Investment Application Form

- Step 1 of 7

This application is for an: *

Individual
Joint Account

If you would like to set up an account for an entity including a trust, company, or society, please call 06 370 0070 or email [email protected] for an application form.

Part 1a

Member 1 Details

Full Legal Name

First Name * *

Middle Name

Surname * *

Preferred Name

Date of Birth

IRD Number

Occupation

Home Phone

Mobile *

Email Address *

Residential Address

Suburb

Postcode

City

Tick if this person is the primary contact

Click here if this person is the primary contact

How did you hear about WBS?

Disclosure: Are you a senior member of the New Zealand or Foreign Government, Judiciary, Military, or any Ambassador – or are you immediately related to any?

Select One

I am only a tax resident in New Zealand
I am also a tax resident in another country/countries

If you are also a tax resident in another country/countries, please specify what country/countries and Tax Income Number/s:

Identity Verification

Under the Anti-money Laundering and Countering Financing of Terrorism Act 2009 (AML/CFT), WBS is required to verify your identity and address when you become an investor. Original identity documents (Passport, Firearms Licence or Drivers Licence and Bank Card) along with proof of your address should be provided in person at our office 125 Queen Street, Masterton. However if you are unable to provide the original documents in person we will accept original certified copies posted to P O Box 441, Masterton 5840.

As this application is for an individual account, you can skip this step.

Part 1b

Member 2 Details

Full Legal Name

First Name

Middle Name

Surname

Preferred Name

Date of Birth

IRD Number

Occupation

Home Phone

Mobile

Email Address

Residential Address

Suburb

Postcode

City

Disclosure: Are you a senior member of the New Zealand or Foreign Government, Judiciary, Military, or any Ambassador – or are you immediately related to any?

Select One

I am only a tax resident in New Zealand
I am also a tax resident in another country/countries

If you are also a tax resident in another country/countries, please specify what country/countries and Tax Income Number/s:

Identity Verification

Under the Anti-money Laundering and Countering Financing of Terrorism Act 2009 (AML/CFT), WBS is required to verify your identity and address when you become an investor. Original identity documents (Passport, Firearms Licence or Drivers Licence and Bank Card) along with proof of your address should be provided in person at our office 125 Queen Street, Masterton. However if you are unable to provide the original documents in person we will accept original certified copies posted to P O Box 441, Masterton 5840.

As this application is for an individual account, you can skip this step.

Part 1c

Signing Authority (Joint Accounts Only)

How many individuals will be required to authorise transactions or give us instructions in relation to your WBS investment(s)?

Any one alone
Any two together
Other

Please state

Part 2

Investment Details

Please select one or both of the following

Term Investment

Term Length

90 Days
120 Days
180 Days
270 Days
1 Year
18 Months
2 Years
Other

Please state

Our Term Investment rates are reviewed regularly and subject to change. View our current investment rates by clicking here.

Term Investment Amount (minimum $500)

Call Investment

Call Investment

Call Investment Amount (minimum $500)

Our Call Investment rates are reviewed regularly and subject to change. View our current investment rates by clicking here.

Total Amount

$ 0.00

Part 3

Bank Account Details

Nominated bank account details: please provide a copy of a bank deposit slip or bank statement for account verification. This is your nominated NZ bank account that you would like your investments interest/principal to be paid to.

Bank Account Number

IRD Details

Please provide details of the IRD number applicable to this Investment. (If your IRD number is 8 digits, then please enter a 0 as the first digit.)

IRD Number

Please select which Resident Withholding Tax rate applies to this investment:

10.5%
17.5%
30%
33%
NRWT (Non-Resident Withholding Tax)

If you do not select a Resident Withholding Tax rate, interest paid on Call and Term Investments will be taxed at 33%. If you do not provide an IRD number interest will be taxed at 45%.

If you are unsure which tax bracket you fit into visit www.ird.govt.nz.

Part 4

Deposit Communication

Please select one method of receiving account statements and other communications from WBS — you can change this at any time

I wish to receive communications by email
I wish to receive communications by post

Please confirm the email address that all communications should be sent to

Postal Address (if different to residential address)

Suburb

Postcode

City

Please note: If you choose to receive your communications by mail then additional fees and charges may apply.

Part 5

Declaration

I/We have read, understood and accept the terms of the updated Product Disclosure Statement dated 24 December 2020. I/We agree to the terms outlined above in relation to document certification and the Privacy Act 2020 as amended or replaced by subsequent legislation and the use of personal information. I/We agree to WBS obtaining information for AML/CFT purposes as authorised above. I/We agree to WBS disclosing information as required in accordance with any applicable law.

Your Privacy

Personal information gathered in this form will be held securely by WBS and in accordance with our Privacy Policy any applicable provisions of the Privacy Act 2020 as amended or replaced by subsequent legislation. The information will be used to administer your investments or loan with us. Certain information will be released to Inland Revenue to comply with tax requirements. You have the right to access your information that we hold at any time and to correct it.

Click here if you agree that the above information is true and correct. *

Click here to confirm that the information submitted is true and correct *

Thank you for you application.

One of our team will be in touch to discuss your application and confirm the details of your investment.

Please note:

WBS will not accept your application until full payment has been received and all AML/CFT and other customer due diligence procedures have been adequately completed.
WBS reserves the right to decline any application either in whole or part, without giving any reason. If you have deposited funds with us and your application is subsequently declined, we will return your funds togethr with any interest accrued theron.