collection and verification of know your customer information … · 2017-09-18 · other trust...
TRANSCRIPT
Guide to completing this form
Complete the following in block letters:• Section 1 – Trust Information (applicable to all trusts) • Section 2 – Trustee details (applicable to all trusts)• Section 3 – Settlors and Beneficiaries (applicable only where “Other trust type” is selected in Section 1 Part C)• Section 4 – Privacy• Section 5 – Declaration (applicable to all trusts)
Guide to completing this formThis form can be completed by either a Customer, Bank Staff or Broker to collect and verify the Know Your Customer (KYC) information requirements.
Completed By: Customer Bank staff Broker • Bank Staff and Broker to complete the Bank Use Only section by adding a tick into the Verified boxes below on the right
hand side regardless of completion method during the process of collecting the KYC information from the customer and where required, verifying it against identification document(s) or via electronic search.
• Where the method of completion has been marked as Bank Staff, the Bank Staff Declaration in Section 5 must be completed by Bank Staff only
• Where the method of completion has been marked as either Customer or Broker, the Customer Declaration in Section 5 must be completed by the customer.
• Bank Staff to image the supporting documentation to CommSee in all circumstances• Bank Staff and Broker to complete the Bank Use Only: Verifications section in all circumstances• Bank Staff to complete the Bank Use only: Reasonableness section
Collection and Verification of Know Your Customer Information for TrustsBPB KYC Form
What is the objective/purpose of the charity? (e.g. vocational training for disabled, persons, assistance for tsunami victims, building fund for a particular school or institution etc.)
Is the organisation Not For Profit? (Tick (✔) the box that is applicable)
No Yes Please provide industry/sector
Is the organisation operating as a charity? (Tick (✔) the box that is applicable)
No Yes If Yes, please complete the following question:
Full name of trust*
Full Business Name (if any)
Industry
ABN (if any)
Section 1 – Trust information (all trusts)
The information against the check boxes indicates field must be verified against an acceptable identification documentation or data source.
Verified*
Verified
Section 1 – Part A: General Information (all trusts)
Is there a Trust Deed? (Tick (✔) the box that is applicable)
No Yes We will need to obtain pages of the Trust Deed where the name of the trust, trustees, beneficiaries and settlor/s appear (if applicable).
Bank Use Only
* Verify Full Name of Trust
Complete all fields per organisation type
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Purpose of seeking an account/facility with the Commonwealth Bank of Australia or related company
Objective of the trust
Country where the trust was established
What type of trust is it? (Tick (✔) the box that is applicable)
Managed investment scheme registered by Australian Securities and Investment Commission (ASIC)
Please provide the Australian Registered Scheme Number (ARSN)
Please provide Global Intermediary Identification Number (GIIN):
Managed investment scheme that is not registered by Australian Securities and Investment Commission (ASIC) that only has wholesale clients and does not make small scale offerings to which section 1012E of the Corporations Act 2001 applies
Please provide Global Intermediary Identification Number (GIIN):
Registered Trust subject to the regulatory oversight of a Commonwealth statutory regulator (e.g. APRA) in relation to its activities as a Trust (including self-managed superannuation funds)
Please provide name of regulator
Please provide a registration number given by the regulator
Government Superannuation Fund established by legislation Please provide name of legislation
Complete sections 2, 4 and 5 of this Form if you have ticked one of the boxes above.
Other trust type (e.g. family trust, discretionary, deceased estate, property trust, unit trust, bare trust)
Trust description
Complete sections 1 Part D, 2, 3, 4 and 5 of this Form if you have ticked “Other trust type” box above.
Section 1 – Part C: Trust type
Section 1 – Trust information (all trusts) (continued) Bank Use Only
Has the trust been established in Australia? (Tick (✔) the box that is applicable)
Yes No If No, please complete the following 3 questions
Section 1 – Part B: Primary business activity
Is the trust’s primary business activity investing?
No Yes
Tick (✔) Yes if the trust earns more than 50% of its total income from investing activities (e.g. rent, interest or dividends) or more than 50% of the trust’s assets produce or are held for producing investment income.
VerifiedThe type of trust must be verified
Verified
Section 1– Part D: Trust Tax Information (mandatory)
Please complete the following:• Provide all countries where the Organisation is a resident for tax purposes (the Organisation
must be a tax resident of at least one country); and Tax Identification Number (TIN) of the Organisation for each country of tax residency; or
• Select one of the below reasons;a. The organisation’s country of tax residency does not issue TINsb. The organisation has not been issued with a TIN by its country of tax residencyc. The organisation’s country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected ,account operations might be impacted until TIN is provided)
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Section 1 – Trust information (all trusts) (continued) Bank Use Only
Australia Only Please proceed to Section 2
Australia and Other Countries Please complete the below and proceed to Section 2
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia The Organisation’s country of tax residency does not require disclosure of TIN
Reasonableness check performed by Bank Staff
Other Countries Only Please complete the below and proceed to Section 2
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
• Section 2 – Trustee details (all trusts) Bank Use Only
Individual Trustee
Please complete all sections for Trustees whether they be an individual or a company. If there are multiple trustees, copy the relevant pages from Section 2 and complete the details of the trustees.
How many trustees are there?
Verified
Verified*
Title Mr Mrs Ms Miss Other
Surname Given name(s)
Other names known by (if any)
Occupation Income range (if disclosed)
Date of birth Gender
Male FemaleFull residential address (PO Box not acceptable)
State Postcode Country
Daytime phone
Evening phone Fax number
Mobile number
*Verify either the Date of Birth or the Address
Complete all fields per organisation type
• Please provide all countries where you are a resident for tax purposes; and Tax Identification Number (TIN) for each country of tax residency; or
• Select one of the below reasons;a. My country of tax residency does not issue TINsb. I have not been issued with a TIN by my country of tax residencyc. My country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected, account operations might be impacted until TIN is provided)Note: If you are a resident or citizen of the US, it is mandatory to include US as a country of tax residency
Tax Residency Information (mandatory)
Do you have an existing Commonwealth Bank account? (Tick (✔) the box that is applicable)
No Yes Please provide account number
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• Section 2 – Trustee details (all trusts) (continued) Bank Use Only
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia My country of tax residency does not require disclosure of TIN Reasonableness check performed by Bank Staff
Other Countries Only Please complete the below
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
If there are additional individual trustees, please provide details on a separate sheet.
Please tick (✔) the box that is applicable
Australia Only
Australia and Other Countries Please complete the below
Company Trustee
Full name of Company
Full business name (if any)
Industry
Is the organisation Not For Profit? (Tick (✔) the box that is applicable)
No
Yes Please provide industry/sector
Is the organisation operating as a charity? (Tick (✔) the box that is applicable)
No
Yes If Yes, please complete the following question:What is the objective/purpose of the charity? (e.g. vocational training for disabled, persons, assistance for tsunami victims, building fund for a particular school or institution etc.)
Registered office address (PO Box is not acceptable)**
State Postcode Country
Principal place of business/administration address (PO Box is not acceptable) Same as registered office address
State Postcode Country
# Government Bodies only Verified#
Postal address Same as registered office address Same as principal place of business/administration address
State Postcode Country
For Financial Institutions or Non-Banking Financial Institutions only, please provide:Global Intermediary Identification Number (GIIN)
Australian Company Number (ACN) (mandatory)
Verified
Australian Business Number (ABN)
Verified
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Section 2 Part A – Type of Company Bank Use Only
Company Trustee (continued)
Has the organisation been established in Australia? (Tick (✔) the box that is applicable)
Please provide full address of the Company’s principal place of business in Australia OR the full address of the Company’s local agent in Australia
State Postcode Country
Nature of business activity
Name of foreign registration authority
Foreign registration number
The reason for seeking an account/facility with the Commonwealth Bank of Australia or related company
Local agent: Full name of individual or company name
Australian Registered Body Number (ARBN)
For foreign company registered in Australia, please provide the following additional information.
Yes Please continue to Section 2 Part A
No Please answer the following questions:Country where organisation was established/incorporated/registered
Continue to Section 2 Part A
Please note if the organisation is a foreign company and is registered in Australia, the answer should be “No” and the rest of this section applies.
Section 2 – Trustee details (all trusts) (continued) Bank Use OnlyBank Use Only
Please select whether the company is public or private and answer the questions that follow:
Public Verified
Is the company a wholly owned or majority owned subsidiary of a domestic public domestic public listed company?
No
Yes
Is the company listed on an exchange?
Please provide Primary exchange
Verified
Private
Yes Please provide name of Parent company listed on a stock exchange
Verified
No If the Company is not listed and is not a Bank or a Non-Banking Financial Institution, and is also not a wholly owned or majority owned subsidiary of a domestic public listed company, please proceed to Section 2 Part B. Otherwise, please complete the following questions prior to proceeding to Section 3.
Primary business activity
No Yes
Is the company’s primary business activity investing?
Tick (✔) Yes if the company earns more than 50% of its total income from investing activities (e.g. rent, interest or dividends) or more than 50% of the company assets produce or are held for producing investment income.
Complete all fields per organisation type
If the applicant is a Bank, please answer the following questions:Is the organisation regulated by APRA and registered as an Authorised Deposit-taking Institution (ADI)?
No Yes Verified
Verified
Is the organisation regulated by the Australian Securities and Investments Commission (ASIC) and
have an AFS Licence number?
No Yes AFS Licence number
Verified
Verified
If the answers provided are both ‘No’, please complete Beneficial Owners Details in Section 2 Part D, otherwise proceed to Section 3
P
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Section 2 Part A – Type of Company (continued) Bank Use Only
Section 2 Part C – Type of Company Bank Use Only
Proprietary/Private Please answer all remaining questions in Section 2 - Part C & Part D
How many directors are there?
Full given name(s) Surname
If there are more directors, please provide details on a separate attached sheet.
Verified
Verified
Note: Details of a minimum of one (1) director needs to be provided. Each director who intends to be a signatory to the account is required to complete a separate KYC Form for Individuals.
If the applicant is a Non-Banking Financial Institution, please answer the following questions:
Verified
Is the organisation regulated by Australian Securities and Investment Commission (ASIC) and have an Australian Credit Licence Number?
No Yes Australian Credit Licence number
Is the organisation regulated by the Australian Securities and Investments Commission (ASIC) and have an AFS Licence number?
No Yes AFS Licence number
If the answers provided are both ‘No’, please complete Beneficial Owners Details in Section 2 Part D, otherwise proceed to Section 3
Section 2 Part B – Organisation Tax Residency (mandatory) Bank Use Only
• Provide all countries where the Organisation is a resident for tax purposes (the Organisation must be a tax resident of at least one country); and Tax Identification Number (TIN) of the organisation for each country of tax residency; or
• Select one of the below reasons;a. The organisation’s country of tax residency does not issue TINsb. The organisation has not been issued with a TIN by its country of tax residencyc. The organisation’s country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected, account operations might be impacted until TIN is provided)
Australia Only Please proceed to Section 2 Part C
Australia and Other Countries Please complete the below and proceed to Section 2 Part C
Please complete the following:
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia The organisation’s country of tax residency does not require disclosure of TIN Reasonableness
check performed by Bank Staff
Other Countries Only Please complete the below and proceed to Section 2 Part C
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
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Section 2 Part C – Type of Company (continued) Bank Use Only
Director details to be provided
Other names known by (if any) Date of birth
Title Full given name(s) Surname
Residential address (PO Box is not acceptable)
State Postcode Country
Verified
Verified
Verified
Do you have an existing Commonwealth Bank account? (Tick (✔) the box that is applicable)
No
Yes Please provide account number and continue to Section 2 Part D
Please continue to Section 2 Part D
Verified
Complete all fields per organisation type
Please detail all beneficial owners in the section below:
Note: If there are more beneficial owners please provide details on a separate sheet.
A. Are there any individuals who own 25% or more of the shares in the company, either directly or indirectly?
B. Are there any individuals who control 25% or more of the shares in the organisation, either directly or indirectly, for example through voting rights?
Beneficial Owners – Company
No Please answer Question B.
No In that case, in the section below provide details of any individuals who are responsible for the strategic or financial decisions of the company (that is, the individual who exercises primary control over the company because of the position they hold, e.g. the CEO, Managing Director or equivalent).
Yes Provide details of all individuals below.
Yes Provide details of all individuals in the section below.
Details of Beneficial Owners
Beneficial Owner 1
Section 2 Part D – Beneficial Owners – Company Bank Use Only
Title Full given name(s) Surname
Other names known by (if any) Date of birth Gender
Male FemaleResidential address (PO Box is not acceptable)
State Postcode Country
Do you have an existing Commonwealth Bank account? (Tick (✔) the box that is applicable)
No Yes Please provide account number
Verified
Verified*
* Verify either the Date of Birth or the Address
• Please provide all countries where you are a resident for tax purposes; and Tax Identification Number (TIN) for each country of tax residency; or
• Select one of the below reasons;a. My country of tax residency does not issue TINsb. I have not been issued with a TIN by my country of tax residencyc. My country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected, account operations might be impacted until TIN is provided)Note: If you are a resident or citizen of the US, it is mandatory to include US as a country of tax residency
Tax Residency Information (mandatory)
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Section 2 Part C – Beneficial Owners – Company (continued) Bank Use Only
Beneficial Owner 2
Title Full given name(s) Surname
Other names known by (if any) Date of birth Gender
Male FemaleResidential address (PO Box is not acceptable)
State Postcode Country
Verified
Verified*
* Verify either the Date of Birth or the Address
Do you have an existing Commonwealth Bank account? (Tick (✔) the box that is applicable)
No Yes Please provide account number
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia My country of tax residency does not require disclosure of TIN Reasonableness check performed by Bank Staff
Other Countries Only Please complete the below and proceed to the next Beneficial Owner (if applicable) or Section 3
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia Only Please proceed to next Beneficial Owner (if applicable) or Section 3
Australia and Other Countries Please complete the below and proceed to the next Beneficial Owner (if applicable) or Section 3
• Please provide all countries where you are a resident for tax purposes; and Tax Identification Number (TIN) for each country of tax residency; or
• Select one of the below reasons;a. My country of tax residency does not issue TINsb. I have not been issued with a TIN by my country of tax residencyc. My country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected, account operations might be impacted until TIN is provided)Note: If you are a resident or citizen of the US, it is mandatory to include US as a country of tax residency
Australia Only Please proceed to the next Beneficial Owner (if applicable) or Section 3
Australia and Other Countries Please complete the below and proceed to the next Beneficial Owner (if applicable) or Section 3
Tax Residency Information (mandatory)
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia My country of tax residency does not require disclosure of TIN Reasonableness check performed by Bank Staff
Other Countries Only Please complete the below and proceed to the next Beneficial Owner (if applicable) or Section 3
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
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Section 2 Part C – Beneficial Owners – Company (continued) Bank Use Only
Beneficial Owner 3Title Full given name(s) Surname
Other names known by (if any) Date of birth Gender
Male FemaleResidential address (PO Box is not acceptable)
State Postcode Country
Do you have an existing Commonwealth Bank account? (Tick (✔) the box that is applicable)
No Yes Please provide account number
Verified
Verified*
* Verify either the Date of Birth or the Address
Beneficial Owner 4
Title Full given name(s) Surname
Other names known by (if any) Date of birth Gender
Male FemaleResidential address (PO Box is not acceptable)
State Postcode Country
Do you have an existing Commonwealth Bank account? (Tick (✔) the box that is applicable)
No Yes Please provide account number
Verified*
* Verify either the Date of Birth or the Address
Verified
• Please provide all countries where you are a resident for tax purposes; and Tax Identification Number (TIN) for each country of tax residency; or
• Select one of the below reasons;a. My country of tax residency does not issue TINsb. I have not been issued with a TIN by my country of tax residencyc. My country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected, account operations might be impacted until TIN is provided)Note: If you are a resident or citizen of the US, it is mandatory to include US as a country of tax residency
Australia Only Please proceed to the next Beneficial Owner (if applicable) or Section 3
Australia and Other Countries Please complete the below and proceed to the next Beneficial Owner (if applicable) or Section 3
Tax Residency Information (mandatory)
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia My country of tax residency does not require disclosure of TIN Reasonableness check performed by Bank Staff
Other Countries Only Please complete the below and proceed to the next Beneficial Owner (if applicable) or Section 3
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
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Section 2 Part C – Beneficial Owners – Company (continued) Bank Use Only
• Please provide all countries where you are a resident for tax purposes; and Tax Identification Number (TIN) for each country of tax residency; or
• Select one of the below reasons;a. My country of tax residency does not issue TINsb. I have not been issued with a TIN by my country of tax residencyc. My country of tax residency does not require disclosure of a TINd. TIN information will be provided later (If this reason is selected, account operations might be impacted until TIN is provided)Note: If you are a resident or citizen of the US, it is mandatory to include US as a country of tax residency
Australia Only Please proceed to Section 3
Australia and Other Countries Please complete the below and proceed to Section 3
Tax Residency Information (mandatory)
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Australia My country of tax residency does not require disclosure of TIN Reasonableness check performed by Bank Staff
Other Countries Only Please complete the below and proceed to Section 3
Country/ies of Tax Residency Please list country/ies of tax residency.
Tax Identification Number (TIN) or Reason for no TIN Please provide a TIN for each country of tax residency or select one of the reasons for no TIN (Refer to options a, b, c, d above)
Complete the full name of each beneficiary and/or type of membership class in the Membership Class section below.Full name of Beneficiary 1
w
Full name of Beneficiary 2
Full name of Beneficiary 3
If there are more beneficiaries, please provide details on a separate sheet.Membership ClassDetails of membership class/es (e.g. unit holders, family members of named persons, charitable purposes etc.)
If there are more membership classes, please provide details on a separate sheet.
Section 3 – Sub-section 2: Beneficiary information
Verified
w
w
w
w
w
Section 3 – Beneficiaries and Settlors of Trust
w
w
w
Was the “settled sum” $10,000.00 or more?
No Yes If Yes, provide name of settlor (Not required if settlor is deceased)
Section 3 - Sub-section 1: Settlor of Trust
Complete only if ‘Other Trust Type’ was selected in Section 1, Part CComplete all fields per organisation type
Verified
Bank Use Only
Note: If there are additional company trustees, please provide details on separate sheets.
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Bank Use Only
Additional beneficiary class details have been collected and are held in the Trust Deed imaged to the customer profile under Section _______.
Section 4 – Privacy (applicable to all trusts)
Commonwealth Bank of Australia is collecting your personal information to identify you in accordance with the Anti-Money Laundering and Counter-Terrorism Financing Act 2006. For more information about how we collect and handle personal information, including how you can access, or seek correction of, your information or contact us with any feedback, please see our Privacy available on www.commbank.com.au.
Section 5 – Declaration (applicable to all trusts)
Customer Declaration (Complete if “Completed By: Customer or Broker” has been selected)
This declaration is to be signed by a trustee (or a person authorised by the trustee) of the trust.
I understand and acknowledge that the law requires applicants to provide true and correct information and state all the names by which they are commonly known. I also understand that the law prohibits the use of false names, as well as the giving, use or production of false or misleading information or documents in connections with the provision of financial services and the making, possession or use of a false document in connection with an identification procedure.
I have obtained the consent of any individual(s) whose personal information is provided in this application. They have authorised the collection, use or exchange of their information in accordance with Group Privacy Policy.
I certify that I am authorised by, and have the consent of the organisation and all beneficial owners to provide this information on their behalf and they have confirmed to me that the information provided about them is true and correct. I confirm I have made them aware that this information and information relating to the account may be provided to the tax authorities.
I declare that the details as shown on this form are complete and correct and that I will advise the bank if these details change.
✗
Signature Date
PositionName
Bank Staff Declaration (Complete if “Completed By: Bank Staff” has been selected)
Note: Brokers cannot complete this section
I confirm the information collected in this form has been supplied by the customer
The customer has confirmed that:
The information is true and correct and they will promptly advise the Bank if any of their information changes.
They are authorised by, and have the consent of the organisation and all beneficial owners to provide this information on their behalf and the beneficial owners have confirmed that the information provided about them is true and correct.
They have made them aware that this information and information relating to the account may be provided to the tax authorities.
A. Name of the person who completed this checklist:
Name Date
B. How was the customer information collected i.e. meeting/phone/email
C. Date of the meeting/phone call/email
D. Customer/s Authorised representative who provided the Customer information
Full given name(s) Surname
Position (if applicable)
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Bank Use Only: Verifications
Completed by:Bank Staff or Broker
I confirm that the information checked in the verification documents correctly reflects the information supplied by the customer and matches the information in this completed form.
Bank Staff/Broker Bank Staff/Broker number
✗
Signature
Bank Staff/Operations Support
I confirm that the information checked in the verification documents as set out above correctly reflects the information supplied by the customer in the form.
Support/Operations Staff number
✗
Signature Date
Bank Use Only: Discrepancy
Please complete this section if any discrepancy has been identified in KYC information and the way in which it has been resolved.
In the instance where changes or additions were made by me on this form, all such information was collected by me directly from the customer and all the changes or additions to this form have been initialled by me
Bank Use Only: Reasonableness
Completed by:Bank Staff
I confirm that the declaration of country/ies of tax residence is reasonable given the information known about the customer, including the information collected for AML/KYC purposes.
Bank Staff Staff number
✗
Signature Date
Comment
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