IDENTIFICATION FORM AUSTRALIAN COMPANY

Transcription

1 AUSTRALIAN COMPANY GUIDE TO COMPLETING THIS FORM This frm is fr nly. Fr cmpanies incrprated r registered utside f Australia use the FOREIGN COMPANY IDENTIFICATION FORM. Cmplete ne frm fr each cmpany. Tax infrmatin must be cllected frm an authrised representative f the Cmpany. SECTION 1: AUSTRALIAN COMPANY IDENTIFICATION PROCEDURE 1.1 General Infrmatin Full name as registered by ASIC ACN Registered ffice address Street Principal place f business (if any) Street 1.2 Cmpany Type (select nly ONE f the fllwing categries) Prprietary (cmpanies whse name ends with Prprietary Ltd r Pty Ltd; als knwn as private cmpanies) Prvide the names f the directrs belw and prceed t 1.3 Public (includes public listed cmpany, a majrity wned subsidiary f a public listed cmpany r a licensed cmpany Prceed t 1.3 subject t federal, state r territry gvernment regulatry supervisin) If Prprietary, prvide the names f all directrs If there are mre directrs, prvide details n a separate sheet and tick this bx. 1.3 Listing and Regulatry Details - if applicable (select any f the fllwing categries if applicable) Australian Public Listed cmpany (cmpanies that are listed n an Australian financial market such as the ASX) Prceed t Sectin 2 Name f market / exchange Majrity Owned Subsidiary f an Australian Public Listed cmpany (cmpanies that are majrity wned by an Australian cmpany that is listed n an Australian financial market such as the ASX) Australian listed cmpany name Prceed t Sectin 2 Name f market / exchange Regulated cmpany (subject t the supervisin f a Cmmnwealth, r Territry statutry regulatr beynd that prvided by ASIC as a cmpany registratin bdy. Examples include Australian Financial Services Licensees (AFSL); Australian Credit Licensees (ACL); r Registrable Superannuatin Entity (RSE) Licensees). Hwever, this excludes charities registered with/regulated by the ACNC. Regulatr name Licence details (e.g. AFSL, ACL, RSE) Prceed t Sectin 2 Street Glbal Advisrs, Australia, Limited (ACN: ) and Street Glbal Advisrs, Australia Services Limited (ACN: )

2 1.4 Beneficial Ownership Please cmplete either r (r bth if applicable) if the cmpany is NOT ne f the 3 types f cmpanies defined in sectin 1.3 abve Sharehlder Beneficial Owners Prvide the names f the individuals wh ultimately wn 25% r mre f the cmpany s issued share capital (thrugh direct r indirect sharehldings). Cmplete all fields belw and prvide a legible certified cpy f ID fr each individual. Beneficial Owner 1 Beneficial Owner 2 Beneficial Owner 3 If there are mre Sharehlder Beneficial Owners, prvide details n a separate sheet and tick this bx Cntrller Beneficial Owners If there are n individuals wh meet the requirement f 1.4.1, prvide the names f the individuals wh directly r indirectly cntrl* the cmpany. * includes exercising cntrl thrugh the capacity t determine decisins abut financial r perating plicies; r by means f trusts, agreements, arrangements, understanding & practices; vting rights f 25% r mre, including vet pwer. If n such persn can be identified then the mst senir fficial/s f the cmpany (such as the managing directr r directrs wh are authrised t sign n the cmpany s behalf). Cmplete all fields belw and prvide a legible certified cpy f ID fr each individual. Cntrller 1 Cntrller 2 Cntrller 3 Street Glbal Advisrs, Australia, Limited (ACN: ) and Street Glbal Advisrs, Australia Services Limited (ACN: )

3 If there are mre Cntrller Beneficial Owners, prvide details n a separate sheet and tick this bx. SECTION 2: TAX INFORMATION Cllectin f tax status in accrdance with the United s Freign Accunt Tax Cmpliance Act (FATCA) and Cmmn Reprting Standard (CRS). 2.1 Tax Status Tick ne f the Tax Status bxes belw r n the next page (if the cmpany is a Financial Institutin, please prvide all the requested infrmatin belw) A Financial Institutin (A custdial r depsitry institutin, an investment entity r a specified insurance cmpany fr FATCA/ CRS purpses) Prvide the Cmpany s Glbal Intermediary Identificatin Number (GIIN), if applicable If the cmpany is a Financial Institutin but des nt have a GIIN, prvide its FATCA status (select ONE f the fllwing statuses) Deemed Cmpliant Financial Institutin Excepted Financial Institutin Exempt Beneficial Owner Nn Reprting IGA Financial Institutin Nnparticipating Financial Institutin Other (describe the cmpany s FATCA status in the bx prvided) If the cmpany is a Financial Institutin, please prceed t sectin 3 t cmplete the frm. Australian Public Listed Cmpany, Majrity Owned Subsidiary f an Australian Public Listed cmpany r Australian Registered Charity (Public listed cmpanies r majrity wned subsidiaries f Australian listed cmpanies as per 1.3 that are nt Financial Institutins as described abve r a cmpany that is an Australian Registered Charity) If the cmpany type is listed abve, please prceed t sectin 3 t cmplete the frm. An Active Nn-Financial Entity (NFE) (Active NFEs include entities where, during the previus reprting perid, less than 50% f their grss incme was passive incme (e.g. dividends, interests and ryalties) and less than 50% f assets held prduced passive incme. Fr ther types f Active NFEs, refer t Sectin VIII in the Annexure f the OECD Standard fr Autmatic Exchange f Financial Accunt Infrmatin at ) If the cmpany is an Active NFE, please prceed t sectin 2.3 ( f Tax Residency). Other (Entities that are nt previusly listed Passive Nn-Financial Entities) Please prceed t sectin 2.2 (Freign Beneficial Owners). 2.2 Freign Beneficial Owners (Individuals) Are any f the cmpany s Beneficial Owners tax residents f cuntries ther than Australia? Yes N Tax Residency rules differ by cuntry. Whether an individual is tax resident f a particular cuntry is ften (but nt always) based n the amunt f time a persn spends in a cuntry, the lcatin f a persn s residence r place f wrk. Fr the US, tax residency can be as a result f citizenship r residency. Street Glbal Advisrs, Australia, Limited (ACN: ) and Street Glbal Advisrs, Australia Services Limited (ACN: )

4 If Yes, please prvide the details f these individuals belw and cmplete a separate Individual Identificatin Frm fr each Beneficial Owner. Rle (such as Directr r Senir Managing Official) If there are mre Beneficial Owners, prvide details n a separate sheet and tick this bx.. Please prceed t sectin 2.3 ( f Tax Residency). 2.3 f Tax Residency Is the Cmpany a tax resident f a cuntry ther than Australia? Yes N If Yes, please prvide the Cmpany s cuntry f tax residence and tax identificatin number (TIN) r equivalent belw. If the Cmpany is a tax resident f mre than ne ther cuntry, please list all relevant cuntries belw If N, please prceed t sectin 3 t cmplete the frm. A TIN is the number assigned by each cuntry fr the purpses f administering tax laws. This is the equivalent f a Tax File Number in Australia r an Emplyer Identificatin Number in the US. If a TIN is nt prvided, please list ne f the three reasns specified (A, B, r C) fr nt prviding a TIN. 1. TIN If n TIN, list reasn A, B r C 2. TIN If n TIN, list reasn A, B r C 3. TIN If n TIN, list reasn A, B r C If there are mre cuntries, prvide details n a separate sheet and tick this bx. Reasn A The cuntry f tax residency des nt issue TINs t tax residents Reasn B The Cmpany has nt been issued with a TIN Reasn C The cuntry f tax residency des nt require the TIN t be disclsed SECTION 3: COMPANY VERIFICATION Please cmplete Sectin 3.1 and Sectin 3.2 (if yu are a custdian) Sectin 3.1: Dcumentatin Requirements fr Cmpanies If yu selected ne f the 3 types f cmpanies listed in sectin 1.3 f this frm we d nt require any identificatin dcuments at this pint in time. Crss X If yu did nt select ne f the 3 types f cmpanies defined in sectin 1.3 we require all f the fllwing: Yu must prvide a cpy f the cmpany extract taken frm the ASIC database OR a cpy f the latest cmpany annual statement issued by ASIC which must cntain the cmpany name, registered ffice, registratin number and any beneficial wners. Fr all beneficial wners listed in and 1.4.2, yu must prvide an riginal certified cpy f ne f the fllwing types f identificatin dcuments fr each beneficial wner.* Please attach each identificatin cpy t yur applicatin frm. Australian / Territry driver s licence cntaining a phtgraph f the persn Australian passprt (a passprt that has expired within the preceding 2 years is acceptable) Card issued under a r Territry fr the purpse f prving a persn s age cntaining a phtgraph f the persn Freign passprt r similar travel dcument cntaining a phtgraph and the signature f the persn Sectin 3.2: Dcumentatin Requirements fr Custdians (leave blank if yu are nt a custdian) Street Glbal Advisrs, Australia, Limited (ACN: ) and Street Glbal Advisrs, Australia Services Limited (ACN: )

5 Crss X If yu are a custdian f anther entity please prvide ne f the fllwing dcuments t cnfirm yur appintment as Custdian: Extract f a Custdy Agreement evidencing authrity t Act fr the Client specified in sectin 3B f the Applicatin Frm Letter appinting the Custdian signed by the Client specified in sectin 3B f the Applicatin Frm * Fr ther identificatin dcumentatin ptins, instructins n hw t certify a dcument, and wh can certify cpies f identificatin dcuments please refer t the Custmer ID frm fr individuals which is available n ur website at ssga.cm Street Glbal Advisrs, Australia, Limited (ACN: ) and Street Glbal Advisrs, Australia Services Limited (ACN: )