/Trustee 1 (Surnae or faily nae) Nae of Partner/Trustee 2 (Full first naes) (Surnae or faily nae) (Full first naes) If your partnership is not a written partnership, what sort of partnership is it? Married De Facto Siblings Other - please specify Copany applicants please ake sure a copy of the Certificate of incorporation and copies of docuentation listing ALL directors, shareholders and their shareholding is attached to this application. C. If application is by a Copany, Incorporated Body, School Board of Trustees: Nae of copany or organisation Registered no. (if applicable) Registered office address Trading nae (if applicable) Mailing address Street nuber and nae, suburb, town/city. Address fro where the business is to be operated Daytie contact telephone nuber Contact nae Eail address Proposed service Tick one only. Use a separate for for each type of service. This application is for a licence to operate the following service: Sall passenger Large passenger Vehicle recovery Goods Describe the nature, type and area of the service proposed/contracted to: Rental Exaples: Taxi service, app-based service, lio, shuttle, vehicle recovery, general carrier. *At all ties at least one person in control of the service ust hold a Certificate of knowledge of law and practice, unless you are operating a sall passenger service or rental service. Nae of person holding a Certificate of knowledge of law and practice* ṁ Photocopy of evidence attached. Type of Certificate of knowledge odule held? Large passenger service Vehicle recovery service Goods service page 1 1 Continued over the page 10/17

6 Application for Transport Service Licence TL01 Attach a separate list of plate nubers if there isn t enough space. Plate nubers of the vehicles to be used in the service: Manageent If there isn t enough space, please attach additional details on a separate sheet of paper. Everyone listed in this section ust fill out a Personal details for (TL02) and subit it with this application List the naes of the people to be responsible for the anageent and/or control of the service. Full nae Position (eg owner/driver, director, partner, transport anager) Full nae You ust let the Transport Agency know if the people in control of the service change. The representative will also need to coplete a TL02 for. Position If you re applying for a sall passenger service licence, and none of the people in control of the service live in New Zealand, please provide the details of your representative living in New Zealand. Full nae of representative Address of representative Consent & declaration All fields ust be copleted. If you don t, we ay have to send your application back to you to be copleted. There are penalties for supplying false or isleading inforation. Providing false or isleading inforation ay also result in the revocation of the transport service licence. I state that, to the best of y knowledge and belief, all the inforation given for this application is true and correct and I a not disqualified or prohibited fro obtaining or holding a transport service licence. I consent to the disclosure by the New Zealand Police and other relevant persons or authorities of all charges and convictions against e and any other inforation they hold about e to the Transport Agency. The inforation about e that the police ay consider relevant to y application and release to the Transport Agency in vetting coprises any conviction history, infringeent/deerit reports; and it ay include any other inforation such as active charges and warrants to arrest, any inforation received or obtained by the New Zealand Police, and any interaction I have had with the police in any context (including faily violence), even where I have not been charged, or charges are withdrawn, or I have been acquitted (not guilty) of a charge, or I have been discharged without conviction. You can find ore inforation about New Zealand Police vetting at I authorise the Transport Agency to ake all enquiries as to y character and suitability (including financial inforation) to be the holder of a transport service licence for the ter of the period of the licence as the Transport Agency ay consider necessary. Full nae of person aking declaration Signature of person aking declaration Date Privacy Act 1993 You should note that the inforation you provide on this for is required by Part 4A of the Land Transport Act 1998 and section 2 of the Land Transport Rule: Operator Licensing The Privacy Act 1993 provides rights of access to, and correction of, any readily retrievable inforation held about you by the Transport Agency. Should you wish to exercise these rights please contact the NZ Transport Agency, Palerston North Office, Private Bag 11777, Palerston North 4442 or eail info@nzta.govt.nz. Continued over the page Office use only Application nuber Fee & Receipt nuber page 2 10/17

7 Payent The transport service licence fee is $ You will also be charged a $9.70 vetting fee, unless this has been paid in the last 12 onths. I enclose a cheque or oney order for the payent of the transport service licence fee. I would like to pay the transport service licence fee by credit card (details below - please note the Transport Agency does not accept Aex or Diners Club credit cards). Nae on credit card Credit card nuber Expiry date / Send this application and payent to Licensing Assessents Tea, NZ Transport Agency, Private Bag 11777, Palerston North Don t forget to also attach a Personal details for (TL02) for each person who will be in control of the service. page 3 10/17

8 Personal details supporting an application for transport service licence TL02 Under section 30L of the Land Transport Act 1998, the NZ Transport Agency ust be satisfied that anyone who will have, or is likely to have, control or involveent in the operation of the transport service is a fit and proper person, including a representative. Give nae of individual, partnership or organisation aking the application. Details The particulars specified in this application are required by Section 2 of the Land Transport Rule: Operator Licensing 2017 and will for part of the Register of Transport Services Licences. Corresponding inforation held on this register ay be aended by writing to the NZ Transport Agency, Private Bag 11777, Palerston North If you weren t born in New Zealand, you ll need to provide a certified copy of your passport and iigration status with this for. All directors who have indirect or direct control of the anageent of the organisation are required to coplete a copy of this for. This is so that the Transport Agency can deterine if they all eet the requireents of a fit and proper person. These personal details support an application for a Transport Service Licence by: Nae (Surnae or faily nae) (Full first naes) Are you or were you known by any other naes? (nae changed by deed poll, arriage, alias) Date of birth / / If not born in NZ, what is your iigration status? (NZ Citizen, NZ Peranent resident, Work perit) Driver licence nuber Country of birth Class(es) of licence held Show street nuber and nae, suburb, town/city. Physical address Mailing address Daytie contact telephone nuber Eail address Background Have you ever been declared bankrupt? No Yes List date(s) of discharge Have you ever been involved in the anageent or control of any copany that has been placed in receivership or liquidation? No Yes Give details page 1 Continued over the page 10/17 07/10

9 Personal details supporting an application for transport service licence TL02 If you answered yes to any of these questions please list all previous offences/convictions including traffic infringeent notices either in New Zealand or overseas and also include any charges pending. Continue on a separate piece of paper if insufficient space. Have you ever been convicted of any criinal offence in New Zealand or overseas? No Yes Give details below Do you have any charges pending for criinal or traffic offences in New Zealand or overseas? No Yes Give details below Have you ever had any traffic offences/infringeents in New Zealand or overseas? (Including speed caera infringeents, seatbelt or obile phone infringeents, roadside suspensions, vehicle ipoundent or any other traffic offence except parking infringeents) No Yes Give details below Nature of offence Penalty Do you have any outstanding fines, court costs, reparation or road user charges debts? Details No Yes Give details below Penalty Qualifications Have you ever held or applied for a Transport Service Licence in New Zealand? No Yes Give details below (when and which type of Transport Service Licence) List any relevant driving or anageent experience relating to the transport industry, including affiliation, in any capacity, with a taxi copany/organisation. Sall passenger service vehicles are defined as 12 seats and under including the driver. Will you be driving either a sall passenger service vehicle or vehicle recovery vehicle? No Yes What is your driver identification card unique identifier? Consent & declaration This section ust be copleted. You are entitled to access, and ay request correction of, any readily retrievable inforation about you held by the Transport Agency. Failure to coplete any question ay result in the application being returned. There are penalties for supplying false inforation. I state that, to y best knowledge and belief, all the inforation given for this application for is true and correct. I consent to the disclosure by the New Zealand Police and other relevant persons or authorities of all details of any charges or convictions against e to the NZ Transport Agency. I authorise the Transport Agency to ake all enquiries it considers necessary as to y fitness and propriety to be the holder of a transport service licence for the ter of the period of the licence. (Pursuant to Part 4A Land Transport Act 1998 and the Land Transport Rule: Operator Licensing 2017.) Signature of person aking declaration. Date Attach this Personal details for to the TL01 application page 2 10/17

Applying for a large passenger service licence

Applying for a large passenger service licence Applying for a large passenger service licence To operate a large passenger service the law requires individuals or copanies to hold the appropriate transport service licence. This pack includes: application

More information

Applying for a goods service licence

Applying for a goods service licence Applying for a goods service licence To operate a goods service the law requires individuals or companies to hold the appropriate transport service licence. This pack includes: application checklist information

More information

BERMUDA NATIONAL PENSION SCHEME (GENERAL) REGULATIONS 1999 BR 82 / 1999

BERMUDA NATIONAL PENSION SCHEME (GENERAL) REGULATIONS 1999 BR 82 / 1999 QUO FA T A F U E R N T BERMUDA NATIONAL PENSION SCHEME (GENERAL) REGULATIONS 1999 BR 82 / 1999 TABLE OF CONTENTS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Citation Interpretation PART 1 PRELIMINARY PART II REGISTRATION

More information

Office Use Only. Section 2 Applicant Details and Establishment (see Note 2 in the Guide) 2A Name of Applicant. 2B Business Address of Applicant

Office Use Only. Section 2 Applicant Details and Establishment (see Note 2 in the Guide) 2A Name of Applicant. 2B Business Address of Applicant Return this application to: Road Transport Operator Licensing Unit Department of Transport, Tourism and Sport Clonfert House, Bride Street, Loughrea, Co. Galway ROAD HAULAGE OPERATOR S LICENCE APPLICATION

More information

APPLICATION FOR CLASS A TRAINER S LICENCE $ CLASS B TRAINER S LICENCE $ CLASS C TRAINER S LICENCE $ C4:04-17 YOUR PERSONAL DETAILS

APPLICATION FOR CLASS A TRAINER S LICENCE $ CLASS B TRAINER S LICENCE $ CLASS C TRAINER S LICENCE $ C4:04-17 YOUR PERSONAL DETAILS NEW ZEALAND THOROUGHBRED RACING INC PO Box 38386, WMC Telephone: (04) 576 6240 Facsimile: (04) 568 8866 Web: www.nzracing.co.nz Email: licensing@nzracing.co.nz APPLICATION FOR CLASS A TRAINER S LICENCE

More information

NEW ZEALAND THOROUGHBRED RACING INC

NEW ZEALAND THOROUGHBRED RACING INC C4:07-16 YOUR PERSONAL DETAILS 1. Title (Mr/Mrs/Miss/Ms) 2. Surname 3. Given Names (in full) NEW ZEALAND THOROUGHBRED RACING INC PO Box 38386, WMC Telephone: (04) 576 6240 Facsimile: (04) 568 8866 Web:

More information

Application for early release: severe financial hardship (Case 1)

Application for early release: severe financial hardship (Case 1) Application for early release: severe financial hardship (Case 1) Use this form if you wish to apply for the early release of your superannuation benefit on the grounds of severe financial hardship. Please

More information

Application for a site senior executive certificate of competence

Application for a site senior executive certificate of competence Application for a site senior executive certificate of competence Use this form to apply for a new SSE certificate of competence under the Health Regulations 2016 FORM 1. Applicant details Full name: 2.

More information

Early release of superannuation benefits on grounds of financial hardship

Early release of superannuation benefits on grounds of financial hardship Early release of superannuation benefits on grounds of financial hardship CHECK THAT YOU QUALIFY You may be eligible to claim your preserved benefit on the grounds of financial hardship if you are an Australian

More information

Licence Application Form COMPANY

Licence Application Form COMPANY Licence Application Form COMPANY COMPLETING THIS FM Use BLACK pen only Print clearly in BLOCK LETTERS DO T use correction fluid any amendments should be crossed out and initialled 1. COMPANY DETAILS Company

More information

IRD number application - non-resident/offshore individual

IRD number application - non-resident/offshore individual IR742 August 2016 IRD number application - non-resident/offshore individual For full details go to www.ird.govt.nz (search keyword: offshore). Only use this form if you're a non-resident or offshore person.

More information

Christchurch BOAT, CARAVAN & MOTOR HOME SHOW. 8 th, 9 th, 10 th JULY 2016 HORNCASTLE ARENA

Christchurch BOAT, CARAVAN & MOTOR HOME SHOW. 8 th, 9 th, 10 th JULY 2016 HORNCASTLE ARENA Christchurch BOAT, CARAVAN & MOTOR HOME SHOW 8 th, 9 th, 10 th JULY 016 HORNCAST ARENA WELC O M E TO THE Christchurch BO AT, CARAVAN & MOTOR HOME SHOW Dear Exhibitor, We would like to offer you the opportunity

More information

Smartsave Fund Registration No. R

Smartsave Fund Registration No. R This form can be used to request a transfer of your whole account balance in Smartsave to your nominated KiwiSaver Scheme. Please note you will need to meet eligibility criteria outlined in this form and

More information

Early Learning Payment application

Early Learning Payment application Early Learning Payment application Early Learning Payment is available to families who are enrolled in a Family Start or Early Start programme. It helps pay the cost of early childhood education for children

More information

State of Delaware VOYA PLAN and Your Voya Retirement Insurance and Annuity Company Investment Program - Plan-related Information

State of Delaware VOYA PLAN and Your Voya Retirement Insurance and Annuity Company Investment Program - Plan-related Information State of Delaware VOYA PLAN 664093 and 664094 Your Voya Retireent Insurance and Annuity Copany Investent Progra - Plan-related Inforation August 17,2016 The purpose of this docuent is to suarize certain

More information

Life Short Term Disability

Life Short Term Disability a lifetie of coitent c o p a n i o n b u s i n e s s plan f o r groups of 2 t h r o u g h 9 e p l o y e e s www.copanionlife.co Life Short Ter Disability Approxiately 30% of all people age 35 to 65 will

More information

SIO Supervisor Application Form

SIO Supervisor Application Form SIO Supervisor Application Form Any personal information collected is for the purpose of assessing an application to be a Summary Instalment Order Supervisor under the Insolvency Act 2006. The information

More information

Benefit Payment and Rollout Request. Step 2 Employment details (to be completed by all members)

Benefit Payment and Rollout Request. Step 2 Employment details (to be completed by all members) Benefit Payment and Rollout Request You can use this form if you are eligible to request a payment from your benefit or you wish to rollover some or all of your benefit to another fund. If you want to

More information

Motor Vehicle Insurance Proposal

Motor Vehicle Insurance Proposal Motor Vehicle Insurance Proposal Important Notices Please read this section before completing this Proposal. Definitions Excess Excesses apply to all sections of Your policy and are detailed in the Schedule

More information

Section 2 Applicant Details and Establishment (see Section 2 in the Guide) 2A Name of Applicant. 2B Business Address of Applicant

Section 2 Applicant Details and Establishment (see Section 2 in the Guide) 2A Name of Applicant. 2B Business Address of Applicant ROAD HAULAGE OPERATOR LICENCE APPLICATION FORM This is an application form for a Road Haulage Operator Licence, and for all the appropriate documents for vehicles to be authorised under the licence. Please

More information

4. Are you a business entity registered with the PA Department of State? YES tf NO, you must register (see checklist on how to register)

4. Are you a business entity registered with the PA Department of State? YES tf NO, you must register (see checklist on how to register) Secretary \ fepmi OF > Revised 12/1/13 Pennsylvania Public Utility Coission rrruuir 5 *! 400 North Street, Second Floor TbCHNIL At Harrisburg, PA 17120 (717) 772-7777 www.puc.da.aov ro Application for

More information

SMSF ADVISERS NETWORK PTY LTD

SMSF ADVISERS NETWORK PTY LTD SMSF ADVISERS NETWORK PTY LTD ABN 64 155 907 681 An Australian Financial Services Licensee Licence Number: 430062 29-33 Palmerston Crescent, South Melbourne Vic 3205 Ph: 1800 906 456 Fax: 1300 306 351

More information

Benefit Release due to severe hardship

Benefit Release due to severe hardship Benefit Release due to severe hardship The following information will be used solely for determining whether you are experiencing severe financial hardship. The completed form (or copy) will not be made

More information

Early release of superannuation benefits on grounds of financial hardship

Early release of superannuation benefits on grounds of financial hardship Early release of superannuation benefits on grounds of financial hardship CHECK THAT YOU QUALIFY You may be eligible to claim your preserved benefit on the grounds of financial hardship if you are an Australian

More information

Appendix Table A1. MPC Stratified by Additional Variables

Appendix Table A1. MPC Stratified by Additional Variables Appendix Table A1. MPC Stratified by Additional Variables This table presents estiates of the MPC out of liquidity for groups of consuers stratified by whether they have low, ediu, or high levels of credit

More information

Application for early release: severe financial hardship (Case 2)

Application for early release: severe financial hardship (Case 2) Application for early release: severe financial hardship (Case 2) Use this form if you wish to apply for the early release of your superannuation benefit on the grounds of severe financial hardship. Please

More information

Application form for companies

Application form for companies Application form for companies Octopus Choice Important information Before completing this application form, make sure you have read and fully understand... 1 Our risk statement: www.octopuschoice.com/risks

More information

Azerbaijan Retention Summary

Azerbaijan Retention Summary The Tax of the Republic of Art 39.1 The Tax of the Republic of Art 71.4 Suary Taxpayers violation of the tax legislation 3 fro the date of the violation Taxpayers Accounting docuents 5 Not stated including

More information

Application form for companies

Application form for companies Application form for companies Octopus Cash Important information Before completing this application form, make sure you have read and fully understand our terms & conditions: www.octopuscash.com/terms

More information

Chartered Accountants Australia and New Zealand Application for a Certificate of Public Practice by a New Zealand resident member

Chartered Accountants Australia and New Zealand Application for a Certificate of Public Practice by a New Zealand resident member Chartered Accountants Australia and New Zealand Application for a Certificate of Public Practice by a New Zealand resident member Please fill in your Membership Number, if known Please complete ALL sections

More information

APPLICATION FOR REPRESENTATIVE, ASSOCIATE OR MANAGING BROKER LICENCE

APPLICATION FOR REPRESENTATIVE, ASSOCIATE OR MANAGING BROKER LICENCE APPLICATION FOR REPRESENTATIVE, ASSOCIATE OR MANAGING BROKER LICENCE PART A NATURE OF APPLICATION Type of applicant (please check) First-time applicant (Submit criminal record check with application. See

More information

Important Information 1. Please answer questions as fully as possible. Incomplete answers may result in delays in completing the claim.

Important Information 1. Please answer questions as fully as possible. Incomplete answers may result in delays in completing the claim. Motor Vehicle Insurance Claim Form Before completing this form please call us to see if your claim can be processed over the phone. MAS, FREEPOST 884, PO Box 13042, Johnsonville, Wellington. Phone 0800

More information

Splitting Super Contributions

Splitting Super Contributions Catholic Super Splitting Super Contributions The trustee of Catholic Super recommends that you seek advice from a licensed, or appropriately authorised, financial adviser regarding your super before you

More information

Application for an RBF Life Pension

Application for an RBF Life Pension Pension RBF Contributory Scheme Application for an RBF Life Pension About this form Complete this form to start an RBF Life Pension in the RBF Contributory Scheme. Members of the Tasmanian Accumulation

More information

Financial Hardship Redemption form

Financial Hardship Redemption form Superannuation and Deferred Annuity Financial Hardship Redemption form This form is to be used when redeeming your superannuation benefit from the Zurich Deferred Annuity or from the Zurich Master Superannuation

More information

Contributions Splitting Application

Contributions Splitting Application Alcoa of Australia Retirement Plan Contributions Splitting Application Before completing this form please read the factsheet Splitting super contributions in Alcoa of Australia Retirement Plan available

More information

claiming a superannuation death benefit guide

claiming a superannuation death benefit guide claiming a superannuation death benefit guide This document explains how to make a claim for a superannuation death benefit and what will happen when a death benefit claim is submitted. HS 1129.9 11/17

More information

Including a partner form

Including a partner form Including a partner form If you get a benefit from Work and Income and now have a partner, your partner will need to be included in your benefit and may get payments as well. If you and your partner are

More information

MyLife MyPension Application for Lump Sum Withdrawal. Suburb State Postcode. Step 2 Attach documentation if your personal details have changed

MyLife MyPension Application for Lump Sum Withdrawal. Suburb State Postcode. Step 2 Attach documentation if your personal details have changed MyLife MyPension Application for Lump Sum Withdrawal If you need help For assistance call our Service Centre on 1300 963 720. Step 1 Complete your personal details Please print in black or blue pen, in

More information

Claim Form GROUP PTY LTD. RSM GROUP Pty Ltd - Wholesale Broking

Claim Form GROUP PTY LTD. RSM GROUP Pty Ltd - Wholesale Broking GROUP PTY LTD Claim Form RSM GROUP Pty Ltd - Wholesale Broking ABN 40 006 361 226 AFS Licence No. 239631 380-382 Canterbury Road, Surrey Hills Vic 3127 Private Bag 4000 Surrey Hills Vic 3127 T: (03) 9276

More information

*Suburb *State *Postcode. *Suburb *State Postcode*

*Suburb *State *Postcode. *Suburb *State Postcode* SMF Eligible Rollover Fund This form serves as your instruction to us on how to deal with your benefit. We recommend that you consult your licensed financial adviser to assist you in your decision making.

More information

Early release of superannuation benefits on grounds of severe financial hardship

Early release of superannuation benefits on grounds of severe financial hardship Newcastle Permanent Superannuation Plan Early release of superannuation benefits on grounds of severe financial hardship The following information will be used solely for determining whether you are experiencing

More information

Here s how to use the Auto Accident kit documents. For each vehicle, please: Form Print out Use of form

Here s how to use the Auto Accident kit documents. For each vehicle, please: Form Print out Use of form Here s how to use the Auto Accident kit docuents. For each vehicle, please: For Print out Use of for University DOUBLE Front cover Evidence of Coverage SIDED to show to police Auto Accident For Use for

More information

Family law instructions for payment of entitlement

Family law instructions for payment of entitlement Family law instructions for payment of entitlement If you need help Call our Helpline 1800 682 626. Please provide the following details in order for the Family Law entitlement to be paid in accordance

More information

REQUEST FOR WITHDRAWAL

REQUEST FOR WITHDRAWAL Accumulation account REQUEST FOR WITHDRAWAL If you need help For assistance call us on 1300 133 177 or refer to the NGS Super website www.ngssuper.com.au. Step 1. Complete your personal details Please

More information

Application Form New Investors

Application Form New Investors Application Form New Investors Existing Investors, please complete the Additional Application Form Issued by Evolution Trustees Limited ABN 29 611 839 519, AFS Licence No. 486 217 Dated 26 April 2018 1.

More information

A helpful guide to completing the Making Changes to Accounts for Organisations

A helpful guide to completing the Making Changes to Accounts for Organisations A helpful guide to completing the Making Changes to Accounts for Organisations This guide will ensure you have all the right information to enable Westpac to update your account quickly and efficiently

More information

Cash Deposit Fund Application form. Dated 1 July 2017

Cash Deposit Fund Application form. Dated 1 July 2017 Cash Deposit Fund Application form Dated 1 July 2017 AET Cash Deposit Fund ARSN 093 367 518 Australian Executor Trustees Limited ABN 84 007 869 794 AFSL 240023 AET Cash Deposit Fund Application form Dated:

More information

About this form. About the subsidy. Who may qualify. Payment information. Appointing your residential service provider as your agent

About this form. About the subsidy. Who may qualify. Payment information. Appointing your residential service provider as your agent Residential Support Subsidy Authorisation Form CLIENT NUMBER About this form This form provides you with information about: the Residential Support Subsidy who may qualify how payments are made. The form

More information

Early release of superannuation benefits on grounds of financial hardship

Early release of superannuation benefits on grounds of financial hardship ANZ Australian Staff Superannuation Scheme Early release of superannuation benefits on grounds of financial hardship Check that you qualify You may be eligible to claim your preserved benefit on the grounds

More information

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION PLEASE READ THESE INSTRUCTIONS CAREFULLY This is an interactive

More information

Withdraw super from your Rollover Account

Withdraw super from your Rollover Account Withdraw super from your Rollover Account This is the form you should use when you withdraw your superannuation from your APSS Rollover Account. The minimum amount you may withdraw from your APSS Rollover

More information

Name (Last) (First) (Middle) Sex. City Province Postal Code Telephone Number. Married Common-law Separated Divorced Widowed Single

Name (Last) (First) (Middle) Sex. City Province Postal Code Telephone Number. Married Common-law Separated Divorced Widowed Single Monthly Pension Application This application should be submitted at least one month in advance of the date your pension is to begin, but no earlier than 90 days from the beginning of the month in which

More information

ALCOA OF AUSTRALIA RETIREMENT PLAN Rollover form

ALCOA OF AUSTRALIA RETIREMENT PLAN Rollover form ALCOA OF AUSTRALIA RETIREMENT PLAN Rollover form Roll other super money into the ALCOA OF AUSTRALIA RETIREMENT PLAN To rollover other super money you have from previous super funds, complete this form

More information

Analysis of the purchase option of computers

Analysis of the purchase option of computers Analysis of the of coputers N. Ahituv and I. Borovits Faculty of Manageent, The Leon Recanati Graduate School of Business Adinistration, Tel-Aviv University, University Capus, Raat-Aviv, Tel-Aviv, Israel

More information

Helpline Ministry of Social Development PO Box 1556 Wellington 6140 New Zealand

Helpline Ministry of Social Development PO Box 1556 Wellington 6140 New Zealand Special Needs Grant International Custody Dispute Payment If you need help filling in this form, please phone 0800 559 009 within New Zealand, or +64 9 913 0300 outside New Zealand. Who can get this payment

More information

Care Providers Directors and Officers Liability Addendum

Care Providers Directors and Officers Liability Addendum IMPORTANT NOTICES Please read these notices before completing the Addendum. Your Duty of Disclosure Before you enter into an insurance contract, you have a duty to tell us anything that you know, or could

More information

Qualification Awarding body Year

Qualification Awarding body Year Application for Registration as an Chartered Tax Adviser (CTA) Student 2018 Personal Details Title: Surname: First Name: Work Telephone Number: Mobile Telephone Number: E-mail (A valid e-mail address is

More information

Name (Last) (First) (Middle) Sex. City Province Postal Code Telephone Number

Name (Last) (First) (Middle) Sex. City Province Postal Code Telephone Number Carpenters Pension und of SK onthly Pension Application This application should be submitted at least one month in advance of the date your pension is to begin, but no earlier than 90 days from the beginning

More information

Temporary Accommodation Assistance Application

Temporary Accommodation Assistance Application Temporary Accommodation Assistance Application If you need help with this form call us on % 0800 673 227. Please read this before you start If you are a Canterbury homeowner who has had to leave your home

More information

Application to transfer super benefits to a KiwiSaver scheme

Application to transfer super benefits to a KiwiSaver scheme Application to transfer super benefits to a KiwiSaver scheme Use this form if you want to transfer your full benefit to a KiwiSaver scheme account. NOTE: You can only start the transfer process once you

More information

Application for an RBF Account Based Pension

Application for an RBF Account Based Pension Pension RBF Tasmanian Accumulation Scheme Application for an RBF Account Based Pension About this form Complete this form to advise: your personal details how much you d like to invest which Member Investment

More information

Magellan High Conviction Fund - Class B Units Application Form

Magellan High Conviction Fund - Class B Units Application Form V1 12/17 Magellan High Conviction Fund - Class B Units Application Form APIR Code: MGE9885AU ARSN Code: 164 285 947 Issued by Magellan Asset Management Limited ABN 31 120 593 946, AFS Licence. 304 301

More information

RAY WHITE (EMERALD) 80 Egerton Street Emerald QLD 4720 PH: FAX:

RAY WHITE (EMERALD) 80 Egerton Street Emerald QLD 4720 PH: FAX: RAY WHITE (EMERALD) 80 Egerton Street Emerald QLD 4720 PH: 4982 2400 FAX: 4982 3499 reception.emerald@raywhite.com SUPPORTING DOCUMENTS Identification. You are required to meet a 100 Point identification

More information

How to apply for a super payout

How to apply for a super payout How to apply for a super payout STEP 1 CHECK THAT YOU RE ELIGIBLE You wish to receive part or all of your super payout in cash A portion of your super benefit may be preserved. If the preserved amount

More information

your ref: my ref: please ask for Date:

your ref: my ref: please ask for Date: APPENDIX 2 Regulatory Services Ealing Council Perceval House 14-16 Uxbridge Road London W5 2HL Team Email: Licensing@ealing.gov.uk Tel: (020) 8825 6655 Team tel: (020) 8825 6655 Minicom: (020) 8825 6543

More information

Tax file number application or enquiry for individuals living outside Australia

Tax file number application or enquiry for individuals living outside Australia Instructions and form for individuals living outside Australia Tax file number application or enquiry for individuals living outside Australia WHAT IS A TAX FILE NUMBER (TFN)? A TFN is a unique number

More information

Title Mr Mrs Ms Miss Other Date of birth / / Given names. Step 2 Attach documentation if your name and/or address has changed

Title Mr Mrs Ms Miss Other Date of birth / / Given names. Step 2 Attach documentation if your name and/or address has changed Pension Lifetime Pension Benefit Payment If you need help Call our Helpline 1800 682 626. Step 1 Complete your personal details Please print in black or blue pen, in uppercase, one character per box. A

More information

The Institute of Chartered Accountants of Sri Lanka

The Institute of Chartered Accountants of Sri Lanka The Institute of Chartered Accountants of Sri Lanka Executive Diploa in Business and Accounting Financial Matheatics Financial Matheatics deals with probles of investing Money, or Capital. If the investor

More information

TENANCY APPLICATION ALL PERSONS OVER THE AGE OF 18 YEARS ARE TO FILL IN A SEPARATE APPLICATION AND ARE TO BE PLACED ON THE LEASE.

TENANCY APPLICATION ALL PERSONS OVER THE AGE OF 18 YEARS ARE TO FILL IN A SEPARATE APPLICATION AND ARE TO BE PLACED ON THE LEASE. TENANCY APPLICATION Ray White Deception Bay 729 Deception Bay Road Rothwell Qld 4022 P 07 3204 0911 F 07 3204 0933 E deceptionbay.qld@raywhite.com ALL PERSONS OVER THE AGE OF 18 YEARS ARE TO FILL IN A

More information

APPLICATION SCREENING COVER NOTICE

APPLICATION SCREENING COVER NOTICE APPLICATION SCREENING COVER NOTICE An application fee of $25.00 is charged per person. NO CASH PLEASE (check or money order only). The application fee covers the cost of checking landlord, credit, employment

More information

How to transfer your Bendigo SmartStart superannuation balance to a KiwiSaver scheme

How to transfer your Bendigo SmartStart superannuation balance to a KiwiSaver scheme How to transfer your Bendigo SmartStart superannuation balance to a KiwiSaver scheme Who can transfer? You can apply to transfer your Bendigo SmartStart superannuation balance to a KiwiSaver scheme once

More information

Application for membership (Spouse Contribution Account (SCA) Section) Part A

Application for membership (Spouse Contribution Account (SCA) Section) Part A ANZ Australian Staff Superannuation Scheme ANZ Australian Staff Superannuation Scheme Application for membership (Spouse Contribution Account (SCA) Section) Part A Guidelines for completing this application

More information

Title Mr Mrs Ms Miss Other Date of birth / / Given names. Suburb State Postcode. Suburb State Postcode

Title Mr Mrs Ms Miss Other Date of birth / / Given names. Suburb State Postcode. Suburb State Postcode Payment Instructions for Deferred & Immediate Retirement Income Benefits from Mars Australia Retirement Plan If you need help For assistance call the MARP Helpline on 1300 883 298 Step 1 Complete your

More information

Triodos Bank Organisation application for Depository Receipts in Triodos Bank NV.

Triodos Bank Organisation application for Depository Receipts in Triodos Bank NV. Triodos Bank Organisation application for Depository Receipts in Triodos Bank NV. Important notice In order to complete this application form you need to know what the current sterling price is for each

More information

Request for Partial/Full Commutation

Request for Partial/Full Commutation REI Super Pension Request for Partial/Full Commutation If you need help For assistance, information on your benefit entitlements, or to access the Privacy Policy and your personal information call the

More information

Application Form New Investors

Application Form New Investors V1 12/17 Application Form New Investors Issued by Magellan Asset Management Limited ABN 31 120 593 946, AFS Licence. 304 301 Dated 28 September 2017 1. Introduction Existing investors, please complete

More information

Application form for a restricted FM service Radio Broadcasting Licence

Application form for a restricted FM service Radio Broadcasting Licence Application form for a restricted FM service Radio Broadcasting Licence (Audio media service) Name of applicant (i.e. the company, partnership, etc applying for the licence):... Name of service:... (Issue

More information

Application Form New Investors

Application Form New Investors Application Form New Investors Dated 20 September 2016 Issued by Investors Mutual Limited ABN 14 078 030 752 AFS Licence No. 229988 This application form must not be given to another person unless accompanied

More information

Last For A Lifetime. Making Your Money. Why You Need to Know About Annuities

Last For A Lifetime. Making Your Money. Why You Need to Know About Annuities Making Your Money Last For A Lifetie Why You Need to Know About Annuities A Joint Project of The Actuarial Foundation and WISER, the Woen s Institute for a Secure Retireent Acknowledgeents Special thanks

More information

Instructions for Completing Claim Form

Instructions for Completing Claim Form UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF ICHIGAN SOUTHERN DIVISION In Re: AUTOOTIVE PARTS ANTITRUST LITIGATION Case No. 12-md-02311 Honorable arianne O. Battani In Re: WIRE HARNESS

More information

ewrap Super/Pension Transfer authority

ewrap Super/Pension Transfer authority ewrap Super/Pension Transfer authority Complete this form in BLOCK LETTERS and: post it to ewrap, PO Box 7241, Cloisters Square, Perth WA 6839 do not use this form if you wish to close your existing ewrap

More information

Departing Australia Superannuation Payment Direction Form

Departing Australia Superannuation Payment Direction Form Departing Australia Superannuation Payment Direction Form Use this form to request a benefit payment from the Russell Investments Master Trust (the Fund, iq Super), if you worked in Australia on an eligible

More information

apply for a super payout

apply for a super payout HOW TO apply for a super payout STEP 1 CHECK THAT YOU RE ELIGIBLE You wish to receive part or all of your super payout in cash A portion of your super benefit may be preserved. If the preserved amount

More information

Fisher Funds LifeSaver Plan First Home Withdrawal Form

Fisher Funds LifeSaver Plan First Home Withdrawal Form Fisher Funds LifeSaver Plan First Home Withdrawal Form If you would like help in completing this form, please email lifesaver@fisherfunds.co.nz or phone us on 0508 FISHER (0508 347 437), if calling from

More information

University Suites Student Housing

University Suites Student Housing University Suites Student Housing STATEMENT OF RENTAL POLICY Thank you for choosing University Suites as your new home. Please take a moment to read the following criteria. These criteria are used as a

More information

Notice of change of General Partner details Excluding NZ registered companies Limited Partnerships Act 2008

Notice of change of General Partner details Excluding NZ registered companies Limited Partnerships Act 2008 Page 1 of 9 Form version October2017 www.limitedpartnerships.govt.nz 0508 266 726 Post your completed form to: National Processing Centre, Private Bag 92061, Victoria Street West, Auckland 1142 Notice

More information

Title Mr Mrs Ms Miss Other M/F Date of birth / / Given names - - Step 2A What form of identification will you need to provide?

Title Mr Mrs Ms Miss Other M/F Date of birth / / Given names - - Step 2A What form of identification will you need to provide? Contributions Splitting Application If you need help Call the Helpline 1800 682 626. Step 1 Complete your personal details Please print in black or blue pen, in uppercase, one character per box. A Title

More information

BENEFIT PAYMENT AND ROLLOVER

BENEFIT PAYMENT AND ROLLOVER BENEFIT PAYMENT AND ROLLOVER Important Information To claim a benefit you will need to complete a Benefit Payment form and return it to GROW together with the appropriate identification (refer to Completing

More information

Apply for a super payout

Apply for a super payout ANZ Australian Staff Superannuation Scheme Apply for a super payout Step 1 Check that you re eligible You wish to receive part or all of your super payout in cash A portion of your super benefit may be

More information

IFA/FTA membership application form 2017

IFA/FTA membership application form 2017 1 IFA/FTA membership application form 2017 1 Eligibility for membership Membership is open to individuals in finance, those who have achieved an accounting, financial or taxation qualification, or are

More information

Claims Management Claim Form. When you have filled in the form, please send it to us at:

Claims Management Claim Form. When you have filled in the form, please send it to us at: For our use only.../... Claims Management Claim Form When you have filled in the form, please send it to us at: Solicitors Regulation Authority Claims Management The Cube 199 Wharfside Street Birmingham

More information

Don t return this page

Don t return this page Student Allowance/Student Loan/Scholarship Overseas study application form Complete this form if you want to apply for a Student Allowance/Student Loan/Scholarship for overseas study. You can also apply

More information

Application for Accreditation by NAATI Approved Australian Course

Application for Accreditation by NAATI Approved Australian Course Application for Accreditation by NAATI Approved Australian Course B FORM Please use a blue or black pen to complete this form. Please print in BLOCK LETTERS. NAATI Number: (if known) Part 1 Is this your

More information

Application for registration of a Limited Partnership Limited Partnerships Act 2008

Application for registration of a Limited Partnership Limited Partnerships Act 2008 Page 1 of 9 Version October 2017 www.limitedpartnerships.govt.nz 0508 266 726 Post your completed form to: National Processing Centre, Private Bag 92061, Victoria Street West, Auckland 1142 Application

More information

Application Form New Investors

Application Form New Investors Application Form New Investors Dated 1 July 2018 Issued by Investors Mutual Limited ABN 14 078 030 752 AFS Licence No. 229988 This application form must not be given to another person unless accompanied

More information

Qualification Awarding body Year

Qualification Awarding body Year Application for Registration as an Chartered Tax Adviser (CTA) Student 2018 Personal Details Title: Surname: First Name: Work Telephone Number: Mobile Telephone Number: E-mail (A valid e-mail address is

More information

Return of Private Foundation. or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation

Return of Private Foundation. or Section 4947(a)(1) Nonexempt Charitable Trust Treated as a Private Foundation For Return of Private Foundation 990-PF Departent of the Treasury Internal Revenue Service À¾ ½ Note: The foundation ay be able to use a copy of this return to satisfy state reporting requireents. For

More information

MAT 3788 Lecture 3, Feb

MAT 3788 Lecture 3, Feb The Tie Value of Money MAT 3788 Lecture 3, Feb 010 The Tie Value of Money and Interest Rates Prof. Boyan Kostadinov, City Tech of CUNY Everyone is failiar with the saying "tie is oney" and in finance there

More information

MORTGAGE LOAN APPLICATION

MORTGAGE LOAN APPLICATION MORTGAGE LOAN APPLICATION About Your Application... The completed application will tell us about your personal and business background; it will let us know your loan requirements and details of the property

More information