AYERS Alliance Business Account Application Form

Transcription

1 AYERS Alliance Business Account Application Form

2 AYERS Alliance Business Account Application and Mandate APPLICANT DETAILS Complete the form using a BLACK PEN and print in clear CAPITAL LETTERS Legal Name of Business Name in Chinese (if applicable) Trading Name of Business Name in Chinese (if applicable) Business Type Company Partnership Sole Trader Other (Please specifiy) Other Type Australian Companies (Please tick) (i) (ii) (iii) (iv) (v) Limited Pty Ltd Pty Ltd who is majority owned by an Australian listed company Pty Ltd who is majority owned by a Foreign Company listed on a recognised stock exchange (RSE). Pty Ltd who is majority owned by a Foreign Company who is not listed on a recognised stock exchange (RSE). Name of Stock Exchange - if tick to (iii or iv) above Foreign Companies (Please tick) Country of Incorporation (if not Australia) (i) (ii) (iii) (iv) Parent RSE Listed & has ARBN Parent RSE Listed & no ARBN Parent n-rse Listed & Has ARBN Parent n-rse Listed & ARBN If non-rse listed then complete below: Parent/Overseas company is registered as (tick): Public Private Other: Name of Stock Exchange - if tick to (i or ii) above ACN/Other Registered Number Registered Office Address RSE Listed Argentina, Australia, Austria, Belgium, Brazil, Canada, China, Denmark, Finland, France, Germany, Greece, Hong Kong, Iceland, Ireland, Italy, Japan, Luxembourg, Mexico, Netherlands, New Zealand, rway, Portugal, Singapore, South Africa, Spain, Sweden, Switzerland, Turkey, United Kingdom, United States, Korea Stock Exchange, Kuala Lumpur Stock Exchange, Stock Exchange of Thailand and Philippine Stock Exchange Inc. Certificate of Incorporation Number Date of Incorporation Landline Telephone Number Business Registration Number/Other Registered Number Business Registration Expiry Date (if applicable)

3 Fax Number (if any) Bearer Share? Registered Office Company Website (if any) Trading Address (and in country of formation if no ARBN) Landline Telephone Number (write as above if same as registered office address) Correspondence Address Fax Number (if any) Company Website (if any) (write as above if same as registered office address) Does the company hold an AFSL or is it regulated by APRA? If so, list licence number Trading Address Nature of business? (write as above if same as registered office address) Correspondence Address Approximate annual turnover? (write as above if same as registered office address) Geographical areas of operation? Nature of business? e.g. Australia, Taiwan, Hong Kong, China Mainland, etc Approximate annual turnover? Main suppliers and customers? (if applicable) Geographical areas of operation? e.g. Australia, Taiwan, Hong Kong, China Mainland, etc Main suppliers and customers? (if applicable)

4 CONTACT PERSON INFORMATION Full Name Position / Title Landline Telephone Number Mobile Telephone Number Address of Contact Person Address of Contact Person Please tick the following if you want to have all of the notification documents by postal mail. If it is left blank, all of the notification documents will be sent to you by (Please make sure your address provided previously is correct) All of the notification documents will be sent by postal mail. CHOICE OF COMMUNICATION METHODS DIRECTOR/ SHAREHOLDER/ AUTHORISED SIGNATORY INFORMATION This needs to be completed for all DIRECTORS, PRINCIPAL SHAREHOLDERS /ULTIMATE BENEFICIAL OWNERS (10% or more of the entire shares of the company) and AUTHORISED SIGNATORIES. (Add additional sheets where required.) Please tick relevant box(es) INDIVIDUAL 1 DIRECTOR SHAREHOLDER AUTHORISED SIGNATORY Full Name Date of Birth Residential Address Nationality Name of Employer (Company Name) Job Title Former Name (If applicable) Other Name (If applicable) (If provided you will need to provide evidence of your former name) (If provided you will need to provide evidence of your Other name) Percentage of Shareholdings % (if applicable)

5 Please tick relevant box(es) INDIVIDUAL 2 DIRECTOR SHAREHOLDER AUTHORISED SIGNATORY Full Name Date of Birth Residential Address Nationality Name of Employer (Company Name) Job Title Former Name (If applicable) Other Name (If applicable) (If provided you will need to provide evidence of your former name) (If provided you will need to provide evidence of your Other name) Percentage of Shareholdings % (if applicable) INDIVIDUAL 3 DIRECTOR SHAREHOLDER AUTHORISED SIGNATORY Full Name Date of Birth Residential Address Nationality Name of Employer (Company Name) Job Title Former Name (If applicable) Other Name (If applicable) (If provided you will need to provide evidence of your former name) (If provided you will need to provide evidence of your Other name) Percentage of Shareholdings % (if applicable)

6 Please tick relevant box(es) INDIVIDUAL 4 DIRECTOR SHAREHOLDER AUTHORISED SIGNATORY Full Name Date of Birth Residential Address Nationality Name of Employer (Company Name) Job Title Former Name (If applicable) Other Name (If applicable) (If provided you will need to provide evidence of your former name) (If provided you will need to provide evidence of your Other name) Percentage of Shareholdings % (if applicable) INDIVIDUAL 5 DIRECTOR SHAREHOLDER AUTHORISED SIGNATORY Full Name Date of Birth Residential Address Nationality Name of Employer (Company Name) Job Title Former Name (If applicable) Other Name (If applicable) (If provided you will need to provide evidence of your former name) (If provided you will need to provide evidence of your Other name) Percentage of Shareholdings % (if applicable)

7 TAX FILE NUMBER NOTIFICATION Collection of tax file information is authorised and its use and disclosure are strictly regulated by tax laws and the Privacy Act. It is not an offence if you choose not to quote your tax file number, or claim an exemption, but if you do not, tax may be taken out of your interest. If you quote your tax file number, or claim an exemption, no tax will be taken out of the interest paid to your investment accounts. Tax file number or reason for exemption (if applicable) I/We agree that: AYERS Alliance Limited (AYERS Alliance) and any company which is related to AYERS Alliance; any person authorised to operate my/our account(s); any person through whom I/we have applied, or by whom I/we are introduced to AYERS Alliance (eg., financial planner, financial adviser, broker or accountant); any payment systems operators and participants in the payment system; and (each of the above referred to as a Recipient) may exchange with each other any personal information about me/us including: any information provided by me/us in this AYERS Alliance application form or any other form; any other personal information I/we provide to any Recipient or which any Recipient otherwise lawfully obtains about me/us; any transaction details or transaction history arising out of my/our arrangements with any Recipient; and any information which verifies your identity I/We agree that if AYERS Alliance engages anyone (a Service Provider) to do something on its behalf (for example a mailing house, a debt collection agency, a lawyer and identity verification service providers), then AYERS Alliance and the Service Provider may exchange with each other any personal information referred to above and any other personal information the Service Provider lawfully obtains about PRIVACY ACKNOWLEDGEMENT AND CONSENT me/us in the course of acting on AYERS Alliance s behalf. I/ We agree that any personal information referred to above may be used by any Recipient and Service Provider for any purpose related to the provision of the form and to carry out any associated payments, administration and account servicing. In addition, such information can be used to assess any application I/we make for a different product or service, for planning, product development and research purposes and to seek my/our feedback on AYERS Alliance products and services and to verify your identity. AYERS Alliance may give any personal information about me/us to entities other than the Recipients and the Service Providers referred to above where it is required or allowed by law or where I/we have otherwise consented. I/We understand that: if I/we fail to provide any information requested in this application form, or do not agree to any of the possible exchanges or uses of such information as set out above, my/our application may not be accepted by AYERS Alliance; Personal information may be transferred to members of the AYERS Alliance Group located overseas. I/We understand that the information and documentation collected by AYERS Alliance to perform any required identification verification, or in the course of obtaining an identification reference, is required by the Anti-Money Laundering and Counter-Terrorism Financing Act.

8 MANDATE FOR BUSINESS ACCOUNTS DECLARATION I/We the director(s)/members/partners have read and understood and agree that the Account holder named above will be bound by the documents which comprise the Client Agreement and Financial Services Guide for this account opened by me/us on behalf of the Account holder with AYERS Alliance Limited (AYERS Alliance) and that I/we are duly authorised by the Account holder to open the account. The following resolutions were passed; or as a Partnership; We the undersigned being the present partners of the firm: or as a Company hereby request and authorise AYERS Alliance as follows: 1. That an Account be opened or continued (as the case may be) with AYERS Alliance and any other Account or Accounts as may be subsequently directed by the Account holder and that: 5. That those people authorised as signatories on behalf of the Account holder are those listed in the Schedule to this mandate. Any advice of changes to the authorised signatories shall be given to AYERS Alliance in writing and signed by a director or authorized signatory (or similar if Account Holder is a Partnership). AYERS Alliance is entitled to act upon any such written notice. 6. That a copy of any resolution of the Board, Committee or Partners (as applicable) if purporting to be certified as correct by the Chair of the Meeting or by a Company Secretary shall as between AYERS Alliance and the Account holder, be conclusive evidence of the passing of the resolution so certified. 7. That this mandate will stay in force until revoked or changed. Any revocation or change needs to be in writing and signed in accordance with Section 127(1) of the Corporations Act I HEREBY CERTIFY that the foregoing are true copies of the resolutions as entered in the Minute Book of the Account holder and are in accordance with the Partnership Deed, Rules or Constitution (as applicable)of the Account holder. Executed by the Account holder in accordance with section 127(1) of the Corporations Act 2001: Any one to Authorise Signatory; or Any two Authorised Signatories; Be Authorised to: a. instruct AYERS Alliance to honour and comply with all transactions on behalf of the Account holder, whether the Account be in credit or overdrawn, to comply with all directions given for or in respect of any Account or Accounts of any kind whatsoever on behalf of the Account holder, and to accept and act upon all receipts for monies deposited on any Account or Accounts in the name of the Account holder, provided that such transactions are signed by any Authorised Signatory of the Account holder and such signature(s) shall be sufficient authority and shall bind the Account holder in all transactions between AYERS Alliance and the Account holder. b. withdraw and deal with any of the Account holder s securities or property or documents of title thereto which may be deposited with AYERS Alliance for safe custody from time to time, whether by way of security or otherwise. Chief of Director Name of Chief of Director (BLOCK LETTERS) Director Name of Director (BLOCK LETTERS) 2. That in the absence of any directions to the contrary, all Accounts subsequently opened shall be operated and dealt with upon the terms set out above insofar as the same may be applicable. 3. That AYERS Alliance be forthwith supplied with a copy of the Partnership Deed, Rules or Certificate of Incorporation (as applicable) of the Account holder and of each amendment thereto as soon as the same has been made. 4. That AYERS Alliance be supplied with a list of names and specimens of signatures of any other person or persons authorised to sign on behalf of the Account holder, and be, from time to time, informed in writing by the proper officer of the Account holder of any changes which may take place in relation to Authorised Signatory s, and may be entitled to act upon any such notice until the receipt of further notice in writing from the Account holder. Legal Name of Business (BLOCK LETTERS) Date

9 Names of Members of the Committee / Board / Partners/ Specimen Signature Authorised Signatories in full Specimen Signature

10 I r a t i o n l a s Identity / Citizenship Declarations Corporate Account Details Applicant s Full Name in English (Chinese) Details of Applicant (Please write complete name as per Certificate of Incorporation/Registration) Certificate of Incorporation Number Corporate Trustee s Details Name in Chinese ( if applicable ) d e n t i t y / C i t i z e n s h i p D e c Is the Corporate / Trust is registered body in US? Is any one of the Directors of the Corporate a US citizen? (The answer must be if one of the Directors holds multiple citizenships and one of which is US citizenship.) Is any one of the Directors of the Corporate a Green Card Holder? (i.e. In possession of a US alien registration Card as a lawful permanent resident by the US Citizen and Immigration Service) Is the Corporate associated with any public listed company in any Stock Exchange? (If, please provide further details in writing. ) Does any one of the Directors of the Corporate hold any other Citizenship? Does any one of the Directors have the permanent right of abode in any other country (i.e. In possession of a permanent right of abode document issued by the Immigration Authority of any other country) Does any one of the major shareholders (share holdings are 10% or more) of the Corporate hold any other Citizenship? 10 % Does any one of the major shareholders (share holdings are 10% or more) have the permanent right of abode in any other country (i.e. In possession of a permanent right of abode document issued by the Immigration Authority of any other country) 10 % If there is an answer to any one of the above questions, please provide further details below. * Director / Major shareholder (1) () Other nationality Australia Canada Others, please specify * You may select more than one if applicable Full name printed on the identification document Document numbers (if applicable) Permanent address in the above country Surname Given Name ID Type Number Name in Chinese ( if applicable ) * Director / Major shareholder (2) () * Please use additional form(s) for providing more information. Other nationality Australia Canada Others, please specify * You may select more than one if applicable Full name printed on the identification document Document numbers (if applicable) Permanent address in the above country Surname Given Name ID Type Number Name in Chinese ( if applicable ) Principal Account Holder s Signature Secondary Account Holder s Signature Account Holder s authorized person(s) / Trustee & Chop Date (DD/MM/YYYY): AAIP-AOF-BL-A-1111A Date (DD/MM/YYYY): Date (DD/MM/YYYY):

11 Customer Financial Needs Analysis 顧 客 財 務 狀 況 分 析 Customer Financial Needs Analysis Authorized person of Corporate account is required to complete this analysis from the company s perspective. ( Please complete the form using a BLACK PEN and print in clear CAPITAL LETTERS ( Strictly Private and Confidential Any information supplied on this Financial Needs Analysis is treated with the utmost confidentiality. It is to be used by your adviser purely to assess your current financial situation in order to offer you a personalised financial advices and develop an appropriate financial plan for you that is based on your needs, goals and objectives. You are granting us permission to use your information solely for this purpose. information will be disclosed to any third party and will be treated in accordance with the Privacy Ordinance relating to the retention of such information. This analysis is for one Account Holder s use only. Joint Account Holder should complete a separate Customer Financial Need Analysis. ( ) PERSONAL INFORMATION Applicant s Full Name in English (Chinese) Name in Chinese ( if applicable ) Surname Given Name Identification Document Details National ID Passport Passport / ID Number Employment Status Permanent Employment Contractual Employment Self - Employed Employer/Business Family Details Name Year of Service Spouse Name Age. of Children Age(s) Investment Experience Nil Less than 1 year 1 to 3 years 3 to 5 years 5 to 10 years More than 10 years Equities Warrants /Stock Options Forex Precious metals (e.g. gold, etc.) () Futures & Options Mutual Funds /Unit Trust Hedge Funds Structured Investment Products Fixed Income Securities (e.g. bonds, etc.) () Investment Preferences Risk Tolerance Very Conservative (Under 5%)* (5%)* Conservative (5%-8%)* (5%-8%)* Average (8%-12%)* (8%-12%)* Aggressive (12-20%)* (12-20%)* *(Annualized Return %) Very Aggressive (20% +)* (20%)* Time Horizon (years) Liquidity Requirement Low High AAIP-AOF-BL-A-1111A Initial Please turn to next page

12 Customer Financial Needs Analysis Financial Status Information Current Net Worth & Liquid Asset (USD) * ( ) Current Net Worth (Assets Minus Liabilities) ( ) 3 Mil. above 2 Mil. - 3 Mil. 1 Mil. - 2 Mil. 500K - 1 Mil. 200K - 500K 200K below Current Liquid Assets (Cash and all assets that can be quickly converted to Cash) ( ) 3 Mil. above 2 Mil. - 3 Mil. 1 Mil. - 2 Mil. 500K - 1 Mil. 200K - 500K 200K below s i s y l a Deposit Accounts(USD) * () Country Bank Balance (USD equivalent) 500K below 500K - 2 Mil. 2 Mil. above 500K below 500K - 2 Mil. 2 Mil. above 500K below 500K - 2 Mil. 2 Mil. above s n s A d e e l N a i c n a n i r F e m o t u C Investments (USD) * Type Funds Bonds Equities Other Nil Nil Nil 500K below 500K - 1 Mil. 1 Mil. - 2 Mil. 2 Mil. above 500K below 500K - 1 Mil. 1 Mil. - 2 Mil. 2 Mil. above 500K below 500K - 1 Mil. 1 Mil. - 2 Mil. 2 Mil. above 500K below 500K - 1 Mil. 1 Mil. - 2 Mil. 2 Mil. above Credit Status (USD) * ( ) Are you required to repay loan?? Remaining Principal Total Tenors (Months) 500K below 500K - 1 Mil. (Please provide details below) ( ) 1 Mil. - 2 Mil. Remaining Tenors (Months) Other Please specify Monthly Payment (USD) Annual Interest Rate (%) (%) Source of Fund * Declaration Retirement Provision/ Pensions (USD) (Corporate applicant is not required to give details here. ) Saving Sales of Property Inheritance Do you have any retirement/pension plans in force?? Expected Retirement Age Expected Retirement Fund (Present Value) Salary Investment Profit Other Please specify 50 below above 500K below 500K - 1 Mil. 1 Mil. - 2 Mil. 2 Mil. above Expected Annual Expense in Retirement (Present Value) 60K below 60K - 200K 200K - 800K 800K above Remarks/ Recommendation Purpose of Opening An Account 開 戶 目 的 * If the Corporate applicant has submitted the certified true copy of the latest Audited Annual Financial Report, details in that field is not required. ( ) DECLARATION I hereby certify that the information provided in this Financial Needs Analysis is true and accurate to the best of my knowledge and belief, which reflects my current financial situation. Print Name Customer Signature Date ( DD/MM/YYYY ): AAIP-FNA-BL-A-1111A