Deposit Account application form - Ascend Self Managed Superannuation Funds

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1 AMP Bank Deposit Account application form - Ascend Self Managed Superannuation Funds Please staple all relevant material together This application is for Self Managed Super Funds (SMSFs) that use AMP Ascend Self Managed Super Administration. Application forms for other customer types are available from Please print in CAPITAL LETTERS and place a cross in any applicable boxes. 1. Select your account Your account will be opened once we receive your application form and deposit if opening a Term Deposit. You will not be able to operate your account if the required identification s are not submitted with the application form. 1.1 Select the type of account you would like to open. You can choose more than one type easycash Management Term Deposit Account (minimum opening balance $5,000) 1.2 How do you want to pay your opening deposit? (Only mandatory for a Term Deposit) Your opening deposit amount $ By cheque (must be payable to the applicant(s) or AMP Bank Limited) Transfer from another superannuation fund by direct credit Deduct from my nominated account (section 8) on (date) If you have asked AMP Bank to transfer the opening deposit from your account above, please ensure sufficient funds are available in your nominated account. If there are insufficient funds in your nominated account, you may be charged dishonour fees. 2. Does your SMSF have an existing AMP Bank account? If Yes - please provide account details If No - proceed to section Details of the existing AMP Bank account Account name Account type Account number 3. Customer details 3.1 Please select your trustee type Individual(s) as Trustee Company as Trustee Please specify your account name (if applicable, cheque book and deposit books will be issued in this name) Eg 1. John and Mary Smith ATF the Smith Family Super Fund. 2. J & M Brown Pty Ltd ATF the Brown Family Super Fund. 3.2 Contact details - please provide details for the primary contact person(s) for this new account. If insufficient space, please complete and attach a separate sheet Contact name Position Contact phone number Mobile number Fax number ( ) ( ) Credit provider and product issuer is AMP Bank Limited ABN , Australian credit licence , AFSL No of 11 NS /12

2 address 4. Trust details Full name of Trust Full business name of the Trustee Type of Trust Country where Trust established 5. Trustee details Company Trustees - complete section 6 Trustee 1 Title Last name Individual Trustee(s) - complete below Trustee 2 Title Last name First name(s) First name(s) of birth Residential address (not a PO Box) of birth Residential address (not a PO Box) Suburb State Postcode Suburb State Postcode Trustee 3 Title Last name Trustee 4 Title Last name First name(s) First name(s) of birth Residential address (not a PO Box) of birth Residential address (not a PO Box) Suburb State Postcode Suburb State Postcode 6. Company as Trustee details 6.1 General information Full name of company (as registered by ASIC) Australian Company Number (ACN) Registered office address (must not be a PO Box) Suburb State Postcode Principal place of business address As above, or Address (must not be a PO Box) Suburb State Postcode Mailing address As above, or Suburb State Postcode 2 of 11

3 6.2 Regulatory/Listing details Regulated company (licensed by an Australian Commonwealth, State or Territory statutory regulator). Regulator name Licence details 6.3 Director details Please complete for ALL directors of the company. (If more than 4 directors, please copy this page and attach as a separate sheet.) How many directors does your company have? Director 1 Director 2 Director 3 Director Major shareholder details (only needs to be completed for proprietary companies that are not regulated in section 6.2) Provide details of ALL individuals who own, through one or more shareholdings, more than 25% of the issued capital of the company. (If more than 4 major shareholders, please copy this page and attach as a separate sheet.) Shareholder 1 Full name Residential address (Not be a PO Box) Shareholder 2 full name Residential address (Not be a PO Box) Shareholder 3 Full name Residential address (Not be a PO Box) Shareholder 4 Full name Residential address (Not be a PO Box) 7. Term Deposits only Select your term. Note: AMP Bank may adjust the maturity date to be a banking day. The interest rate applied to your Term Deposit will be the rate that is current on the day the account is opened and the deposit is received by us. Years Months Days or the Maturity of 7.1 For terms of one year or more, when would you like interest paid? (Lower interest rates will apply where interest is paid other than annually) Annually Every 6 months Every 3 months Every month (please choose one) 7.2 How would you like your interest paid? Reinvest interest (available for terms of 1 year or less) Transfer interest into my nominated bank account (refer to section 8) 7.3 What would you like to do when your deposit matures? Reinvest for the same term (this option will be chosen if you do not give us instructions). Reinvest for a term of Years Months Days or the Maturity of Transfer to my nominated bank account (details below). 3 of 11

4 8. Nominate an existing bank account If you would like to register an existing bank account to transfer money between your new AMP Bank account and another AMP Bank or other financial institution account (this includes direct debits), complete the section below. Your nominated account must not be a credit card. The conditions applying to direct debit requests are contained in AMP Bank s Deposit Products Terms and Conditions brochure. Account in the name(s) of Signature 1 Signature 2 Existing AMP Bank account number OR Name of financial institution Branch name BSB number Account number You authorise the following: Non-AMP Bank accounts. Please provide a certified copy of one of the following: Previous bank statement (not more than 3 months old). Deposit slip. Cheque. 1. AMP Bank to verify the details of the account with your financial institution. 2. Your financial institution to release information allowing AMP Bank to verify your account details. Warning: Please enter your details correctly as AMP Bank will not be liable for any loss or other consequences arising from the account information being incorrect. Your existing bank account details can be found on a previous bank statement or cheque book. 9. BankNet and BankPhone access For BankNet or BankPhone access on your new company or trust account, you will need to call us on to register after your new account has been established and we have completed the verification of your identity and the identity of the account signatories. 10. Cheque book/deposit book (available for easycash Management) Do you require a cheque book or deposit book? If No leave blank and proceed to section 15. Yes - I/we would like a cheque book in my/our account name Yes - I/we would like a deposit book in my/our account name If you are opening more than one account that is eligible for cheque and deposit books and you cross the boxes above we will send you one of each for each of your new accounts. 11. Fax banking Would you like to apply for BankFax? BankFax allows you to transfer funds between your AMP Bank accounts, stop cheques, request transactions and order statements - full terms and conditions are contained in AMP Bank s Deposit Products Terms and Conditions brochure available from Yes, I/we would like to operate and transact by fax No 12. AMP Bank Access Card link (available for easycash Management) Do you require card access to your account? For card access, the signing authority in section 16 must be Any to Sign. Cards must be issued in the individuals name, not the Company/Trust name. Signatory 1 - name on card Signatory 2 - name on card 4 of 11

5 13. Privacy consent and disclosure statement Each applicant acknowledges and agrees that: 1. I am providing personal information to AMP Bank for the purpose of enabling AMP Bank to verify my identity as required under the Anti-Money Laundering and Counter Terrorism Financing Act 2006 (AML/CTF) and to establish and manage the product(s) and services named in this application. 2. My personal information will be used to process my application and administer this product and any other AMP Bank product made available to me and generally further my relationship with AMP Bank, its related corporations and associates and its advisers. 3. My personal information may be used for related purposes such as for marketing and research and to provide me with ongoing information about the range of financial services that is available. These may include investment, retirement, financial planning, banking, life and general insurance and other products and customer services that may be available by AMP Bank, other members of the AMP group of companies (AMP group)*, my financial planner, broker or introducer or service providers and joint venture/co-branded partners of AMP Bank. 4. AMP Bank requires this information in order to establish and manage this product. If I choose not to provide the information necessary to process this application, or I provide incorrect information, AMP Bank may not be able to process it. 5. Unless I have instructed otherwise, I consent to any information held about me by AMP Bank, including personal information, to be disclosed to a financial planner, broker or originator named in this application. 6. Unless I have instructed otherwise, I consent to any information held about me by AMP Bank, including personal information, to be disclosed to the administrator, appointed from time to time, of my superannuation fund specified as the account holder in this application. 7. I have the right to ask to see the information that the AMP group holds about me. If I believe the information is inaccurate, incomplete or out-of-date I may ask that it be corrected. There are some limited situations that are set out in the National Privacy Principles where I will not have this right. 8. I understand that if I do not wish to receive relevant news about other products and services offered, other than my statements, I must write to notify AMP Bank. 9. In addition to the organisations listed above AMP Bank may disclose my personal information to third parties including marketing research companies, organisations with whom AMP Bank has an arrangement to promote its services and organisations to whom AMP Bank outsource functions (for example mailing houses). 10. I consent to AMP Bank communicating with me by for product account and marketing purposes. The AMP Privacy Policy sets out the AMP group s policies on management of personal information and may be obtained by contacting us, your AMP financial planner or at For further information about how we handle your information or to request access to the information we hold about you, you can contact us by calling or by writing to: AMP Bank, Locked Bag 5059, PARRAMATTA NSW 2124 *AMP group means AMP Limited ABN and its subsidiaries which are all related bodies corporate. 14. Financial planner authority to operate account - easycash Management Account If you wish your financial planner to be able to operate your account on your behalf, please mark the box below with. I/We hereby authorise Full Access on my/our account for my/our financial planner. I/We request AMP Bank to add my/our financial planner, whose details and Sales ID are noted in section 19 of this application form, to operate my/our account. By signing this application form, I/we agree that my/our financial planner is my/our agent for the purpose of accessing the account opened on acceptance of this application and that I/we are responsible for the actions of the financial planner, for example, I/we are liable for any withdrawals or fees and charges which the financial planner incurs and which will be debited to the account. I/We further agree that the operating authority for the account is any to sign. I/We will notify AMP Bank in writing to cancel this authority and this authority remains in force until then. 15. Documentation Please return the signed application form along with all supporting s as set out in section 18 to: AMP Bank, Customer Services, Reply Paid 79702, PARRAMATTA NSW of 11

6 16. Account signing authority Please choose your signing authority: Any to sign (any one of the signatories can operate the account without the other s permission). All to sign (all of the signatories are required to act to operate the account). Access Cards cannot be issued. Any 2 to sign (2 of the signatories are required to act to operate the account). Complete only if there are 3 or more signatories. 17. Trustee acknowledgement By signing below, the signatory(ies) on behalf of the company or Trust declares, acknowledges and confirm that I/we: 1. Have authorised AMP Bank to verify the account details as set out above. 2. Have read and understood the Privacy Act Consent and Disclosure Statement as set out in section Have read and agree to be bound by the direct debit service agreement (if applicable). 4. Agree to be bound by AMP Bank s Deposit Products Terms and Conditions, which will be mailed after application. (Please read these conditions carefully as you will automatically agree to them the first time you or a person authorised by you operates the account.) 5. Understand that AMP Bank may decline this application for any reason in its absolute discretion. 6. Am/Are not commonly known by any names different to those disclosed in this application form, unless disclosed otherwise to AMP Bank. 7. Have provided true and accurate information in relation to this application. Any or information to be used for the purposes of this application (whether or not provided on or with this application): is correct and complete, if it is about another person, is provided with the authority of that person (if required), and may be used for any other products, services or benefits offered or provided to you or through AMP Bank or any other company in the AMP group and subject to their privacy obligations, may be disclosed to and used by the providers of such products, services or benefits to facilitate compliance with anti-money laundering and counter-terrorist financing legislation. 8. Understand that it may be a criminal offence to knowingly provide false or misleading information or s in connection with this application. If an agent or third party signatory has been appointed and is signing this application on your behalf, the last 2 declarations above are also given by and bind the agent or third party in the agent s or third party s personal capacity. Where an agent or third party signatory has been appointed, the agent s or third party signatory s proof of authority to act on your behalf must also be provided (such as a Power of Attorney, accompanied by a Third Party Access form. This form is available at By submitting this application you also acknowledge that we may decide to delay or refuse any request or transaction (this includes preventing withdrawals from the account) if we have not been able to verify your or a signatory s identity, or if we believe in good faith that allowing the transaction may cause us to commit an offence. We do not accept responsibility for any such delay or refusal. Signature 1 Signature 2 Position Position Name of signatory Name of signatory 6 of 11

7 18. Identification procedure Certain details provided in this form must be verified. This section sets out which details must be verified and how this may be done. If you are sending your proof of identity, please send certified copies only. Do not send originals. Documents written in a language that is not English must be accompanied by an English translation prepared by an accredited translator. Option 1 1. Provide an extract from the ATO database. 2. Go to click Super Fund Lookup and insert the fund name or ABN. 3. Print off the extract and attach. Option 2 Verify: the full name of the Trust, and the identity of one of the Trustees ( Verified Trustee ), being the Individual Trustee named in section 5 of this form or the Company Trustee named in section 6 of this form, using one of the following options: Option 2A Where the Verified Trustee is an Individual named in section 5 of this form: Trust name Verified Trustee Verify the full name of the Trust using one of the following sources: An original or certified copy or certified extract of the Trust Deed. A notice (such as a notice of assessment) issued by the Australian Taxation Office within the last 12 months. Please block out the TFN and numbers that include the TFN before scanning, copying or storing this notice. A letter from a solicitor or qualified accountant verifying the name of the Trust. An original or certified copy of one of the following s must be provided: Current Australian State or Territory Driver s Licence containing the holder s photograph. Australian passport that is current or has expired within the preceding 2 years. Card issued under a State or Territory law, for the purpose of providing a person s age, containing a photograph of the person in whose name the card is issued. Foreign government issued passport (or similar international travel ) that contains the holder s photograph and signature. Option 2B Where the Verified Trustee is an Company named in section 6 of this form: Trust name Verified Trustee Verify the full name of the Trust using one of the following sources: An original or certified copy or certified extract of the Trust Deed. A notice (such as a notice of assessment) issued by the Australian Taxation Office within the last 12 months. Please block out the TFN and numbers that include the TFN before scanning, copying or storing this notice. A letter from a solicitor or qualified accountant verifying the name of the Trust. Verify: full name of Company, and ACN or ARBN of an Australian or foreign company registered with ASIC, and if the company is registered by a foreign registration body, any identification number issued on formation, incorporation or registration, and whether the Company is registered as a public, proprietary, private or other company type. Using one or more of the following sources as necessary: A search of the ASIC database. An original or certified copy of a certificate or registration issued by ASIC. A search of the relevant foreign registration body. An original or certified copy of a certificate of registration (or equivalent) issued by the relevant foreign registration body. Where the above sources are not available for a foreign company not registered with ASIC, a disclosure certificate from an individual acting as agent of the Company (contact your financial planner or Customer Service for disclosure certificate requirements). 7 of 11

8 18. Identification procedure (for Option 2A above) If you have completed section 2 as an existing AMP Bank customer and have provided proof of your identity to us since 12/12/2007 you may not need to be re-identified. Please phone us on to confirm. Your identity can be verified from an original or certified copy of one Primary Photographic which can be your current Australian Passport (if expired, may not be expired for more than the preceding 2 years) or your current Australian Driver s Licence OR if you are unable to provide a Primary Photographic, please provide one Primary Non-photographic AND one Secondary Identification. What are your options in completing the identification requirements? Requirement 1 Take this form together with your (s) of identity to your AMP Bank representative/amp financial planner who will complete section 19 and post it to AMP Bank on your behalf. Requirement 2 Take your original (s) of identity with you and present them to one of the persons able to certify s. A list of persons able to certify (s) are shown below. The certifier should be requested to take a clear and legible copy of the identification and to record on the copy of the original : This and the following (x) page(s) is/are a true and accurate copy of the original cited by me this (day) of (month) (year). The certifier must add their full name (please print) and signature and state the type of approved certifier (from the list of certifiers below). Attach the certified copy(ies) of your identity (and that of any third party) to this form together with any other attachments (eg Third Party Access form, change of name, etc) and mail to: AMP Bank, Customer Services, Locked Bag 5059, PARRAMATTA NSW 2124 If you are sending in proof of identity, please send certified copies only. Do not send originals. List of identification s Primary Photographic Identification Document means: current Australian Driver s Licence containing your photograph, or current Australian Passport or expired within the preceding 2 years, or card issued under a State or Territory law, for the purpose of proving a person s age, containing a photograph of the person in whose name the card is issued, or foreign government issued passport that contains your photograph and signature. Primary Non-photographic Identification means: Australian birth certificate, or Australian citizenship certificate, or Pensioner Concession Card issued by Centrelink, or Health Care Card issued by Centrelink. Secondary Identification means: An original notice issued to an individual, as listed below, that contains your name and residential address: issued by the Commonwealth or a State or Territory within the preceding 12 months that records the provision of financial benefits, or issued by the Australian Tax Office within the preceding 12 months that records a debt payable to or by you, or issued by a local government body or utilities provider within the preceding 3 months that records the provision of services to your address or to you. List of Approved Certifiers Your verifying your identity may be certified by one of the following: An officer with, or authorised representative of, a holder of an Australian financial services licence, having 2 or more continuous years of service with one or more licences. A Justice of the Peace. An agent in charge of, or a permanent employee (with 2 or more continuous years of service) of an Australia Post outlet. A Bank Officer with 2 or more years continuous service. An Accountant who is a member of the Australian Institute of Chartered Accountants, CPA Australia or the National Institute of Accountants with 2 or more years of continuous membership. A solicitor or barrister. A judge of a court. A magistrate. A police officer. A complete list of Approved Certifiers is available on the reverse of the Identification Verification form that is available at 8 of 11

9 19. Identification verification and declaration (to be completed by an AMP representative/amp financial planner only) Verified trustee Please fill in either 1 or 2. Document type/description Person to whom it relates (name as shown) Document number Expiry date Place/Office of issue 1 OR 2 Primary Photographic Primary Non-photographic AND Secondary Identification Applicant Please fill in either 1 or 2. Document type/description Person to whom it relates (name as shown) Document number Expiry date Place/Office of issue 1 OR 2 Primary Photographic Primary Non-photographic AND Secondary Identification AMP Bank sales channel agent to confirm: 1. I declare that I have sighted the original identification s or certified copies of the identification s detailed above (as indicated). Copies of the s sighted are attached and submitted with this application. 2. I declare that : I have not given any advice to the applicant(s) on AMP Bank Limited s Deposit Products. I have given advice to the applicant(s) on the relevant AMP Bank Deposit Product(s) and I am qualified to provide this advice. AMP Bank sales channel agent name (please print) Sales ID number AMP Bank sales channel agent signature Source code Business name of AMP Bank sales channel agent Contact phone number ( ) 9 of 11

10 20. AMP Ascend Self Manager Super - Authority to disclose information To: AMP Bank Limited Reply Paid PARRAMATTA NSW 2124 By signing below: The customer authorises AMP Bank Limited ABN , AFSL No ( AMP Bank ) to disclose Data by electronic file (or such other method as AMP Bank agrees) to Class Super Pty Ltd (ABN ) and Smartsuper Pty Ltd (ABN ) ( the Data Recipients ) each business day. This disclosure is authorised for the accounts opened on acceptance of this application. Data is: customer information, which may include personal information, and account information including account balance, and current and historical account and transactional information. The customer agrees that: This Authority applies to the Accounts opened on acceptance of this application. The Data will be used as part of their self managed superannuation fund administration arrangement with AMP Ascend Self Managed Super. Class Super Pty Ltd will make the Data available to Smartsuper Pty Ltd and to the financial planner, broker or originator named in this application for the account(s) to view via a secure website. No agency, partnership, joint venture or any other type of similar relationship exists between AMP Bank and the Data Recipients. AMP Bank and the Data Recipients will not, subject to any prohibition or limitation imposed by law, be liable for delays, non performance, failure to perform, processing errors or any other matter arising out of this authority. This authority is to be read together with the relevant AMP Bank terms and conditions that govern the accounts, however, to the extent of any inconsistency, this authority will prevail. AMP Bank will not be liable to any person for their reliance on any Data supplied to the Data Recipients or any failure of AMP Bank to provide information or to provide complete or accurate Data to the Data Recipients. AMP Bank may decide at its sole discretion, on any ground it thinks fit and, without rendering AMP Bank or the Data Recipients liable in any way, to discontinue the provision of Data to the Data Recipients pursuant to this authority by written notice to the Data Recipients. This authority is only valid from the date it is received by AMP Bank at the above address. This authority may be terminated by providing written notice to AMP Bank at the address above. Signature(s) of account holders This form must be signed by all account holders. A. For accounts held by Individuals or Individuals as Trustees, sign here: Signature Signature Name (please print) Name (please print) B. For accounts held by Companies or Company as Trustee, sign here: Executed pursuant to section 127 of the Corporations Act 2001 (Cth). Signature Signature Name (please print) Name (please print) Director/Sole Director & Company Secretary Director/Company Secretary 10 of 11

11 AMP BANK USE ONLY External Datafeed Maintenance Add Smartsuper/Class Super. 21. Tax File Number or exemption Collection of Tax File Number (TFN) information is authorised by tax laws. The Privacy Act 1988 and tax laws strictly regulate the use and disclosure of TFNs. You are not required by law to provide your TFN and it is not an offence if you do not provide it. If you do not supply your TFN or exemption, we will be obligated to deduct tax from the account at the highest marginal rate plus Medicare levy. If you are not an Australian resident, we may be obligated to deduct non-resident withholding tax from the account. This includes accounts where the primary address of any one of the applicant(s) addresses is outside of Australia. Please print in CAPITAL LETTERS and place a cross in any applicable boxes. Applicant 1 Tax File Number Applicant 2 Tax File Number Or, if you re exempt please indicate reason: Tax returns not required Territory Residents Or, if you re exempt please indicate reason: Tax returns not required Territory Residents PLEASE NOTE: This page must always be the last page when you are returning your completed application form and any other supporting s, including identification s. Please detach the page from the rest of the application form and submit it as the last page. 11 of 11

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