Sole/Joint account. Your application to add a new customer to a. For Halifax use only. 1. Your personal details. For Halifax use only Sanctions/NCCT.

Transcription

1 Your application to add a new customer to a Sole/Joint Please write clearly in the white spaces with capital letters or tick the boxes. Please complete all sections of this form. For Halifax use only What will you be using the for? opened Colleague file number TNT Code Sort code Account number 1. Your personal details Are you an existing Halifax customer? Are you an existing Halifax customer? Your title Mr Mrs Miss Ms Other (please specify) Your title Mr Mrs Miss Ms Other (please specify) Your last name Your first names Your last name Your first names Any other name you use/have used (if applicable) Any other name you use/have used (if applicable) Your date of birth Are you: Male Female Your date of birth Are you: Male Female Are you: Employed Self employed Part time Unemployed Are you: Employed Self employed Part time Unemployed t working Seeking work Retired Student t working Seeking work Retired Student If unemployed how long since you last worked? Years Months If unemployed how long since you last worked? Years Months Your country of birth Your nationality Your country of birth Your nationality Your additional nationalities (if applicable): Your additional nationalities (if applicable): Your country of residence Your country of residence Which countries are you tax resident* in or have you been a resident of in the past two years? Which countries are you tax resident* in or have you been a resident of in the past two years? If you have a United States (US) Taxpayer Identification Number (TIN) please provide details below Please note: This may be your US Social Security Number If you have a United States (US) Taxpayer Identification Number (TIN) please provide details below Please note: This may be your US Social Security Number *Please note: tax resident relates to countries where you have the obligation to file a tax return or where you are subject to income tax in the UK or in another country. You must provide at least one country. Your relationship to the first customer For Halifax use only Sanctions/NCCT. Sanctions ref. no (if applicable) Sanctions ref. no (if applicable)

2 1. Your personal details continued 1.1. Your contact details Your telephone numbers and area dialling codes Home Mobile Work Your telephone numbers and area dialling codes Home Mobile Work 1.2. Your residential details Your home address (where you live) Your home address (where you live) When did you start living at this address? Month Year When did you start living at this address? Month Year Your previous address (if less than three years at current address) Your previous address (if less than three years at current address) When did you start living at this address? Month Year When did you start living at this address? Month Year Your correspondence address (if different from your home address) Your correspondence address (if different from your home address) What is your current residential status? What is your current residential status? Owner no mortgage Owner with mortgage Local authority tenant Private tenant Owner no mortgage Owner with mortgage Local authority tenant Private tenant Living with parents Living with parents 2. Your debit card details I would like to apply for a debit card I would like to apply for a debit card The type of card we give you depends on our assessment of your personal circumstances. Customer name to appear on card The type of card we give you depends on our assessment of your personal circumstances. Customer name to appear on card Mother s previous name (new debit card customers only) Mother s previous name (new debit card customers only) Your date of birth Your date of birth

3 3. Your agreement with us Current s and other services Our agreement with you is made up of general conditions contained in the Halifax bank conditions which can be found in the Getting Started Guides. These include the Reward payments, interest and fees leaflet which contains our standard fees. If there is any overlap or conflict between the additional conditions and the Halifax bank conditions, the additional conditions apply. Eligibility To have the you must be 18 or over. Joint s All holders can operate their s individually and are individually and jointly liable for all amounts owed to us on those s. It is important that you read the Halifax bank conditions leaflet as this explains how we deal with joint s and your responsibilities. Bank statements: We will send statements to both of you unless one of you signs here to say that you do not want us to send statements to you. You can cancel this arrangement at any time by writing to us and we will then send separate statements to both of you. I do not wish to receive statements Halifax is part of the Lloyds Banking Group. The Lloyds Banking Group includes us and a number of other companies using brands including Lloyds Bank, Bank of Scotland and their associated companies. To see how we use your information, please read the privacy statement on our website ( or ask for a printed copy of this. We may search credit reference and fraud prevention agencies to check your identity and help us make decisions. The agency keeps a record of our search, whether or not your application proceeds. Our search is not seen or used by lenders to assess your ability to obtain credit. Marketing permissions Your data is safe with us we do not share your data for marketing outside the Lloyds Banking Group. We would like to tell you about offers, products and services that may be of specific interest to you. If you choose no for all of these options, we will not be able to send you this information. Please confirm how we may contact you (if more than one applicant, please use separate sections indicated): Please write to me Please me Your signature Please phone me Please text me Please write to me Please me My personal data and Lloyds Banking Group Please phone me Please text me The Lloyds Banking Group includes us and a number of other companies using brands including Lloyds Bank, Halifax and Bank of Scotland, and their associated companies. More information on the Lloyds Banking Group can be found at I confirm that I have received the following documentation: Halifax bank conditions Welcome Pack We need to perform searches to decide whether to accept your application, including checks to confirm your identity. We make these checks, including electoral register checks, through European credit reference agencies ( CRAs ) and fraud prevention agencies ( FPAs ). The CRA will record the searches, even if an application does not go ahead or is unsuccessful. This may affect your ability to borrow from other lenders within a short period. Lloyds Banking Group companies may also tell CRAs how you run your relationship with them (such as whether or not you pay anything you owe on time), which may also affect your ability to borrow from other lenders. If the information you provide is false or inaccurate, or we suspect fraud, we may provide details to FPAs and other relevant organisations. Law enforcement agencies may access and use this information. You will be financially linked by CRAs to any other names you use or have used, and any joint applicants. This means joint applicants financial affairs may be treated as affecting each other, and will be revealed whenever CRAs are searched, until one of you successfully files a disassociation with the CRAs. If you ask, we will tell you which CRAs and FPAs we (and other Lloyds Banking Group companies) have used so you can get a copy of your details from them. You are legally entitled, on payment of a fee, to see any information held about you by any credit reference agency. Advised and provided with Interest Rates Applicable to this Account s signature s signature Reward payments, interest and fees leaflet For Halifax use only Credit reference/bureau search result *Prompt screen print voters roll Halifax is a division of Bank of Scotland plc. Registered in Scotland. SC Registered Office: The Mound, Edinburgh EH1 1YZ. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority under registration number , except for lending which we are licensed by the Office of Fair Trading.

4 4. Additional personal and employment details Please complete all sections of this form. What is your current Marital/Civil Partnership status? What is your current Marital/Civil Partnership status? Single Married/ Civil Partnership Divorced/ dissolved Civil Partnership Single Married/ Civil Partnership Divorced/ dissolved Civil Partnership Separated Widowed Separated Widowed Number of children under 18: Number of children under 18: Are you working? Are you working? Your occupation Your occupation Your employer s name Your employer s name Your employer s address Your employer s address Post town Post town County (if known) County (if known) How long have you worked for your current employer? Years Months How long have you worked for your current employer? Years Months How long did you work for your previous employer? Years Months How long did you work for your previous employer? Years Months Is your employment pensionable? Is your employment pensionable?

5 5. Your monthly household income and expenditure details s income Source: If yes Frequency e.g. weekly Direct to a bank Cheque Cash Into this Salary/wages Benefits Pension Investments Other If other please state type Total net monthly income Amount Amount expected through this per month Amount Colleague: If unknown use customer notes to explain situation. s income Source: If yes Frequency e.g. weekly Direct to a bank Cheque Cash Into this Salary/wages Benefits Pension Investments Other If other please state type Total net monthly income Amount Amount expected through this per month Amount Colleague: If unknown use customer notes to explain situation Monthly commitments The total amount of any borrowing or credit facilities held on a joint basis should be shown in full against both holders. Mortgage/rent HP/other loans Halifax loans Amount Mortgage/rent HP/other loans Halifax loans Total each month Total each month 6. Details of your savings What type of savings do you have? What type of savings do you have? savings Halifax savings only Halifax and non-halifax savings n-halifax savings only savings Halifax savings only Halifax and non-halifax savings n-halifax savings only What is the total amount of your savings What is the total amount of your savings

6 7. Your banking details Is this a personal or business? Personal Business Is this a personal or business? Personal Business Do you have any other bank/building society s? Do you have any other bank/building society s? 7.1. Other banking details Details of main with another bank or building society. Details of main with another bank or building society. Bank/building society name Bank/building society name Bank/building society address Bank/building society address Post town Post town County County How many other bank s do you hold with the Halifax or any other banks? How many other bank s do you hold with the Halifax or any other banks? Current Savings Personal loan Mortgage ne ne Current Savings Personal loan Mortgage Which of the following facilities do you use: Cheque card Debit card Which of the following facilities do you use: Cheque card Debit card For how long have you banked there? Years Months For how long have you banked there? Years Months Is the to be closed? Is the to be closed? If no please explain why If no please explain why Would you like us to transfer your? Would you like us to transfer your? 7.2. Your credit card details Do you hold a credit card? If yes how many? Do you hold a credit card? If yes how many? Are any Halifax? If yes what is your credit limit? Are any Halifax? If yes what is your credit limit? What other card type(s) do you hold? Chargecard Storecard What other card type(s) do you hold? Chargecard Storecard Other (please specify) Other (please specify) 7.3. Your mortgage details Do you have a mortgage? Do you have a mortgage? If yes is it with the Lloyds Banking Group? (e.g. C&G, Halifax, Bank of Scotland) If yes is it with the Lloyds Banking Group? (e.g. C&G, Halifax, Bank of Scotland) What is the outstanding balance on your mortgage? What is the value of your house? What is the outstanding balance on your mortgage? What is the value of your house?

7 For Halifax use only Confirmation of customer s identity Please note that the Retail Procedures on Interchange Identification of Customers should be referred to and copies of ID should be taken, dated and signed as true copies of the original. Does customer meet Single ID requirements? Does customer meet Single ID requirements? Proof of identity (tick one box only): (tick one box only): Standard Secondary Third party PHD Ref. Standard Secondary Third party PHD Ref. What document has been seen? What document has been seen? What is the reference number? Expiry date e.g. passport (available) What is the reference number? Expiry date e.g. passport (available) Correctly certified copy of documents attached Correctly certified copy of documents attached If required Proof of address (cross one box only): If required Proof of address (cross one box only): Standard Secondary Third party PHD Ref. Standard Secondary Third party PHD Ref. What document has been seen? What document has been seen? What is the reference number? Expiry date e.g. passport (available) What is the reference number? Expiry date e.g. passport (available) Correctly certified copy of documents attached Correctly certified copy of documents attached Account maintenance Please note, no credits can be accepted until all necessary ID requirements have been met. Until ID has been completed a 646 indicator should be inserted. Indicator 646 inserted (if applicable) Follow up to be by manager. Tax status amended (if applicable) Disclosure (no marketing) indicator 040 inserted (if applicable) Staff indicator 041 inserted (if applicable) Planned Overdraft limit loaded and facility letter sent (if applicable) Strict flag (LOA) loaded (if applicable) Meeting booked with If decline result telephone call made to advise Time : Stage One What happens next card given Decline letter sent If accept result note diarised to call 24 hours before the appointment By signing this section, both staff members are confirming that the evidence attached meets the Banks identification requirements. Name of colleague completing this form Checker s name (or Grade C equivalent) Colleague s signature Checker s signature

8 10424i HX-0114

9 IMPORTANT INFORMATION PLEASE READ CAREFULLY On completion, the Specimen signature slip below must be detached and sent to the SMD Unit daily in the pre-printed SMD Personal envelope. Please ensure all sections are fully completed using black ink. Please do not mark or write on the front of the specimen signature slip except in the designated boxes. Please remove the Specimen signature slip and send to SMD before sending the form to AQCU. Branch sort code completed Account number(s) Signing instructions: Either party to sign Other see attached s name s name s signature HX-0711

10