How to complete the AML/CTF Investor Identification Information Form
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- Emmeline Dickerson
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1 How to complete the MLCF Investor Identification Information Form he ustralian government has introduced legislation called the nti-money Laundering and Counter errorism Financing ct 2006 which is designed to combat money laundering and terrorism financing. he introduction of this legislation means that investors must provide additional identification details when they request a designated service. You may also be asked to provide supporting identity documentation. What is a designated service, and are you requesting one of them? 1. re you acquiring (e.g. buying or transferring) a NW reasury Bond? 2. re you applying for a NW reasury Bond by completing an application form? If the answer is yes to either of these questions, you are requesting a designated service and therefore must complete an Investor Identification Information Form and provide the identity documents specified on the form. Which type of investor are you and which section of the form should you complete? he amount of information you need to provide depends upon your Investor ype. You need only complete the section(s) of the form that relate to your particular Investor ype and circumstances, as follows: Investor ype IndividualIncluding joint Individuals Form Individual (Complete one form per joint Individual holder) Company (foreign or domestic) Company rust Financial Planners, Brokers or other FL Holders rust F Licensee Information Form What do you need to do? 1. Complete the appropriate form or forms for your Investor ype by typing it, or handwriting in blue or black pen ink. Do not use correction fluidtape or pencil. Please initial all corrections. Complete one form for each Investor. 2. Include originally certified copies of identity documents as specified on each form. list of people who can certify documents is on the other side of this page. Do not send original documents as they may get lost. Certified copies of documents will not be returned to you. 3. Each gent, Power of ttorney, Parent or Guardian acting on behalf of an Individual Investor must identity themselves and provide supporting documentation. 4. If you are requesting a designated service via a financial planner or broker, provide your identity documents to them for verification 5. ttach all of the relevant documents to the front of the transfer or application form and mail to: Link Market ervices Limited egistry Operations MLCF Processing Locked Bag 14 YDNEY OUH NW 1235 ULI Please note: If you are lodging this form with an pplication for NW reasury Bonds please send this form with your application to the address specified on the application form. F Licensees: 6. Verify the Investors identity and then complete the F Licensee form. ttach it to the Investor Identification Information Form. COP ML0211
2 Who can certify identity documents for you? he following individuals are authorised to certify identity documents. his list may be different to other lists you are accustomed to using. One of the people on this list should certify your identity documents or we may have to reject your forms. 1) legal practitioner enrolled on the roll of the upreme Court of an ustralian tate or erritory, or the High Court of ustralia; 2) judge of a court; 3) magistrate; 4) chief executive officer of a Commonwealth court; 5) registrar or deputy registrar of a court; 6) Justice of the Peace (a.k.a. JP); 7) notary public (for the purposes of tatutory Declaration egulations 1993); 8) police officer; 9) n agent of ustralia Post, who is in charge of an office supplying postal services to the public; 10) permanent employee of ustralia Post with 2 or more years continuous service who is employed in an office supplying postal services to the public; 11) n ustralian consular officer or an ustralian diplomatic officer (within the meaning of the Consular Fees ct 1955); 12) n officer with 2 or more years continuous service with one or more financial institutions (for the purposes of tatutory Declaration egulations 1993) e.g. bank manager; 13) n officer with 2 or more years continuous service with one or more finance companies (for the purposes of tatutory Declaration egulations 1993) e.g. finance company manager; 14) n officer or a representative with 2 or more years continuous service with one or more holders of an ustralian financial services licence e.g. financial planner; 15) member of the Institute of Chartered ccountants in ustralia, CP ustralia or the National Institute of ccountants with 2 or more years continuous membership e.g. ccountant or CP. Privacy tatement: Link Market ervices Limited advises that the nti-money Laundering & Counter errorism Financing ct 2006 (MLCF) requires information about you (including but not restricted to, your name, street address, date of birth or country of origin) be collected and verified before a designated service is provided to you. he minimum information collected complies with the rules of the MLCF ct. NW reasury Corporation or Link may request additional information from you before providing you with the requested designated service. Please note: your personal information may be disclosed to the MLCF regulator, UC, or a law enforcement agency.
3 INDIVIDUL Investor Identification Information Form nti-money Laundering and Counter errorism Financing (MLCF) legislation 2006 ervice equested by the Investor Please tick one ransfer registration pplication for an issue of NW reasury Bonds Issuer name N ecurity codedescription N W W E Issuer Details U Y E U Y C B O P D O I ection 1 to be completed by all Investors. ection 1 Investor identification details urname First name(s) Middle name(s) esidential street address (Do not use a PO Box or C- ddress) uburbowncity Line 1 tateerritorycountyegion Line 2 PostZip code Line 3 Country (if not ustralia) Line 4 Country of birth Date of birth dd mm yyyy Country(s) of residency Country(s) of citizenship Primary Occupation or Business ctivity ection 2 Investors gent or Power of ttorney or Person cting on behalf of a Minor ection 2 to be completed by a person authorised to ct for the Individual. Full name of person acting on behalf of the Individual esidential address (Do not use a PO Box or C- ddress) ddress line 1 ddress line 2 Proof of Identity and uthorisation to ct on the Investors Behalf ignature Phone number I have attached a certified copy of my driver s licence, passport or other photo Id which confirms my details above and contains my signature; and I have attached a certified copy of my authorisation to ct on behalf of the Investor. (ick from list over page) In the case of a minor, I have attached a certified copy of the minors birth certificate or extract of birth. Date appointed as agent or PO Date Country code area code number dd mm yyyy gent Power of ttorney Parent or Guardian dd mm yyyy
4 uthorisation In relation to the person authorised to act for the Individual Please DO attach original documents. end only certified copies of original documents. Documents will not be returned. ick uthority to act as Investors gent Power of ttorney Minor(s) tatement and Indemnity Other, please specify: ection 3 Identification documents to be completed by or for the Investor Please complete either Option 1 or Option 2 and attach the applicable document(s). Please DO attach original documents. end only certified copies of original documents. Documents will not be returned. Holders of an FL providing a service to the Investor must complete the F Licensee form at the end of this document which certifies they have verified the identity of the Investor. Option 1 ustralian citizens Please attach at least 1 document; or Foreign citizens Please attach at least 2 documents ection 3 to be completed by all Investors. ick 1 Primary photographic identity document Driver s Licence ustralian Passport (current or expired in the last 2 years) International ravel Document foreign passport Proof of ge Card National Identity Card O Option 2 ustralian citizens Please attach at least 1 primary non-photographic document and 1 secondary non-photographic document; or Foreign citizens Please attach at least 2 primary non-photographic documents and 1 secondary non-photographic document ick 1 ick 1 Primary non-photographic identity document; ND ustralian Birth Certificate or Extract of Birth ustralian Citizenship Certificate Foreign Citizenship Certificate Foreign Birth Certificate Centrelink Pension card or Centrelink Healthcare card econdary non-photographic identity document financial benefit notice issued by the Commonwealth, tate or erritory within the last 12 months n income tax assessment notice issued within the last 12 months local government notice (e.g. council rates) or utilities notice (e.g. power, gas or phone bill) issued within the last 3 months In relation to a minor (under 18 years of age) a notice issued by a school principal within the last 3 months ll foreign language documents must be accompanied by an English translation prepared by an accredited translator Investors signature Date dd mm yyyy
5 Company Investor Identification Information Form nti-money Laundering and Counter errorism Financing (MLCF) legislation 2006 ervice requested by the Investor Issuer details Please tick one Issuer name ransfer registration N W E U Y C O P O I pplication for an issue of NW reasury Bonds ecurity codedescription N W E U Y B D ection 1 Investor identification details Company name egistered office street address (Do not use a PO Box or C- ddress) Line 1 Line 2 uburbowncity tateerritorycountyegion ection 1 to be completed by all Investors. PostZip code Line 3 Country (if not ustralia) Line 4 Country of incorporationorigin Principal place of business street address (Do not use a PO Box or C- ddress) uburbowncity Line 1 tateerritorycountyegion Line 2 PostZip code Line 3 Line 4 Country (if not ustralia) Please tick from each column Domestic company Foreign company Public company Company type and registration details Proprietary or Private company IC registered andor Foreign registered CN or BN Foreign registration number
6 ection 2 If a proprietary or private company, the full name of each director of the company ections 2 & 3 to be completed by private or proprietary Company Investors. ection 3 ddress (Do not use a PO Box or C- ddress) ddress (Do not use a PO Box or C- ddress) ddress (Do not use a PO Box or C- ddress) ddress (Do not use a PO Box or C- ddress) If a proprietary or private company, the name and address of the beneficial owners owning 25% or more of the issued capital ddress (Do not use a PO Box or C- ddress) ection 4 Identification documents to be completed by the Investor ection 4 to be completed by all Investors. Please attach at least 1 identification document which verifies the identity of the company. Please DO attach original documents. end only certified copies of original documents. Documents will not be returned. Holders of an FL providing a service to the Investor must complete the F Licensee form at the end of this document which certifies they have verified the identity of the Investor. ick Identity document certificate of registration issued by IC or other regulator. licence issued by a domestic or foreign regulator. disclosure certificate that verifies information about the company. Other, please specify: Director or ole Director ll foreign language documents must be accompanied by an English translation prepared by an accredited translator Director or Company ecretary Company eal Date dd mm yyyy
7 U Investor Identification Information Form nti-money Laundering and Counter errorism Financing (MLCF) legislation 2006 ervice requested by the customer Issuer details Please tick one Issuer name ransfer registration N W E U Y C O P O I pplication for an issue of NW reasury Bonds ecurity codedescription N W E U Y B D ection 1 to be completed by all Investors. ection 1 rust name Business name (if any) of the rusteeesponsible entity Country of EstablishmentOrigin ection 2 Investor identification details rust identification details lso complete this part of section 1 if you are a rust ype of rust (tick one) Unit rust egistered MI Family rust Charitable rust Property rust Unregistered MI Government uperannuation Fund ection 2 to be completed by all Investors. Corporate Unit rust uthorised rustee Corporation Other Public rading rust Managed Investment rust Full name of the trust beneficiaries O member class of beneficiary Each beneficiary s full name O each member class pecify
8 ection 3 rustee identification details rustee 1 rustee type (tick one) Individual Company Full name of rustee rustee address (Do not use a PO Box or C- ddress) ddress line 1 ddress line 2 ections 3 & 4 to be completed by all Investors. rustee 2 rustee type (tick one) Individual Company Full name of rustee rustee address (Do not use a PO Box or C- ddress) ddress line 1 ddress line 2 rustee 3 rustee type (tick one) Individual Company Full name of rustee rustee address (Do not use a PO Box or C- ddress) ddress line 1 ddress line 2 ection 4 Identification procedure for all of the rustees Number of rustees rustee identity procedure Individual rustee Please complete the applicable sections of the identity information form for individuals. emember to attach certified copies of identification documents so that your identity as a trustee can be verified. Company rustee Please complete the applicable sections of the identity information form for a company. emember to attach certified copies of identification documents so that your identity as a trustee can be verified. Please attach the completed trustee identity information form and identity documents to the back of this document. ection 5 to be completed by all investors. ection 5 rustee ignature rustee ignature Identification documents to be completed by the rustee customer Please attach at least 1 identification document which verifies the identity of the trust. Please DO attach original documents. end only certified copies of original documents. Documents will not be returned. ick 1 rustee identity procedure certified copy of the trust deed certificate issued to the trust by IC or other regulator Other, please specify: ll foreign language documents must be accompanied by an English translation prepared by an accredited translator Date dd mm yyyy
9 Investors full name F Licensee Information Form nti-money Laundering and Counter errorism Financing (MLCF) legislation 2006 Investor type: Individual Company rust Individual minor (under 18 years) ecord of Investor identification procedure o be completed by F licensee Identity details Identity verified from he identity document is Primary document Individuals and non-individuals (Do not attach original documents) Original ttached Certified Copy Not ttached econdary document Individuals (Originals will not be returned) Original ttached Certified Copy Not ttached Document details Primary document econdary document Document issuer Issue date Expiry date Document number dd mm yyyy dd mm yyyy dd mm yyyy dd mm yyyy ccredited English translation Original ttached ighted Original ttached ighted F licensee details Financial Planner, Financial dvisor, Broker F Licensees or their representatives, who are arranging a designated service for the Investor must complete this section of the Investor identification information form verifying that they have confirmed the Investors identity. Full name of F representative F licensee name F licensee type Planner dvisor Broker F license number Licensee address ddress line 1 Phone number Country code area code number ddress line 2 I confirm that I have sighted original or certified copies of the Investors identity documents; and (where applicable). I confirm that I have sighted original or certified copies of the Investors gent or Power of ttorney, Parent or Guardian identity documents. F licensee signature Date verified dd mm yyyy
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