Bankwest Form Sample

Generic Account Authority
Bank Copy
Bankwest, a division of Commonwealth Bank of Australia
ABN 48 123 123 124 AFSL/Australian credit licence 234945
Important Information
• The Bankwest Privacy Statement and Consent must be read and signed before submitting this application.
• This Account Authority will form part of your agreement with us in relation to the account you open.
• If a trustee account, ensure details of the beneficiary are recorded on CIF. The beneficiary cannot access funds or information on the account.
Section 1 – Account details
Title
Surname
Given name(s)
Relationship
Product description
No. to sign
BSB
Special signing instructions
CIF
Service Ctr
Country of residence (if not Australia)
Account holder name (for addressing statements and mail)
Account number
Payment to survivors (if applicable)
Statement frequency
Residential address (PO Box not acceptable)
State
Postcode
State
Postcode
Postal address (if not the same as residential address)
Interest to be credited:
Monthly
Quarterly
To:
Annually
This account
Service Centre
Account number
Service Centre
Account number
Service Centre
Account number
Other account
Overdraft debit interest & fees to be deducted from:
Other account
This account
Nominated Set-Off Account (only parties to loan can open nominated set-off account
i.e. Loan cannot be offset against account held by/with third party.)
Please tick (3) appropriate boxes
Online banking access
Periodical payments
Phone banking access
Cheque book facility
Fax authority
PR/Research mail
Telephone/fax form required
Telephone authority (account must be one to sign)
Tax File Number or exemption lodged
Telephone/fax form required
(if not selected, credit interest may be taxed at highest rate)
PP form required
25
50
PR/Research phone
PR/Research Email
Section 2 – Debit Card Access (account must be one to sign; applicable box must be ticked)
Bankwest Debit Card
Debit MasterCard (selected accounts only)
Colour/design
Section 3 – Lite Transaction Account only
Please tick (3) applicable box
Direct option
Transaction option
Section 4 – Parent/Guardian details (children’s account only)
Title
Surname
Given name(s)
Relationship
CIF
Parent/Guardian address
Contact number
State
Postcode
(
)
Section 5 – Acceptance of conditions
Important: Please read the Product Disclosure Statement carefully before you sign.
I/We agree to the conditions of the account and account access which are contained in the Product Disclosure Statement issued to me/us.
Unless we tell you otherwise, we agree that Bankwest need only supply us with one copy of the Product Disclosure Statement.
Account holder signature(s)
✗
Date
✗
DD/MM/YYYY
✗
✗
Page 1 of 3   BWE-1054 160913 (BWA-A32)
Section 6 – Compliance statement (Bank use only)
I certify that I have:
Updated customer details on CBS
Issued Investment and Transaction Account Terms & Conditions*
Issued the Product Schedule (does not apply to Equity Release)*
Issued the Account Access Conditions of Use*
Issued the Banking Services Rights and Obligations brochure*
Issued the Your Guide to Banking Fees*
Passwords for all account holders recorded on CBS (mandatory)
Privacy Consent form for all account signatories (mandatory)
Completed/Checked that a Privacy Consent Form has been signed by each account holder/signatory
Completed/Checked that the customer identification process has been completed for each account holder/signatory
Staff number
Signature
Date
DD/MM/YYYY
✗
*Documents issued to each account holder,
except where agreed to provide only one copy
to joint account holders
Section 7 – Checked by (Bank use only)
Signature
Staff number
Date
DD/MM/YYYY
✗
Section 8 – Account closed (Bank use only)
Date closed
Closed to
Reason
DD/MM/YYYY
Section 9 – Third Party signing authority
I/We authorise the following third party to sign on this account, and acknowledge that:
1. All transactions by the third party will be binding on me/us.
2. To cancel the authority of the third party to operate on the account, I/we must notify you in writing.
Third Party Debit Card Access (account must be one to sign)
Third Party Online Banking Access (account must be one to sign)
Third Party Phone Banking Access (account must be one to sign)
Account holder signature(s)
✗
✗
✗
✗
Date
DD/MM/YYYY
Section 10 – Third party details
Title
Surname
Given name(s)
Signature of Third Party
Relationship
CIF
Date
DD/MM/YYYY
✗
Section 11 – Compliance statement (Bank use only)
I certify that I have:
Completed/Checked that a Privacy Consent Form has been signed by each account holder/signatory
Completed/Checked that the customer identification process has been completed for the third party nominated above
Updated customer details on CBS/password recorded (mandatory)
Signature
Staff number
Date
DD/MM/YYYY
✗
Section 12 – Cancellation of Third Party Signing Authority
Please cancel the above third party authority as from
DD/MM/YYYY
Third Party Debit Card returned/destroyed
Account holder signature(s)
✗
✗
✗
✗
CBS updated and all accesses deleted for third party
Signature
Staff number
✗
Page 2 of 3   BWE-1054 160913 (BWA-A32)
Generic Account Authority
Customer Copy
Bankwest, a division of Commonwealth Bank of Australia
ABN 48 123 123 124 AFSL/Australian credit licence 234945
Important Information
• The Bankwest Privacy Statement and Consent must be read and signed before submitting this application.
• This Account Authority will form part of your agreement with us in relation to the account you open.
• If a trustee account, ensure details of the beneficiary are recorded on CIF. The beneficiary cannot access funds or information on the account.
Section 1 – Account details
Title
Surname
Given name(s)
Relationship
Product description
No. to sign
BSB
Special signing instructions
CIF
Service Ctr
Country of residence (if not Australia)
Account holder name (for addressing statements and mail)
Account number
Payment to survivors (if applicable)
Statement frequency
Residential address (PO Box not acceptable)
State
Postcode
State
Postcode
Postal address (if not the same as residential address)
Interest to be credited:
Monthly
Quarterly
To:
Annually
This account
Service Centre
Account number
Service Centre
Account number
Service Centre
Account number
Other account
Overdraft debit interest & fees to be deducted from:
Other account
This account
Nominated Set-Off Account (only parties to loan can open nominated set-off account
i.e. Loan cannot be offset against account held by/with third party.)
Please tick (3) appropriate boxes
Online banking access
Periodical payments
Phone banking access
Cheque book facility
Fax authority
PR/Research mail
Telephone/fax form required
Telephone authority (account must be one to sign)
Tax File Number or exemption lodged
Telephone/fax form required
(if not selected, credit interest may be taxed at highest rate)
PP form required
25
50
PR/Research phone
PR/Research Email
Section 2 – Debit Card Access (account must be one to sign; applicable box must be ticked)
Bankwest Debit Card
Debit MasterCard (selected accounts only)
Colour/design
Section 3 – Lite Transaction Account only
Please tick (3) applicable box
Direct option
Transaction option
Section 4 – Parent/Guardian details (children’s account only)
Title
Surname
Given name(s)
Relationship
CIF
Parent/Guardian address
Contact number
State
Postcode
(
)
Section 5 – Acceptance of conditions
Important: Please read the Product Disclosure Statement carefully before you sign.
I/We agree to the conditions of the account and account access which are contained in the Product Disclosure Statement issued to me/us.
Unless we tell you otherwise, we agree that Bankwest need only supply us with one copy of the Product Disclosure Statement.
Account holder signature(s)
✗
Date
✗
DD/MM/YYYY
✗
✗
Page 3 of 3   BWE-1054 160913 (BWA-A32)