Customer Information Certificate – Unregulated Partnership
Definition: a partnership is the relationship that exists between) carrying on business in common with a view to profit(including limited partnerships). The rights of the partners between themselves are governed by a partnership agreement.
Please note that this certificate may have been pre-populated with information that the Bank has previously collected from the customer. In completing this form you are responsible for completing any blank sections, checking the accuracy of any pre-populated section, informing us if any of the information is not correct and supplying the correct information in substitution.Bank use
only (initials)
1 / Full partnership name
2 / Does the partnership have a business /trading name, other than the partnership name, under which it carries on its business?
(Note: this includes any business name, other than the partnership name, registered with ASIC) / Yes (insert business/trading name)
No
3 / Does the partnership have an Australian Business Number (ABN)? / Yes (insert ABN)
No
4 / Is the partnership a tax resident of any country outside of Australia? / Yes
No Go to 6
5 / Country(ies) outside of Australia in which the partnership is a resident for tax purposes and country’s associated Tax Identification Number (TIN)*
*A TIN is an identifying number or equivalent used for tax purposes. If a ‘TIN’ is not available, please specify the reason against the appropriate country.
Note: If the partnership has more than 3 countries in which it is a tax resident, please provide the details on a separate paper. /
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
6 / Full address of the partnership’s principal place of business(not a PO box)
7 / Country of establishment
8 / State or Territory of establishment
9 / Date of establishment / / /
10 / How many partners are in the partnership?
11 / Full nameof each partner in the partnership
Note: For partners that are individuals (natural persons), full name (given name(s) including middle name(s) and family name) is required. An initial, nickname, alias, shortened name or part of a name is NOT acceptable.
12 / Are all partners existing Westpac customers? / Yes
No Complete the applicable Customer Information Certificate for each partner who is not an existing Westpac customer
13 / Beneficial Owner – Owner
Does the partnership have any INDIVIDUALS (NATURAL PERSONS), who ultimately own directly or indirectly,25 per cent or more of the partnership?
Note: This includes INDIVIDUALS (NATURAL PERSONS) who are owners of an underlying entity (e.g. company) and who ultimately own25 per cent or more of the partnership listed above at Q1. / Yes Go to 15
No Go to 14
14 / Beneficial Owner – Controller or Other
The partnership must have at least one ultimate beneficial owner. If you have answered “No” to Q13 above, provide the details of eachINDIVIDUAL (NATURAL PERSONS), who is any of the following:
An individual with 25 per cent or more voting rights(including a power of veto)
An individual who holds the position of senior managing official (or equivalent), e.g. a controlling/managing partner
An individual who controls the partnership through a capacity to make financial and operating decisions on behalf of the partnership / Go to 15
15 / Provide the detailsof each INDIVIDUAL (NATURAL PERSON) who is a beneficial owner
Note: the identity of all beneficial owners must be verified. This can be completed through the provision of certified copies of identification documents or via electronic verification. Electronic verification is only available to individuals with an Australian residential address an Australian mobile number.
Foreign Tax Residency Information:
A Tax Identification Number (TIN) is an identifying number or equivalent used for tax purposes. If a ‘TIN’ is not available, please specify the reason against the appropriate country.
Note: If the beneficial owner has more than 3 countries in which they are a tax resident, please provide the details on a separate paper. / Beneficial Owner 1
All given names:
Family name:
Other name(s) known by (if any):
Date of birth: / /
Permanent residential address, including country (not a PO Box):
Email address for electronic verification purposes:
Foreign Tax Residency Information:
Is beneficial owner 1 a tax resident of any country outside of Australia?
Yes
No
If yes, please indicate the country(ies) in which beneficial owner 1 isa resident for tax purposes and each country’s associated TIN.
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
Beneficial Owner 2
All given names:
Family name:
Other name(s) known by (if any):
Date of birth: / /
Permanent residential address, including country (not a PO Box):
Email address for electronic verification purposes:
Foreign Tax Residency Information:
Is beneficial owner 2 a tax resident of any country outside of Australia?
Yes
No
If yes, please indicate the country(ies) in which beneficial owner 2 isa resident for tax purposes and each country’s associated TIN.
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
Beneficial Owner 3
All given names:
Family name:
Other name(s) known by (if any):
Date of birth: / /
Permanent residential address, including country (not a PO Box):
Email address for electronic verification purposes:
Foreign Tax Residency Information:
Is beneficial owner 3 a tax resident of any country outside of Australia?
Yes
No
If yes, please indicate the country(ies) in which beneficial owner 3 isa resident for tax purposes and each country’s associated TIN.
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
Beneficial Owner 4
All given names:
Family name:
Other name(s) known by (if any):
Date of birth: / /
Permanent residential address, including country (not a PO Box):
Email address for electronic verification purposes:
Foreign Tax Residency Information:
Is beneficial owner 4 a tax resident of any country outside of Australia?
Yes
No
If yes, please indicate the country(ies) in which beneficial owner 4 isa resident for tax purposes and each country’s associated TIN.
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
- Country of tax residence:
OR
TIN not issued by this country
TIN pending issue by country's tax authority
16 / Full name of person providing this certificate
17 / Capacity of person providing this certificate (select appropriate box) / Partner
Company Director
Company Secretary
Authorised Representative
18 / Certification
I hereby certify that:
1.I am authorised to complete this certificate on behalf of the Customer;
2.The details included in this certificate are true and correct as at the date of this certificate;
3.All documents in the possession or control of the Customer that verify the information in this certificate have been supplied to the Bank and all documents so supplied are true and correct as at the date of this certificate; and
4.I acknowledge that the Bank will rely on this certificate to determine whether to provide services to the Customer in compliance with the law.
19 / Signature of person providing this certificate /
20 / Date / / /
Privacy Statement: The personal information the Bank is collecting from you on this form will be used to satisfy the Bank's identification requirements under the Anti-Money Laundering & Counter-Terrorism Financing Act and Rules. If you do not provide all the information requested, the Bank may not be able to provide any product or service to the Customer. The Bank will use and disclose your personal information to other members of the Westpac Group, anyone the Bank engages to do something on its behalf, and other organisations that assist the Bank with its business which may include organisations located outside of Australia and to government agencies and regulators, in some cases offshore. Details are in the Bank’s privacy policy. The Bank's privacy policy, available at westpac.com.au or by calling 132 032 (or from overseas +61 2 9293 9270), contains information about how the Bank handles your personal information, how you can access the personal information the Bank holds about you and seek its correction, how you may complain about a breach of the Australian Privacy Principles and how the Bank will deal with your complaint.
You agree that where you have provided personal information about other individuals in this form you will tell those individuals that you have supplied their information to the Bank and make them aware of the contents of this Privacy Statement and that for each Beneficial Owner whose email address has been provided to the Bank you have made them aware of, and obtained their consent to, the Bank contacting them by email for the purpose of each Beneficial Owner electing to proceed with the Bank conducting online verification of their identity to satisfy the Bank’s identification requirements.
Westpac Group means Westpac Banking Corporation and its related bodies corporate.
Note: It is an offence under the Anti-Money Laundering & Counter-Terrorism-Financing Act 2006 to knowingly provide false or misleading information or knowingly produce a false or misleading document. Penalty: Imprisonment for 10 years.
The Bank’s Reporting Obligations:We are required to identify tax residents of a country(ies) other than Australia in order tomeet account information reporting requirements under local and international laws.
If at any time after account opening, information in our possession suggests that you, theentity and/or any individual who holds ownership and/or control in the entity of 25% ormore (Controlling Person/Beneficial Owner) may be a tax resident of a country(ies) other than Australia, youmay be contacted to provide further information on your foreign tax status and/or theforeign tax status of the entity and/or any Controlling Person/Beneficial Owner. Failure to respond may lead tocertain reporting requirements applying to the account.
By completing this application you certify that if at any time there is a change to the foreigntax status details for you, the entity and/or any controlling persons/beneficial owner, you will inform the bank.You also certify that if at any time there is a change of a controlling person/s/beneficial owner/s in your entity, you will inform the bank.
A controlling person/beneficial owner refers to the individual(s) that directly or indirectly owns a legal interestin the entity of 25% or more and/or exercises actual effective control over the entity, whetherfrom an economic or other perspective such as through voting rights.In addition, in thecase of a trust, a controlling person/beneficial owner includes the settlor(s), trustee(s), appointer(s), protector(s), beneficiary(ies) or classes of beneficiaries and in the case of an entity other thana trust, the term includes persons in equivalent or similar positions.
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