Guide. Opening an account with Big Sky. Forms required to open an account. Personal Details. Privacy

Transcription

1 Guide Opening an account with Big Sky Forms required to open an account To open an account with Big Sky as a new customer you must complete this Customer Application Form. What forms do I need to open an account in joint names? Customer Application Form for the 1st named person on the account(s). Customer Application Form for the 2nd named person on the account(s). Joint Account Application Form. *Note: If one or more of the joint account holders is already a customer of Big Sky, the Customer Application Form is not usually required to be completed for that applicant(s). Third Parties you require to have access to your account In the case where you require an additional person (not an account holder) to have access to all or nominated accounts, we also require you and the person you nominate to complete: Authority to Operate/Add a Signatory Form All forms are available at your local service centre or on our website at bigsky.net.au If you require any assistance in completing this document, please contact a Big Sky Customer Service Consultant on Identification Under the Anti-Money Laundering and Counter Terrorism Financing Act 2006, we require specific forms of identification in order to open your account. Big Sky is required to verify your full name, residential address and/or date of birth. Section 7 of this form details what types of identification documents we require. Section 8 of this form provides the identification Certification Form where a Big Sky staff member cannot sight your original identification documents. Politically Exposed Persons (PEPs) A Politically Exposed Person (PEP) means an individual who holds a prominent public position or function in a government body or an international organisation in Australia or overseas, such as a Head of State or head of a country or government, or a government minister or equivalent senior politician. A PEP can also be an immediate family member of a person referred to above, including a spouse, de facto partner, child and a child s spouse or a parent. A close associate of a PEP, i.e. any individual who is known to have joint beneficial ownership of a legal arrangement or entity is also considered to be a PEP. Personal Details In order to become a Big Sky customer, we need to collect some information about your choice of accounts. Section 1 of this form highlights the personal information we require. Sections 2 to 4 refer to the types of accounts you may like to open, the account access facilities available, and the name(s) required on the account. Privacy Your personal and credit-related information will be collected, used and disclosed by Big Sky in accordance with our Privacy & Credit Reporting Policy and in accordance with the law. You can obtain a copy of our Policy via our website or by phone on Supporting Documents Associated with opening an account: (All supporting documents can be located on the website at bigsky.net.au) Account and Access Facility Terms of Use Financial Services Guide Summary of Accounts & Access Facilities Fees & Charges Schedule Privacy Notice Interest Rate Schedule After fully completing this form, please return to your local Service Centre or mail it to: Big Sky Building Society Limited GPO Box 1801 MELBOURNE VIC 3001 Contact details Address 114 Albert Road South Melbourne VIC 3205 GPO Box 1801 Melbourne VIC 3205 Website bigsky.net.au bigsky@bigsky.net.au Telephone Big Sky Building Society Ltd ABN AFSL/Australian Credit Licence No BSBS

2 Application Form Customer 1. Your details Title: Mr Mrs Ms Miss Date of birth / / Surname: Given name(s) Gender:: M F Residential address (Mandatory) Unit: Street name: Suburb: Street No.: State: Postcode: Country (if not Australia): Contact details Home number: Work No.: Mobile No.: Mailing address (if different from residential address above) Unit: Street name: Suburb: Street No.: State: Postcode: Country (if not Australia): Employment details Employer: Occupation: Are you (or for joint applications, either party) a tax resident in any other country other than Australia? Yes No If you have selected YES, please complete the Self Declaration Form on page 10 of this application form. Contact details Address 114 Albert Road South Melbourne VIC 3205 GPO Box 1801 Melbourne VIC 3205 Website bigsky.net.au bigsky@bigsky.net.au Telephone Big Sky Building Society Ltd ABN AFSL/Australian Credit Licence No BSBS

3 Are you (or for joint applications, either party) a US citizen/resident for tax purposes? Yes No (Under the Foreign Account Tax Compliance Act, you must confirm your US status). If you are a US citizen/resident, please provide your Taxpayer Identification Number: Applicant Name: Number (TIN): Are you (or for joint applications, either party) a Politically Exposed Person? Yes No (See definition on Page 1) Source of funds/wealth (Under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 we are required to collect this information). Select all that apply: Gainful employment Inheritance/gift Business Superannuation Savings Other: Tax file number/ Exemption code: Note that it is not an offence not to quote your tax file number, but, if your tax file number (or relevant exemption) is not quoted any interest earned may be taxed as required by law. Telephone Banking with Staff Assistance: Please nominate an alpha/numeric code (minimum 6 characters) For a Big Sky staff member to provide assistance over the telephone a password can be created, which will be used for identification purposes when you contact 2. Selecting your account Everyday Account Target Saver Term Deposit Christmas Club Net Invest Other (please specify): 3. Selecting your services* I would like to apply for the following services on my account: Internet Banking Telephone Banking Visa Debit Card *Terms and conditions apply please see Terms of Use at bigsky.net.au 4. Account name and other parties associated with account Will your account be in joint names? Will there be a third party making withdrawals or enquiring about your account? Yes Yes No If Yes, please complete the Joint Account Application Form from bigsky.net.au No If Yes, please complete the Authority to Operate/Add a Signatory form from bigsky.net.au Customer Application Form 3

4 5. Consent and declaration Consent for electronic delivery of periodic statements and notices. I understand that: You will not post me periodic statements if I have registered for Internet Banking. These will be available electronically within my secure internet banking login If I choose not to register for Internet Banking, I may be charged for printed periodic statements You may send me notices about my banking and loan accounts to the address I have provided I can revert to periodic statements and notices via post, by submitting a written request to Big Sky Charges may apply for requests to receive periodic statements via post. I agree to receive electronic statements and notices. Membership of Australian Unity Limited As a Big Sky customer you may be eligible to become a member of Australian Unity Limited (AUL) once you have held a Big Sky account for a continuous period of two years, subject to acceptance by AUL. You hereby apply for membership, and agree to become a member of AUL (and to be bound by its Constitution upon becoming a member) unless you provide AUL with written notice that you elect not to be a member of AUL. Admission to membership is at the absolute discretion of the directors of AUL (or their delegate), and they may create categories of membership with the same or differing rights or privileges and admit you to any category. Membership of AUL is on and subject to such rights and privileges (if any) and the terms, rights, restrictions and obligations set out in the Constitution of AUL from time to time. Declarations 1. I believe the above identification details to be true and correct. It is an offence under the Anti-Money Laundering and Counter Terrorism Financing Act 2006 to give false and misleading information. I understand Big Sky will collect personal information from me as required by the Anti-Money Laundering and Counter Terrorism Financing Act 2006 and that it may take steps to verify the personal information it has collected. 2. As a condition of opening an account with Big Sky I have read and accept the conditions of the following: Account and Access Facility Terms of Use Financial Services Guide Summary of Account & Access Facilities Fees & Charges Schedule Interest Rates Schedule Privacy and Credit Reporting Policy I understand that these documents are available on Big Sky s website at and that I can access them online. Alternatively, I can obtain copies of these documents from Big Sky on request by calling I declare that the information provided for meeting Automatic Exchange of Information ( AEOI ) requirements (where applicable) is true and correct and that I will provide all necessary co-operation and assistance in order for use to comply with obligations under Australian legislation designed to give effect to AEOI which includes Foreign Account Tax Compliance Act ( FATCA ) and Common Reporting Standard (CRS) regimes. 4. I declare that the information provided for meeting FATCA requirements (where applicable) is true and correct and that I will provide all necessary co-operation and assistance in order for Big Sky to comply with obligations under Australian legislation designed to give effect to the FATCA agreement between Australia and the United States. Signature: X Name: Date: / / Customer Application Form 4

5 6. Other information request I would like to receive information about the following products that Big Sky and/or its subsidiaries offers: Home Loans Overdraft Health Insurance Online Share Trading Credit Cards Personal or Car Loans Financial Advice Travel Insurance Car/Contents/Home/Boat Insurance Car Search Services Why did you choose Big Sky? Location of Service Centre Comprehensive Products and Services Competitive Rates Employer Relationship Referred by friend/relative Marital Status Other: OFFICE USE ONLY Op No. Initials Account opened in P&R Cheque Signatory Card Yes N/A Provided to customer Account and Access Facility Terms of Use Financial Services Guide Summary of Account & Access Facilities Fees & Charges Schedule Interest Rates Schedule Privacy Notice Op No. Initials Op No. Initials Op No. Initials Visa Debit Card Ordered Yes N/A Cheque Book Ordered Op No. Initials Op No. Initials Internet Banking Password Issued Yes N/A Op No. Op No. Op No. Initials New customer letter sent Initials Scanned to Doxgate Initials Yes N/A Customer Application Form 5

6 7. Identification documents The Anti-Money Laundering and Counter Terrorism Financing Act 2006 requires us to verify your identity when you open an account with Big Sky Building Society. Documents that confirm your full name, date of birth and/or current residential address are required as indicated on the lists below (Note: we require original documents or original certified copies of identification): Any one document from List A; or One document from List B and one document from List C; or Two documents from List B Refer to list D if a minor or List E for special provisions. Refer to list A, B, C, D & E below: LIST A Primary Photographic ID Documents LIST B Primary Non-photographic ID Documents LIST C Secondary ID documents LIST D Minors LIST E Special provision Current Australian drivers licence Passport (current or expired less than two years) issued by the Commonwealth Australian photo ID Card Current Foreign passport (if not in English accompanied by an English translation prepared by an accredited translator) National ID Card issued by a Foreign Government (if not in English accompanied by an English translation prepared by an accredited translator) Australian Birth Certificate or Extract Citizenship Certificate issued by the Commonwealth Pension card issued by Centrelink Health care card issued by Centrelink Birth Certificate issued by a Foreign Government (if not in English accompanied by an English translation prepared by an accredited translator) Citizenship Certificate issued by a Foreign Government (if not English accompanied by an English translation prepared by an accredited translator) A notice that contains your full name and current residential address and was issued in the last 12 months (unless otherwise stated) in the form of: Tax Assessment Notice from the Australian Tax Office Evidence of a financial benefit from the government e.g. family allowance Council Rates Notice issued in the past three months Utilities bill issued in the past three months e.g. water, power, phone etc Birth Certificate or passport - confirm address from parent/guardian s customer details; or A letter from the School Principal within last three months stating: Full name of the minor and their residential address; and The time the minor attended school Indigenous Australians (where list A, B & C Identification cannot be provided): A person who is recognised by the members of the community to be a community elder and is in the form of a letter on the community letterhead If you cannot provide this information, please contact a Big Sky Service Centre Consultant on Customer Application Form 6

7 How do I provide my identification documents to Big Sky? Big Sky requires original documents or original certified copies of identification documents. If you are providing certified copies, please refer to Section 8 of this form for Certification Requirements. OFFICE USE ONLY Verification of Identity Details Customer Identification Procedure Individual carried out and identification documents produced were: From list From list X Name, Date of birth and/or current Residential Address on identification match to Customer Application Form Signature of staff member Date: / / Customer Application Form 7

8 Certifier s Form 1. Customer details and identification Title: Mr Mrs Ms Miss Surname: Given name(s) Customer number: Phone number:: Identification ID type: ID type: ID type: Person to whom it relates (name): Person to whom it relates (name): Person to whom it relates (name): Certifier s details - must not be related to applicant, please see over for details Title: Mr Mrs Ms Miss Surname: Given name(s): Category of Certification: Residential address or business address: (PO Box not acceptable) Suburb: State: Postcode: Occupation: Contact number: Mobile No.: Certifier Statement I have examined the original identification documents listed above. I have endorsed each copy of the identification document in the following manner: This is to certify that this is a true copy of the original which I have sighted: Title, Name, Date of Birth, Signature, and Registration Number (if applicable). I am not related in any way to the applicant. It is an offence under the Anti-Money Laundering and Counter Terrorist Financing Act 2006 to give false and misleading information. X Date: / / Signature Contact details Address 114 Albert Road South Melbourne VIC 3205 GPO Box 1801 Melbourne VIC 3205 Website bigsky.net.au bigsky@bigsky.net.au Telephone Big Sky Building Society Ltd ABN AFSL/Australian Credit Licence No

9 Big Sky approved Certifier s list General Commissioner for Affidavits Commissioner for Declarations Justice of the Peace A person who, under the law in force in a State or Territory, is currently licensed or registered to practise as: Chiropractor Dentist Legal Practitioner Medical Practitioner Nurse Optometrist Pharmacist Physiotherapist Psychologist Veterinary Surgeon. Banking and Post Office Services Permanent employee of Australian Postal Corporation with 2 or more years of continuous service who is employed in an office supplying postal services to the public Banking/Building Society/Credit Union/finance company officer with 2 or more continuous years of service. Legal and Courts A person who is enrolled on the role of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner, (however described) Chief Executive Officer of a Commonwealth Court Clerk or Judge of a court Magistrate Registrar, or Deputy Registrar, of a Court. Accounting and Taxation Services Fellow of the National Tax Accountants Association Member of Chartered Secretaries Australian Unity Member of the Association of Taxation and Management Accountants Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants. Defence and Protection Services Member of the Australian Defence Force who is: An Officer; or Non-commissioned Officer within the meaning of the Defence Force Discipline Act of 1982 with 2 or more years of continuous service; or A Warrant Officer within the meaning of the Act Police Officer Sheriff or Sheriff s Officer Other Services/Roles Marriage celebrant registered under Subdivision C of Division 1 of Part 4 of the Marriage Act 1961 Member of Engineers Australia, other than at the grade of student Member of: The Parliament of the Commonwealth; or The Parliament of the State; or A Territory legislature, or A Local Government Authority of a State or Territory Minister of religion registered under Subdivision A of Division 1 Part 4 of the Marriage Act of 1961 Notary Public Member of the Australasian Institute of Mining and Metallurgy Teacher employed on a full-time basis at a school or tertiary education institution. Approved Overseas Certifiers Employee of the Australian Trade Commission who is in a country or place outside Australia; and under paragraph 3 (d) of the Consular Fees Act of 1955; and exercising his or her function in that place Employee of the Commonwealth who is in a country or a place outside of Australia and authorised under a paragraph 3 (c) of the Consular Fees Act 1955; and exercising his or her function in that place Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955) A person authorised as a notary public in a foreign country. Please send your completed form along with original certified copies of your identification to: Big Sky Building Society Reply Paid 1801 Melbourne VIC 3001 (no stamp required if mailed in Australia) Customer Application Form 9

10 CRS Self Declaration Form Foreign Tax Information Individuals This form is designed to collect the tax status of an individual where this information has not previously been provided or the individual has been identified as a potential taxpayer of a country other than Australia. Complete one form for each individual. Complete all applicable sections of this form in BLOCK LETTERS. PLEASE NOTE: You may be treated as being a non-australian taxpayer if the requested information is not provided. 1. Personal details Surname: Given name(s): Title: Mr Mrs Ms Miss Date of birth: / / Occupation: 2. Residential address (PO Box is NOT acceptable) Unit: Street No.: Street name: Suburb: State: Postcode: Country (if not Australia): Tax status Answer both tax residency questions: Are you a tax resident of Australia? Yes No Are you a tax resident of another Country? Yes No If you are a tax resident of a country other than Australia, provide your tax identification number (TIN) or equivalent overleaf. If you are a tax resident of more than one other country, list all relevant countries overleaf. A TIN is the number assigned by each country for the purposes of administering tax laws. This is the equivalent of a Tax File Number in Australia. If a TIN is not provided, list one of the three reasons specified (A, B or C) for not providing a TIN. Contact details Address 114 Albert Road South Melbourne VIC 3205 GPO Box 1801 Melbourne VIC 3205 Website bigsky.net.au bigsky@bigsky.net.au Telephone Big Sky Building Society Ltd ABN AFSL/Australian Credit Licence No BSBS

11 If you have any questions on how to define your tax residency status, please visit the OECD website or speak to a professional tax adviser as we are not allowed to give tax advice. 1 Country TIN If no TIN, list reason A, B, or C 2 Country TIN If no TIN, list reason A, B, or C 3 Country TIN If no TIN, list reason A, B, or C If there are more countries, print the above table again and provide the additional details. Reason A The country of tax residency does not issue TINs to tax residents Reason B You have not been issued with a TIN Reason C The country of tax residency does not require the TIN to be disclosed 3. Declaration By completing and signing this declaration I certify that the information I have provided is true and correct. Individual Declaration (the person named in this form) X Date: / / Name: CRS Self Declaration Form 2