Your LloydsLink online application for Payments BACS existing BACS user registration Guidance notes Use of this form This application form is only to be completed by an existing Lloyds TSB sponsored user of BACS that wishes to submit BACS transactions using the Bank s Payments BACS product. Service details (Section 1) General information about your current BACS usage. The BACS Service User Number (SUN) is the 6 digit number allocated by the Bank in connection with your use of BACS. The Organisation name is your group name, if not part of a group please enter the registered Service User Name. The Service User Default e-mail address will be used by BACS when sending you e-mail notifications, advising you that your reports are available for collection. Direct Debit Instruction (Section 4) Please complete this instruction with reference to Clause 9. Charges and Payments of the LloydsLink online general conditions and Clause 7. Charges of the Payments BACS Service specific conditions Payment Authorisation Control (Section 5) This is how you manage control of all e-banking services used by your organisation. You may opt for Dual control where two Service Administrators are required to authorise changes to your service, or Single control where just one Service Administrator is required. Please be aware that your selected Payment Authorisation Control applies to all of your e-banking services, not just Payments BACS. We recommend that customers make use of dual control. Service Administrator (Section 6) A Service Administrator is an individual within your organisation who is responsible for the use of the service. The Service Administrator is responsible for: acting as the single point of contact for the service with Lloyds TSB Bank plc approving a user s access to the service removing a user s access to the service configuring a user s role and access rights to the service administration of users. Your nominated Service Administrators will automatically be provided with access to your BACS reports. In addition to the above duties Lloyds TSB will also need you to nominate: A Service Administrator to act as a Primary Service Administrator who will be the recipient for Authentication Cards and Readers. We recommend that you appoint sufficient Service Administrators to cover for holidays and sickness. Agreement (Section 8) On receipt of a signed registration form, your organisation will be considered to have accepted the terms and conditions set out in the Agreement for the use of the Payments BACS service, which is available at www.lloydstsb.com/corporatemarkets Please only complete this application form if you have an existing Lloyds TSB service user number at BACS. For advice on how to transfer the sponsorship of a service user number to Lloyds TSB from another bank or to register as a new user of BACS please contact your Lloyds TSB account relationship manager. Please complete and return this form, by first class post, to the address below (make sure you have included the application reference numbers): Lloyds TSB Electronic Banking Registrations, P.O. Box 72, Bailey Drive, Gillingham Business Park, Gillingham, Kent ME8 OLS. To enable us to process your application for the Payments BACS Service, please complete the following information. Page of 7
1 Customer details Please write clearly in the white spaces with capital letters or cross the boxes. Existing BACS Service User Numbers: (sponsored by Lloyds TSB) Organisation name (group name, if not part of a group enter the registered name to which the service user number(s) relates). Maximum 35 characters Addressee name First line of address Second line of address City/Town County (UK only) Postcode Country (if not UK) Default e-mail address (an individual or group e-mail address for report notifications which must be an organisation issued address) For bank use only Payment BACS bureau number B 3 0 3 1 5 2 Invoice details Invoice address (if different from organisation address in Section 1): Addressee name First line of address Second line of address City/Town County (UK only) Postcode Country (if not UK) Invoice address region: UK EU non-uk Non-EU VAT number (please provide if your invoice address is in the EU but not in the UK) Page 2 of 7
3 Settlement account details Please state the account to be used to collect any charges associated with the service. If you require settlement to an account external to Lloyds TSB, please complete the Instruction to your Bank or Building Society to Pay by Direct Debit from Section 4. (Although this account does not have to be held with Lloyds TSB, it must be in the same currency as the invoice.) Currency: Currency type Sterling Currency (Lloyds TSB a/c only) Branch name Sort code Account number Account name 4 Direct Debit instruction This is to authorise the bank to collect Payments Service charges using the Direct Debiting Scheme. Please arrange completion of this instruction if you require the Bank to collect any charges from an account external to Lloyds TSB. Please see the Direct Debit instruction below. Instruction to your Bank or Building Society to pay by Direct Debit Please complete this form in black ink and send it to: Lloyds TSB Electronic Banking Registrations, P.O. Box 72, Bailey Drive, Gillingham Business Park, Gillingham, Kent ME8 OLS. To the Manager Originator s identification number 8 3 8 0 3 6 Reference number Name and full postal address of your Bank/Building Society Instruction to your Bank or Building Society Please pay Lloyds TSB Payments BACS Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with Lloyds TSB Payments BACS and if so, details will be passed electronically to my Bank/Building Society. Postcode Your signature(s) The name(s) on your account Branch sort code Bank/Building society account number Banks and Building Societies may not accept Direct Debit instructions for some type of accounts. The Direct Debit Guarantee This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society. If the amounts to be paid or the payment dates change Lloyds TSB Payments BACS will notify you 10 working days in advance of your account being debited or as otherwise agreed. If an error is made by Lloyds TSB Payments BACS or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid. You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us. Please detach this Guarantee and keep it for your records. Page 3 of 7
5 Payment Authorisation Control Please indicate the type of control you will be using: We recommend that customers make use of dual control. Dual Control Single Control 6 6.1 Service administrator details Primary service administrator The primary service administrator will be the recipient for Authenticator Cards and readers. Are you contactable out of normal office hours? Yes No Title Mr Mrs Miss Ms Other (please specify) If yes out of hours telephone number including area dialling code (15 characters) Full name (18 characters) Do you require report access? Yes No User name (the name you used when you registered for the Payment BACS service) (16 characters) If yes memorable information required (15 characters maximum) Office telephone numbers and area dialling codes Telephone Memorable information prompt (We will use this prompt if you forget your memorable information) Mobile Fax E-mail address (35 characters) This field must be completed. Your application reference number (ARN) (Displayed on the final screen of the online application process) Exceptions contact? Yes No Exception contacts must know of the value of the submission, the number of items within it and the payment date. They must have payment processing authority. For bank use only Contact ID Page 4 of 7
6 6.2 Service administrator details Second service administrator continued Title Mr Mrs Miss Ms Other (please specify) Are you contactable out of normal office hours? Yes No Full name (18 characters) If yes out of hours telephone number including area dialling code (15 characters) User name (the name you used when you registered for the Payment BACS service) (16 characters) Do you require report access? Yes No Office telephone numbers and area dialling codes Telephone Mobile If yes memorable information required (15 characters maximum) Memorable information prompt (We will use this prompt if you forget your memorable information) Fax E-mail address (35 characters) This field must be completed. Your application reference number (ARN) (Displayed on the final screen of the online application process) Exceptions contact? Yes No Exception contacts must know of the value of the submission, the number of items within it and the payment date. They must have payment processing authority. For bank use only Contact ID If a replacement or additional service administrator is required, please use the additional or replacement service administrator form which can be downloaded from our website. 7 Additional Authenticator Cards and readers Your set-up fee includes 6 cards and 2 readers. If this is insufficient for your needs please specify your additional requirements in the boxes provided. Please note for additional cards and readers you will be charged at the agreed rate. Additional Authenticator Cards Additional Readers Page 5 of 7
8 Agreement For the purpose of this agreement the term Bank is defined as: (please select one) Lloyds TSB Bank plc Lloyds TSB Offshore plc Lloyds TSB Scotland plc We the undersigned confirm the Customer s agreement with the Bank on the terms and conditions contained in or referred to in this Agreement. This Agreement must be signed in accordance with the Electronic Banking clause of the Customer s existing Bank Mandate or in accordance with a specific Electronic Banking resolution. To obtain a specimen resolution, please visit our website at: www.corporatemarkets.lloydstsb.com/doc/corp/pdf/board_resolution_ebanking.pdf The Bank agrees to provide to the Customer and the Customer agrees to take the Payment BACS Service subject to and in accordance with: Full name (in capitals) Position 1 the LloydsLink online General Conditions, and 2 the LloydsLink online Payments BACS Service Specific Conditions The terms and conditions are available (and can be printed if required) from the Lloyds TSB Corporate Markets website at: www.lloydstsbcorporatemarkets.com By signing and returning this form the Customer authorises the Service Administrator(s) nominated under Section 4 above to act in all respects in accordance with the powers granted to them under this Agreement. By signing this Corporate Markets application you confirm that you (or the group of which you form part) have an annual turnover of 15m or more or that your relationship manager has confirmed this service is appropriate for you. Full name (in capitals) Position www.lloydstsbcorporatemarkets.com Please contact us if you would like this in Braille, large print or on audio tape. We accept calls made through RNID Typetalk We may monitor or record phone calls with you in case we need to check we have carried out your instructions correctly and to help improve the quality of our service. Lloyds TSB Corporate Markets is a trading name of Lloyds TSB Bank plc and Lloyds TSB Scotland plc. Lloyds TSB Bank plc Registered Office: 25 Gresham Street, London EC2V 7HN. Registered in England and Wales, no. 2065. Lloyds TSB Scotland plc Registered Office: Henry Duncan House, 120 George Street, Edinburgh EH2 4LH. Registered in Scotland, no. 95237. Authorised and regulated by the Financial Services Authority under numbers 119278 and 191240 respectively. Lloyds TSB Offshore Holdings Limited has registered the business name of Lloyds TSB Commercial in Jersey and has licensed it to Lloyds TSB Offshore Limited. Lloyds TSB Offshore Limited: PO Box 160, 25 New Street, St. Helier, Jersey, JE4 8RG. Registered in Jersey, number 4029. Regulated by the Jersey Financial Services Commission. The Isle of Man branch of Lloyds TSB Offshore Limited is licensed by the Isle of Man Financial Supervision Commission to take deposits and carry on investment business and is registered with the Insurance and Pensions Authority in respect of General Business. The Guernsey branch of Lloyds TSB Offshore Limited is licensed to conduct banking, investment and insurance business by the Guernsey Financial Services Commission under the Banking Supervision (Bailiwick of Guernsey) Law 1994, the Protection of Investors (Bailiwick of Guernsey) Law 1987 and the Insurance Managers and Insurance Intermediaries (Bailiwick of Guernsey) Law 2002 Please remember we cannot guarantee security of messages sent by e-mail. We aim to provide the highest level of customer service possible. If you do experience a problem, we will always seek to resolve this as quickly and efficiently as possible. If you would like a copy of our complaint procedures, please contact your relationship manager or any of our Corporate Banking offices. You can also find details on our website, at www.lloydstsbcorporatemarkets.com/contactus. Page 6 of 7
For bank use only Relationship Manager Organisation name (group name, if not part of a group enter the registered name to which the service user number relates) (35 characters) Market sector: Market segment Commercial Corporate Offshore CRISP customer ID (Corporate) BIT Party ID (BB and Offshore) Located via BIT Customer File Profile OR Bank legal entity: England & Wales Scotland Guernsey Isle of Man Jersey I confirm that the customer details and signatures are correct and in accordance with the Bank Mandate. I will inform Group Operations of any changes required without delay. Relationship Manager s name E-mail address Relationship Manager s stamp Relationship Manager s signature Office Contact number including area dialling code Ongoing KYC checks required? Yes No Account holding branch Branch stamp I confirm that the customer details and signatures are correct and in accordance with Electronic Banking clause of the Bank Mandate. I confirm that we are undertaking the necessary branch procedures to permit the customer to become a BACS user in due course. Manager s signature On completion, please forward to: Lloyds TSB E-Operations, Charlton Place (CP2), Charlton Road, Andover, Hants, SP10 1RE. TNT 25 Dropzpne C31. Group operations BIP input carried out by BIP input checked by BIP organisation ID BIP input date BIP check date Set up date ID&V process completed by ID&V process completion date Page 7 of 7