Investment Application Form Please enable JavaScript in your browser to complete this form. - Step 1 of 7If 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.This application is for an:IndividualJoint AccountPart 1aMember 1 DetailsFull Legal NameFirst Name * *Middle NameSurname * *Preferred NameDate of BirthIRD NumberOccupationHome PhoneMobile *Email Address *Residential AddressSuburbPostcodeCityHow 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?YesNoSelect OneI am only a tax resident in New ZealandI am also a tax resident in another country/countriesIf you are also a tax resident in another country/countries, please specify what country/countries and Tax Income Number/s:Identity Verification Please contact us if you are unable to provide eitherNZ Driver Licence NumberCard Version NumberExpiry DateNZ Passport NumberExpiry DateTick if this person is the primary contactClick here if this person is the primary contact Please note that we will be attempting to verify your identification and address using our online verification software, Centrix. We may request further documentation if we are unable to fully verify New Zealand Passport/Driver Licence/Address details. If you do not have either a valid NZ Passport or a valid NZ Drivers Licence please contact us to discuss alternate ID options. 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. To help us complete this, you authorise WBS to use such online information sources as WBS considers necessary in the circumstances to confirm any information relating to you for AML/CFT purposes or as otherwise required. NextAs this application is for an individual account, you can skip this step.Part 1bMember 2 DetailsFull Legal NameFirst NameMiddle NameSurnamePreferred NameDate of BirthIRD NumberOccupationHome PhoneMobileEmail AddressResidential AddressSuburbPostcode CityDisclosure: Are you a senior member of the New Zealand or Foreign Government, Judiciary, Military, or any Ambassador – or are you immediately related to any?YesNoSelect OneI am only a tax resident in New ZealandI am also a tax resident in another country/countriesIf you are also a tax resident in another country/countries, please specify what country/countries and Tax Income Number/s:Identity Verification Please contact us if you are unable to provide eitherNZ Driver Licence NumberCard Version NumberExpiry DateNZ Passport NumberExpiry DatePreviousNextAs this application is for an individual account, you can skip this step.Part 1cSigning 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 aloneAny two togetherOtherPlease statePreviousNextPart 2Investment DetailsPlease select one or both of the followingTerm InvestmentTerm Length90 Days120 Days180 Days270 Days1 Year18 Months2 YearsOtherPlease stateOur Term Investment rates are reviewed regularly and subject to change. View our current investment rates by clicking here.Term Investment Amount (minimum $500)Call InvestmentCall InvestmentCall Investment Amount (minimum $500)Our Call Investment rates are reviewed regularly and subject to change. View our current investment rates by clicking here.Total Amount$ 0.00PreviousNextPart 3Bank 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 NumberIRD 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 NumberPlease 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.PreviousNextPart 4Deposit CommunicationPlease select one method of receiving account statements and other communications from WBS — you can change this at any timeI wish to receive communications by emailI wish to receive communications by postPlease confirm the email address that all communications should be sent toPostal Address (if different to residential address)SuburbPostcodeCityPlease note: If you choose to receive your communications by mail then additional fees and charges may apply.PreviousNextPart 5Declaration 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. I/We consent to WBS undertaking electronic verification for my personal details through an electronic verification service (“Centrix”). Electronic verification may check information with the document issuer, official record holder, credit bureau or authorised third parties. Please see Centrix’s website for the applicable terms and policies that apply to electronic verification. 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. PreviousSubmit
