IDENTIFICATION FORM 3: TRUSTS, TRUSTEES & SMSFs

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1 IDENTIFICATION FORM 3: TRUSTS, TRUSTEES & SMSFs GUIDE TO COMPLETING THIS FORM Cmplete the fllwing in BLOCK LETTERS: Sectin 1 (all parts) all trusts. AND select and cmplete ne f the fllwing sectins fr ONLY ONE f the trustees: Sectin 2 (applicable parts) selected trustee is an Individual. Sectin 3 (applicable parts) selected trustee is an Australian Cmpany. Only send the cmpleted sectins f this frm with the applicatin frm. Cntact the Crmwell Investr Service Team n if yu have any queries. SECTION 1A: TRUST DETAILS 1.1 General Infrmatin Full name f trust Full business name (if any) Cuntry where trust established 1.2 Type f Trust (select nly ne f the fllwing trust types and prvide the infrmatin requested) Registered managed investment scheme Prvide Australian Registered Scheme Number (ARSN) (G t Sectin 1B) Regulated trust (e.g. an SMSF) Prvide name f the regulatr (e.g. ASIC, APRA, ATO) Prvide the trust s ABN r registratin / licensing details (G t Sectin 1B) Gvernment superannuatin fund Prvide name f the legislatin establishing the fund Other trust type Trust descriptin (e.g. Family, unit, charitable, estate) (G t Sectin 1B (Cmplete Sectin 1.3 and 1.4) 1.3 Beneficiary Details (nly cmplete if Other trust type is selected in sectin 1.2 abve) D the terms f the trust identify the beneficiaries by reference t membership f a class? Yes Prvide details f the membership class/es (e.g. unit hlders, family members f named persn, charitable purpse) (G t Sectin 1.4) N Hw many beneficiaries are there? prvide full name f each beneficiary belw If there are mre beneficiaries, prvide details n a separate sheet PAGE: 1/7

2 1.4 Trustee Details (nly cmplete if Other trust type is selected in sectin 1.2 abve) DO NOT cmplete if the trust is a registered managed investment scheme, regulated trust (e.g. SMSF) r gvernment superannuatin fund. Hw many trustees are there? Trustee 1 prvide full name & address f each trustee belw Trustee 2 Trustee 3 Trustee 4 Trustee 5 Trustee 6 If there are mre trustees, prvide details n a separate sheet PAGE: 2/7

3 SECTION 1B: TRUST IDENTIFICATION DOCUMENTS (CERTIFIED COPIES TO BE PROVIDED) Fr a registered managed investment scheme, regulated trust (eg SMSF) r gvernment superannuatin fund (as selected in 1.2 abve) AND if the Trust has an Australian Business Number (ABN): N Trust dcumentatin is required. If ther trust (as selected in 1.2 abve) OR the Trust des nt have an Australian Business Number (ABN): Tick Acceptable Dcuments (use ne f the fllwing t verify the Unincrprated Assciatin) A certified cpy r certified extract f the Trust Deed. A ntice issued by the Australian Taxatin Office within the last 12 mnths (eg a Ntice f Assessment) A letter frm a slicitr r qualified accuntant that cnfirms the name f the trust. Dcuments that are written in a language that is nt English, must be accmpanied by an English translatin prepared by an accredited translatr IMPORTANT: Please attach a certified, legible cpy f the ID dcumentatin used t verify the Trust. Cmplete ONLY ONE f the fllwing sectins, as required, t cllect the additinal infrmatin abut the identity f ONLY ONE f the trustees: Sectin 2 (applicable parts) where the selected trustee is an individual. Sectin 3 (applicable parts) where the selected trustee is an Australian Cmpany SECTION 2A: INDIVIDUAL DETAILS (t be cmpleted if selected trustee is an Individual) Full Given Name(s) Date f Birth (dd/mm/yyyy) Residential Address (PO Bx is NOT acceptable) Only prvide address details if nt prvided in Sectin 1.4 abve. PAGE: 3/7

4 SECTION 2B: INDIVIDUAL TRUSTEE IDENTIFICATION DOCUMENTS (CERTIFIED COPIES TO BE PROVIDED) Cmplete Part I (r if the trustee des nt wn a dcument frm Part I, then cmplete either Part II r III). PART I ACCEPTABLE PRIMARY ID DOCUMENTS Tick Select ONE valid ptin frm this sectin nly Australian State / 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 State 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*. PART II ACCEPTABLE SECONDARY ID DOCUMENTS shuld nly be cmpleted if the individual des nt wn a dcument frm Part I Tick Tick Select ONE valid ptin frm this sectin Australian birth certificate. Australian citizenship certificate. Pensin card issued by Centrelink. Health card issued by Centrelink. AND ONE valid ptin frm this sectin A dcument issued by the Cmmnwealth r a State r Territry within the preceding 12 mnths that recrds the prvisin f financial benefits t the individual and which cntains the individual s name and residential address. A dcument issued by the Australian Taxatin Office within the preceding 12 mnths that recrds a debt payable by the individual t the Cmmnwealth (r by the Cmmnwealth t the individual), which cntains the individual s name and residential address. Blck ut the TFN befre scanning, cpying r string this dcument. A dcument issued by a lcal gvernment bdy r utilities prvider within the preceding 3 mnths which recrds the prvisin f services t that address r t that persn (the dcument must cntain the individual s name and residential address). PART III ACCEPTABLE FOREIGN ID DOCUMENTS shuld nly be cmpleted if the individual des nt wn a dcument frm Part I Tick BOTH dcuments frm this sectin must be presented Freign driver's licence that cntains a phtgraph f the persn in whse name it issued and the individual s date f birth.* Natinal ID card issued by a freign gvernment cntaining a phtgraph and a signature f the persn in whse name the card was issued* *Dcuments that are written in a language that is nt English must be accmpanied by an English translatin prepared by an accredited translatr. IMPORTANT: Please attach certified, legible cpies f the ID dcumentatin used t verify the individual trustee (and any required translatin). If the selected trustee is an individual, the frm is nw COMPLETE. PAGE: 4/7

5 SECTION 3A: AUSTRALIAN COMPANY DETAILS (t be cmpleted if selected trustee is an Australian Cmpany) 3.1 General Infrmatin Full name as registered by ASIC ACN Registered ffice address (PO Bx is NOT acceptable) Principal place f business (if any) (PO Bx is NOT acceptable) 3.2 Regulatry/ Listing Details (select the fllwing categries which apply t the trustee cmpany and prvide the infrmatin requested) Regulated cmpany (licensed by an Australian Cmmnwealth, State r Territry statutry regulatr) Regulatr name Licence details Australian listed cmpany Name f market / exchange Majrity-wned subsidiary f an Australian listed cmpany Australian listed cmpany name Name f market / exchange 3.3 Cmpany Type (select nly ONE f the fllwing categries) Public If the trust is a registered managed investment scheme, regulated trust (eg SMSF) r gvernment superannuatin fund, the frm is nw COMPLETE. If Other trust type is selected in Sectin 1.2 abve, cmplete Sectins 3B and 3C belw. Prprietary Cntinue t Sectin Directrs (nly needs t be cmpleted fr prprietary cmpanies) This sectin des NOT need t be cmpleted fr public and listed cmpanies. Hw many directrs are there? prvide full name f each directr belw If there are mre directrs, prvide details n a separate sheet. If the cmpany is a regulated cmpany (as selected in Sectin 3.2 abve) AND the trust type selected in Sectin 1.2 abve is: a registered managed investment scheme, regulated trust (eg SMSF) r gvernment superannuatin fund, the frm is nw COMPLETE. Otherwise, cntinue t Sectin 3.5 belw. PAGE: 5/7

6 3.5 Sharehlders (nly needs t be cmpleted fr prprietary cmpanies that are nt regulated cmpanies as selected in Sectin 3.2) Prvide details f ALL individuals wh are beneficial wners thrugh ne r mre sharehldings f mre than 25% f the cmpany s issued capital Sharehlder 1 Residential address (PO Bx is NOT acceptable) Sharehlder 2 Residential address (PO Bx is NOT acceptable) Sharehlder 3 Residential address (PO Bx is NOT acceptable) FOR INTERNAL USE ONLY COMPANY VERIFICATION Standard verificatin prcedure Verify: The full name f the cmpany as registered by ASIC Whether the cmpany is registered as a prprietary r a public cmpany The ACN issued t the cmpany. Tick Verificatin ptins (select ne f the fllwing ptins used t verify the Cmpany) Perfrm a search f the relevant ASIC database. If the ASIC database is nt reasnably available, an riginal r certified cpy f the certificatin f registratin issued by ASIC. Alternative verificatin prcedure Fr a cmpany which is an Australian listed cmpany, a majrity wned subsidiary f an Australian listed cmpany r is a regulated cmpany (ie licensed by an Australian Cmmnwealth, State r Territry statutry regulatr). Verify: Tick That the cmpany is an Australian listed cmpany (if applicable) That the cmpany is a majrity wned subsidiary f an Australian listed cmpany (if applicable) That the cmpany is a regulated cmpany (if applicable). Verificatin ptins (select ne r mre f the fllwing ptins used t verify the Cmpany) Perfrm a search f the relevant market/exchange. Perfrm a search f the relevant ASIC database. Perfrm a search f the licence r ther recrds f the relevant Cmmnwealth, State r Territry statutry regulatr. A public dcument issued by the relevant cmpany. PAGE: 6/7

7 FOR INTERNAL USE ONLY Unithlder I.D: U _ Part 1 Trust Verificatin Dcument 1 Dcument 2 (If applicable) Part 2 Individual Trustee Verificatin Dcument 1 Dcument 2 (if applicable) Dcument 3 (If applicable) Part 3 Cmpany Verificatin (If applicable) Dcument 1 Part 2 Cnfirmatin DFAT search cmpleted. Verified by: Name Signature Date PAGE: 7/7

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