Country Where the Trust was Established

Transcription

1 ACCOUNT APLICATION FORM - TRUST Bank of China (Australia) Limited collects the following customer information in order to comply with the applicable laws including anti-money laundering and counter-terrorism financing laws. If you refuse to provide the information, we regret that we will not be able to process your application. BSB CIF Number Account Name SECTION 1: TRUST INFORMATION 1.1 General Information Full Name of the Trust Date upon Which the Trust was Established Country Where the Trust was Established Type of Trust (Select One Only) 1. A managed investment scheme registered by ASIC 2. A managed investment scheme that is not registered by ASIC, and that: (a) only has wholesale clients; and (b) does not make small scale offerings to which Section 1012E of the Corporation Act 2001 (Cth) applies. 3. A government superannuation fund established by legislation 4. Registered and subject to the regulatory oversight of a Commonwealth statutory regulator in relation to its activities as a trust 5. A Discretionary Trust (e.g. Family Trust) 6. A Unit Trust 7. If Type 1, 2, 3, or 4 is selected in the above Type of Trust table; proceed to Section 3 now. Source of Wealth Source of Funds (for this business relationship) (Select all that apply) Employment Income Investment Income Business Activity Income Gift Sale of Property/Assets Government benefits (Select all that apply) Employment Income Investment Income Business Activity Income Gift Sale of Property/Assets Government benefits Last Financial Year Audited Turnover Currency: Amount: Financial Year: Is the Trust operating as a charity? No Yes, please answer the following question: What is the objective/purpose of the charity? (e.g. disability services, flood relief, aged care, or foreign aid etc.): Is the charity registered with the Australian Charities and Not-for Profits Commission? Yes No If No, please provide the name of the equivalent registration body (if any): 1.2 Details of Beneficiaries 0 Full Name (Given Name, Middle Name, Last Name) DOB (dd/mm/yyyy) CIF No. (Bank Use Only) Please provide Details of Class if the beneficiaries are identified by reference to membership of a class (e.g. Children of xxx) Tax File Number (TFN) or exemption category* ABN (if any) *Please note that quoting TFN is not compulsory. However, if you do not quote your TFN, Bank of China (Australia) Limited is required by law to deduct tax from any interest earned on your account. For more information please contact the Australian Taxation Office. Bank of China (Australia) Limited Page 1 of 7 AFSL No

2 SECTION 2: BENEFICIAL OWNERS OF THE TRUST A Beneficial Owner is an individual who ultimately owns 25% or more interest in the trust property, or exercises control directly or indirectly of the Trust. Generally, the Appointor, the Settlor, the Protector or Enforcer of the Trust is considered as the Beneficial Owner of the Trust. Authorised Signatory with sole signing authority is considered as the Beneficial Owner of the Trust. Beneficial Owner 1 - Settlor % interest in the Trust Bank Use Only CIF No.: New Existing Beneficial Owner 2 - Appointor % interest in the Trust Bank Use Only CIF No.: New Existing Beneficial Owner 3 % interest in the Trust Bank Use Only CIF No.: New Existing Beneficial Owner 4 % interest in the Trust Bank Use Only CIF No.: New Existing Beneficial Owner 5 % interest in the Trust Bank Use Only CIF No.: New Existing If there are more than FIVE Beneficial Owners, complete a separate Beneficial Owner Information Form and attach it followed this page. Bank of China (Australia) Limited Page 2 of 7 AFSL No

3 SECTION 3: FATCA INFORMATION FATCA means the US Foreign Account Tax Compliance Act FATCA Agreement means the Inter-Governmental Agreement between Australia and the US to implement FATCA Note: The Trust, and NOT the Trustee, is the Account Holder for FATCA purposes and the following information should be provided in respect of the Trust. Is the Trust established under the laws of the US (a US Person)? No Yes. Please provide the Company s US Taxpayer Identification Number (TIN):.. If the Trust is a US Person and exemption from FATCA is claimed for the Company, please complete Form W-9. Is the Trust a Financial Institution under the FATCA Agreement? No Yes. Please provide the Trust s Global Intermediary Identification Number (GIIN):.. (if any) and indicate the Trust s FATCA status by completing Part A and Part C of a FATCA Status Declaration. If the Trust is a US Person and/or a Financial Institution, Section 3 is now complete - proceed to section 4. If the Trust is not a US Person or a Financial Institution (a NFFE), are any of the Trust s appointors, beneficiaries, settlers or any of the trustee company s Beneficial Owners or any person who controls the Trust is/are US citizens or residents of the US for tax purposes? We certify that none of the Trust s appointors, beneficiaries, settlers or any of the trustee company s Beneficial Owners or any person who controls the Trust is/are US citizens or residents. Section 3 is now complete proceed to Section 4. Yes. Please indicate the Trust s FATCA status by completing Part B and Part C of the FATCA Status Declaration. SECTION 4: TURSTEE INFORMATION Type of Trustee Total Number of Trustee(s) Remark Individual Company Please complete a separate Individual Information Form or Company Information Form for each of the Trustee and attach the completed form(s) followed this page. Is a Custodian appointed for this Trust Account? Yes, please provide the Custodian s information in a separate customer information form, e.g. Company Information Form. No. SECTION 5: ACCOUNT INFORMATION 5.1 Account Type Demand Deposit Term Deposit Account Foreign exchange Margin Account Cheque Account (AUD Only) 5.2 Cheque Book Order Details Quantity of Cheque Books: (50 cheques per book) Type of Cheque : With Not Negotiable Crossing Without Not Negotiable Crossing Way to Collect : Mail to Correspondent Address Collect Over Counter by 5.3 Anticipated Transactional Activity Purpose of Business Relationship with Bank of China Ltd Anticipated Transactional Activity Daily Business banking Trade Finance Lending Trading (e.g. FX) Saving/Deposits Will any of your transactions be involved in funds from/to overseas? Yes, please list the countries: No Transactions (per month) Number of transactions Amount (AU$) Purpose (e.g. payment) Credit Debit 5.4 Method of Account Operation (select a suitable method of operation of the Account) Any one of the Authorised Signatories listed in Section 5.5 to operate/give instruction All the Authorised Signatories listed in Section 5.5 to operate/give instructions Bank of China (Australia) Limited Page 3 of 7 AFSL No

4 5.5 Authorised Signatory/ies Details Declaration and Consent by the Authorised Signatory/ies: By signing this form, each Authorised Signatory declares that: The information that he/she has provided in this form is true, complete and correct; He/she has read the Bank s Privacy Collection Notice attached to this form (below) and understands and consents to information, including personal information about him/her as Authorised Signatories may be collected, used and disclosed by the Bank in accordance with the Bank s Privacy Policy; He/she must provide any information required by the Bank, to assist in or to ensure compliance by the Bank with its obligations under antimoney laundering and counter-terrorism financing ( AML/CTF ) laws; and He/she consents to the Bank verifying his or her personal details provided in this form. Authorised Signatory 1 (Tick if applicable) Verifying Officer Internet Banking Account Operator / Authorised Signatory 2 (Tick if applicable) Verifying Officer Internet Banking Account Operator / Authorised Signatory 3 (Tick if applicable) Internet Banking Account Operator / Authorised Signatory 4 (Tick if applicable) Internet Banking Account Operator / If there are more than FOUR Authorised Signatories, complete a separate Authorised Signatory Information Form and attach it followed this page. Bank of China (Australia) Limited Page 4 of 7 AFSL No

5 SECTION 6: EXECUTIONS 6.1 General Acknowledgement We acknowledge that we have received a copy of the current Product Disclosure Statement ( PDS ) and Terms and Conditions including: Savings and Investment Accounts Term Deposit Accounts Outward Remittances Schedule of Fees and Charges and agreed to be bound by the relevant Terms and Conditions. We understand that:- (i) We must provide any information required by the Bank to assist in or to ensure compliance by the Bank or its subsidiary with the Anti- Money laundering and Counter-Terrorism Financing ( AML/CTF ) requirements and we understand it is an offence under Part 12 of the AML/CTF Act to provide false or misleading information, provide a false or misleading document or forge a document for use in an applicant identification procedure; and (ii) The Bank may block or freeze our Account which will be opened in our name, any payment or receipt that will be conducted by us using this Account, and where it is obliged to do so under the AML/CTF requirements or other legal/regulatory requirements or for the purpose of prevention or detection of unlawful activities. We understand the Bank may disclose information to Government Agency, law enforcement agencies, service providers or to other third parties. We acknowledge that the Bank may be prohibited from advising us that a disclosure mentioned in paragraph (ii) above has been made. 6.2 Privacy Acknowledgements and Consent Bank of China Privacy Collection Notice The Bank of China Limited, Sydney Branch ABN AFSL No and Bank of China (Australia) Limited ABN AFSL and Australian Credit Licence No (jointly and severally referred to as Bank of China, we, us and our in this collection notice) may collect your personal information from third parties including your employer (to confirm income and employment details), your accountant/tax agent, mortgage brokers, a credit reporting body (for credit application) and public registers provided by the Australian Securities & Investments Commission or the Personal Property Securities Register or State or Territory land and property registers. We collect personal information in order to: establish your identity and assessing your application for our products and services, provide you with the products and services you request; provide you with customer support; monitor and evaluate our products and services; respond to your queries or requests for assistance (including hardship applications) or complaints; take measures to detect and prevent fraud and financial loss; administer our customer relationships, services, products, systems and business functions; comply with our legal obligations and meeting government and law enforcement agencies or regulators requirements, including our obligations under applicable anti-money laundering and counter-terrorism financing and sanctions laws, or a court/tribunal order; develop and research our products and services; conduct appropriate checks for credit-worthiness; maintain and develop our information technology systems, including the testing and upgrading of these systems; and provide you with information relating to our products or services that we believe may be of interest to you. If you do not provide us with your personal information, some or all of the following may happen: we may not be able to provide the requested products or services to you, either to the same standard or at all; we may not be able to provide you with information about products and services that you may want, including information about special promotions; we may not be able to properly investigate or resolve your query or complaint; or we may delay, block or refuse to make a payment or action an instruction relating to your account. We may disclose your personal information to the following third parties: our related bodies corporate within the Bank of China group; credit providers, referees or persons with whom you transact; credit reporting bodies (for credit products), our agents, contractors, brokers, insurers, authorised representatives and credit representatives; other organisations who jointly with us provide products or services to you; other financial institutions; our local Australian clearing agent bank; payment system operators, service providers and participants; card scheme participants; loyalty program redemption partners; government or regulatory bodies or to law enforcement agencies with appropriate authority; fraud bureaus or other organisations to identify, investigate or prevent fraud or other misconduct; external dispute resolution schemes; our professional advisers including lawyers and auditors, consultants; your duly authorised representatives; and our service providers. If you are under 16 or have special needs, we may share your information with your parent or legal guardian or any person appointed to manage your affairs. We may collect personal information where it is required or authorised by or under an Australian law or a court/tribunal order. In certain circumstances we may be required to collect your name, address, date of birth, and other verification information and verifying documents under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 (Cth) and Anti-Money Laundering and Counter-Terrorism Financing Rules Instrument 2007 (No.1) (Cth). If you have applied for credit or provide a guarantee, we may collect personal information about your financial position pursuant to the National Consumer Credit Protection Act 2009 (Cth), and if you give us a mortgage security or other security interests, certain identification information under property laws in some Australian states and territories or the Personal Property Securities Act 2009 (Cth). We may collect your tax file number if you choose to provide it as authorised by the Income Tax Assessment Act 1936 (Cth) and other taxation laws. We may also be required to request your tax residency status under information sharing agreements between the Australian Government with other countries, such as the agreement between Australia and the United States (US) under US law (Foreign Account Tax Compliance Act), that requires us to ask account holders of some products whether they are US citizens or US tax residents. If you are a tax resident of another country, the relevant treaty or law may require us to collect your relevant foreign tax identification number. Sensitive information The Privacy Act protects your sensitive information, such as health information that we may collect on a hardship application. If we need to collect your sensitive information, we will only do so with your consent, except where otherwise permitted by law. We only collect personal information about individuals that is necessary for our business. Our Privacy Policy, available at or from us on request, contains information about how you may access and correct the personal information that we hold about you and how to lodge a complaint relating to our treatment of your personal Bank of China (Australia) Limited Page 5 of 7 AFSL No

6 information, and how we will deal with the compliant. We may disclose personal information overseas to our overseas related bodies corporate and service providers. It is not practicable for us to list every country in which such recipients are located but it is likely that such countries where we will disclose information to our related companies or branches will include Bahrain, Belgium, Brazil, Cambodia, Canada, China, Dubai, France, Germany, Hong Kong, Hungary, Indonesia, Italy, Japan, Korea, Luxembourg, Macau, Malaysia, Mongolia, Netherlands, New Zealand, Panama, Philippines, Poland, Republic of Kazakhstan, Russia, Singapore, Sweden, Taiwan, Thailand, United Arab Emirates, UK, USA, Vietnam and Zambia. Our third party service providers may be located in British Virgin Islands, Cayman Islands, China, Hong Kong and New Zealand. We may notify you of other countries from time to time (including at the time of collecting your information). In the course of a multi-jurisdictional transaction we may also disclose your personal information to our lawyers located in relevant jurisdictions. You may contact us by writing to: Compliance Officer, Legal and Compliance, Bank of China Ltd, York, SYDNEY, NSW Or by telephone on: (toll-free) or between 9:00am and 5:00pm Monday to Friday AEDT (not available on NSW public holidays). This Privacy Collection Notice is last updated on 20 July Declarations and Authority Declaration and Acknowledgement: 1. We attach to this application a copy of the duly stamped trust deed for the Trust. We confirm that the trust deed authorises the opening and operation of bank accounts in the manner set out in this authority. 2. If any Trustee is a company, we also attach to this application a copy of that Trustee's certificate of incorporation. We confirm that there is nothing in any Trustee's constitution and no resolutions have been made by that Trustee purporting to restrict or having the effect of restricting the rights of its Board of Directors to exercise the powers of the Trustee in connection with the signing of cheques, operation of bank accounts or otherwise dealing with the property of Trust. 3. We confirm the Trustee(s) has/have an unrestricted right to be indemnified out of the assets of the Trust in respect of any all liabilities incurred or to be incurred by the Trust or the Trustee(s) in connection with the Account and we undertake to ensure that this indemnity continues and that the assets of the Trust are sufficient to satisfy that right of indemnity at all times. 4. We acknowledge and agree the Bank is not obliged in any circumstances to enquire whether an act purporting to be done in accordance with this authority is a proper exercise of any authority conferred and to the extent permissible by law the Bank is released from all liability for any loss or damage suffered by the Trust or the Trustee(s) arising from the Bank acting on this authority, except as may be incurred directly by reason of fraudulent conduct on the part of any of the Bank's employees. 5. We request the Bank to recognise and act upon this authority until the branch of the Bank where the Accounts are conducted receives notice in writing of their cancellation. 6. All previous authorities as to authorised signatures are cancelled except as regards cheques and other instruments dated up to and including the date of this authority and presented for payment on or after such date. 7. We declare that all of the information that we have provided in this application form is true and correct. 8. We authorise the Bank to charge to the Accounts to recover from us any bank fees, government charges, taxes or duties imposed on transactions on/or which relate to the Accounts. 9. We agree to be bound by the terms and conditions which apply from time to time to Accounts opened by us with the Bank. 11. We acknowledge that we have read and understand the contents of the above Privacy Collection Notice and I agree to be bound by the conditions. Bank of China (Australia) Limited Page 6 of 7 AFSL No

7 6.4 s Where the Trustee(s) is/are a company/ies. Executed by the Trustee in accordance with section 127 of the Corporations Act 2001 (Cth): Full Name of the Director and Date Full Name of the Director/Company Secretary and Date ) Where the Trustee(s) is/are Individual(s), all individual Trustees to sign the application. Full Name of the Trustee of the Trustee and Date Full Name of the Trustee of the Trustee and Date Bank Use Only Summary of Customer Account Customer CIF: Account Type Currency Account No. Short Account No. Remark Tick COMPLIANCE CHECKLIST PDS has been given to the customer. FATCA information and relevant forms (if any) have been collected from the customer. All the required KYC information, including the control structure of the customer has been collected from the customer. The separate CDD forms (if any) completed by the customer, and the original copy / certified true copy of all identification documents have been obtained and attached to this form. Does the Trustee provide professional service (e.g. Accounting, Legal, or Finance Advisory service)? No. Yes SDD has been completed. Comments: I confirm that the KYC procedures have conducted in accordance with the customer due diligence requirements set out in Part B of the Bank s and its subsidiary s joint AML/CTF Program. Account Opening Officer Full Name Staff ID and Date Verifying Officer Full Name Staff ID and Date Bank of China (Australia) Limited Page 7 of 7 AFSL No