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1. DETAILS OF ACCOUNT OWNER
Please provide details of the owner of the ANZ accounts and/or products that will be accessed by the ANZ Direct Online Site Owner.
Name of account owner (organisation or individual)
(‘Account Owner’)
ANZ customer number
Contact phone number
Email address
2. DETAILS OF ANZ DIRECT ONLINE SITE OWNER
Please provide details of the entity you authorise to access your ANZ accounts and/or products via their ANZ Direct Online Site.
ANZ Direct Online Site Name
ANZ Direct Online Client Code
(‘ANZ Direct Online Site Owner’)
Contact phone number (if dierent from above)
Email address (if dierent from above)
3. DETAILS OF THE ANZ ACCOUNTS AND/OR PRODUCTS YOU AUTHORISE THE ANZ DIRECT ONLINE SITE
OWNER TO ACCESS
Complete this form if you want another entity to view or access your ANZ accounts or products in ANZ Direct Online
Please print out your completed form and sign it. Then return it to your ANZ Relationship Manager, or the ANZ representative who assisted you.
The following products are eligible for ANZ Direct Online (ANZ PRODUCTS AND ACCOUNTS ONLY):
Bank Accounts (Domestic Payments) Foreign Currency Accounts (International Payments)
Domestic Reporting Foreign Currency Reporting
Loans Term Deposits
Credit Cards Same Day Cleared Payments
You will have to ask ANZ to include your new ANZ accounts and/or products in ANZ Direct Online by making a separate request once
they are open. This can be done by the ANZ Direct Online Site Owner sending us a Secure Mail request within ANZ Direct Online, or
by asking your ANZ Relationship Manager.
Bank Accounts (Domestic Payments)
Please list below the bank accounts for domestic payments that you authorise the ANZ Direct Online Site Owner to access via ANZDirect Online:
Please tick the accounts that can be debited for Same Day Cleared Payments (‘SCP’).
Charges Apply – see ANZ Fees and Charges Brochure at anz.co.nz
Account name Account number
Bank Branch Number Sux
1
2
3
4
5
6
7
8
9
10
View &
transact
View
only
or
or
or
or
or
or
or
or
or
or
SCP
If you are a Direct Debit Initiator
, please enter your Direct Debit Authorisation Code(s):
ANZ DIRECT ONLINE
THIRD PARTY AUTHORISATION FORM
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Please tick this box if you authorise the ANZ Direct Online Site Owner to view and/or access all your bank accounts for domestic payments
viaANZ Direct Online, that you open in the future.
Please specify whether that authority is view & transact OR view only
Loans
Please list below the loans you authorise the ANZ Direct Online Site Owner to view in ANZ Direct Online:
Account name Account number
Bank Branch
Number
Sux
1
2
3
4
5
6
7
Please tick this box if you authorise the ANZ Direct Online Site Owner to view your loans in ANZ Direct Online, that you open in the future.
Term Deposits
Please list below any term deposits you authorise the ANZ Direct Online Site Owner to view in ANZ Direct Online:
Account name Account number
Number
Sux
1
2
3
4
5
6
7
Please tick this box if you authorise the ANZ Direct Online Site Owner to view your term deposits in ANZ Direct Online, that you open in the future.
Credit Cards
Please tick this box if you authorise the ANZ Direct Online Site Owner to view all your credit cards in ANZ Direct Online (including once they have
been issued, if they have not been issued yet).
All Credit Cards linked to your ANZ Customer Number will be included if this box is ticked.
Foreign Currency Accounts
Please list below the foreign currency accounts you authorise the ANZ Direct Online Site Owner to view and/or access via ANZ Direct Online:
Account name
Account number and details
Number Currency
View &
transact
View
only
1
2
3
4
5
Please tick this box if you authorise the ANZ Direct Online Site Owner to view and/or access all your foreign currency accounts via
ANZ Direct Online, that you open in the future.
Please specify whether that authority is view & transact OR view only
or
or
or
or
or
ANZ DIRECT ONLINE
THIRD PARTY AUTHORISATION FORM
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Foreign Currency Accounts – continued
Select the options below to allow the ANZ Direct Online Site Owner to view Forward Exchange Contract reporting and/or use pre-booked Forward
Exchange Contract Reporting when converting funds for international payments:
Reporting Utilisation
FX Customer Number:
4. OPERATING ANZ DIRECT ONLINE
Appointing authorisers
• The people you nominate to transact on your accounts and products in ANZ Direct Online (your ‘Authorisers’) must be authorised signatories with
authority to transact on your accounts and products under your ANZ Mandate.
• Please remember to check and update your Authorisers and your ANZ Mandate from time to time. New signatories on your accounts will not
automatically become Authorisers on ANZ Direct Online.
• If your Authorisers are able to transact on your accounts in ANZ Direct Online:
– but are not also authorised signatories, with authority to transact on those accounts under your ANZ mandate, or
– if they have dierent authority under your ANZ mandate to the authority they have to transact in ANZ Direct Online (such as joint authority
under your ANZ mandate, but the ability to act severally in ANZ Direct Online), you conrm that by appointing an individual as an Authoriser for
ANZ Direct Online:
– that individual has authority to transact and instruct us on your behalf in ANZ Direct Online; and
– you agree that we can act on any instructions we receive from them that are consistent with the ANZ Direct Online Conditions of Use, even if
they are inconsistent with your ANZ Mandate; and
– you’re responsible for any transactions and instructions that we reasonably believe they have made that are consistent with the ANZ Direct
Online Conditions of Use; and
– you conrm you understand and agree that Authorisers that have ‘view only’ access in ANZ Direct Online will be able to view and download
transactional information for your accounts and products.
Authorising transactions
• Transactions can only be authorised by a maximum of two Authorisers in ANZ Direct Online. This applies even if your ANZ Mandate states more
than two Authorisers must approve a transaction.
• If you specify an Authoriser has ‘joint’ or ‘several’ authority in ANZ Direct Online, they will have that authority for every transaction in ANZ Direct
Online, across all accounts they are authorised to act on. ANZ Direct Online cannot enable an Authoriser to act with joint authority for some
transactions or accounts, and severally for others.
• ANZ Direct Online cannot enable specic combinations of Authorisers to approve transactions. If a transaction requires joint authority to be
approved in ANZ Direct Online, any two Authorisers who have joint authority for the selected account will be able to approve that transaction.
ANZ Direct Online cannot distinguish where a specic combination of Authorisers is required for some transactions or accounts, unless they are
the only people authorised to transact on a particular account.
• Any Authoriser with authority for the selected account will be able to instruct ANZ on that account via a ‘secure mail’ message in ANZ Direct
Online; and any Authoriser can instruct us via a ‘secure mail’ request in ANZ Direct Online if the request does not relate to transacting on an
account or product, or it is a free format ‘secure mail’ message.
EITHER
Tick this box to allow the ANZ Direct Online Site Owner’s Authorisers to authorise transactions on your ANZ accounts and/ products in ANZ
Direct Online with the same authority the ANZ Direct Online Site Owner has given them (including whether it is ‘joint’ or ‘several’). Please contact
the ANZ Direct Online Site Owner if you would like to check what that authority is.
OR:
List below the individuals that will be authorising transactions on your ANZ accounts and/or products in ANZ Direct Online on behalf of the
ANZDirect Online Site Owner. If you have more than 6 Authorisers, please attach a separate page with the details for those individuals.
Only complete this section if you would like the ANZ Direct Online Site Owner to transact on your ANZ accounts and products in ANZ Direct Online.
ANZ Direct Online has system limitations that restrict how transactions can occur. This means that transactions can only take place in
certain ways. As a result, ANZ Direct Online can operate dierently from the authority under your ANZ mandate.
ANZ DIRECT ONLINE
THIRD PARTY AUTHORISATION FORM
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Authoriser 1
User ID (e.g. sta number or surname.
If eld is blank ANZ will allocate a User ID)
Surname
First name
Email address
Contact phone number
All accounts
or specied accounts
(list below)
Authority
Several
Joint
If they are already an Authoriser on another ANZ Direct Online site
what is the Client Code?
Authoriser 2
User ID (e.g. sta number or surname.
If eld is blank ANZ will allocate a User ID)
Surname
First name
Email address
Contact phone number
All accounts
or specied accounts
(list below)
Authority
Several
Joint
If they are already an Authoriser on another ANZ Direct Online site
what is the Client Code?
Authoriser 3
User ID (e.g. sta number or surname.
If eld is blank ANZ will allocate a User ID)
Surname
First name
Email address
Contact phone number
All accounts
or specied accounts
(list below)
Authority
Several
Joint
If they are already an Authoriser on another ANZ Direct Online site
what is the Client Code?
Authoriser 4
User ID (e.g. sta number or surname.
If eld is blank ANZ will allocate a User ID)
Surname
First name
Email address
Contact phone number
All accounts
or specied accounts
(list below)
Authority
Several
Joint
If they are already an Authoriser on another ANZ Direct Online site
what is the Client Code?
4. OPERATING ANZ DIRECT ONLINE – CONTINUED
Authoriser 5
User ID (e.g. sta number or surname.
If eld is blank ANZ will allocate a User ID)
Surname
First name
Email address
Contact phone number
All accounts
or specied accounts
(list below)
Authority
Several
Joint
If they are already an Authoriser on another ANZ Direct Online site
what is the Client Code?
Authoriser 6
User ID (e.g. sta number or surname.
If eld is blank ANZ will allocate a User ID)
Surname
First name
Email address
Contact phone number
All accounts
or specied accounts
(list below)
Authority
Several
Joint
If they are already an Authoriser on another ANZ Direct Online site
what is the Client Code?
5. TERMINATION OF AUTHORITY
Unless ANZ agrees otherwise, the authority granted in this form will remain in full force and eect until the Account Owner requests the removal
of its accounts and/or products from the Site Owner’s site in ANZ Direct Online, or alternatively an Authoriser who is authorised on the open/close
tab of the account mandate requests the Account Owner’s accounts/products be removed from the Site Owner’s site in ANZ Direct Online; and its
accounts and products have been removed from the site.
Within ANZ Direct Online, any Authoriser with authority to transact over an account can approve changes to the Authorisers over that account from
time to time, in accordance with the account mandate.
ANZ DIRECT ONLINE
THIRD PARTY AUTHORISATION FORM
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6. ACCOUNT OWNER CONFIRMATION AND EXECUTION
The Account Owner must sign below to conrm that it:
Appointment of Agent
• appoints the ANZ Direct Online Site Owner and any Authoriser authorised to transact on its accounts/products in ANZ Direct Online, as its agent
for ANZ Direct Online, and requests ANZ Bank New Zealand Limited (‘ANZ’) gives the ANZ Direct Online Site Owner access to its accounts and/or
products to view and/or transact on them in ANZ Direct Online as indicated on this form, on the terms set out in this form and the ANZ Direct
Online Conditions of Use
Dealing with Information
• authorises the ANZ Direct Online Site Owner to view and deal with its information as required, in accordance with the authority granted in this
form, the ANZ Direct Online Conditions of Use and the ANZ Privacy Statement
Acceptance of Governing Documents
• agrees to be bound by this form, the ANZ Direct Online Conditions of Use, the ANZ Privacy Statement, the ANZ General Terms and Conditions
and the ANZ Fees and Charges Brochure (each available at anz.co.nz), and any other terms and conditions that apply to their ANZ accounts and
products or services, in connection with ANZ Direct Online
Fees and Charges
• agrees to pay any fees or charges applicable to ANZ Direct Online in accordance with the ANZ Direct Online Conditions of Use and the ANZ Fees
and Charges Brochure, and consents to the ANZ Direct Online Site Owner selecting whether to charge transaction-related fees to its accounts
and/or products in ANZ Direct Online, and selecting the nominated account for the ANZ Direct Online fees and charges in respect of those
accounts and/or products, in accordance with the ANZ Direct Online Conditions of Use and the ANZ Fees and Charges Brochure
Due Authorisation
• warrants that the signatories to this form are duly authorised by it to sign this form, and have the power and authority to bind it to this form, and
appoint the ANZ Direct Online Site Owner as its agent for ANZ Direct Online
Limitation of ANZ’s liability
• agrees that ANZ has no liability to it, or to anyone else, for any loss arising as a result of the appointment of the ANZ Direct Online Site Owner as it’s
agent for ANZ Direct Online in accordance with this form and the ANZ Direct Online Conditions of Use, except where such loss arises as a result of
ANZ’s negligence, fraud or willful default.
Account Owner Signature
This form may be signed by any person authorised by the Account Owner in such form as is acceptable to ANZ, or by any person who can bind the
Account Owner generally (must be authorised to open/close under the Account Owner’s ANZ account mandate).
Full name
Full name
Title
Title
Signature
Signature
Date
D D M M 2 0 Y Y
Date
D D M M 2 0 Y Y
Full name
Full name
Title
Title
Signature
Signature
Date
D D M M 2 0 Y Y
Date
D D M M 2 0 Y Y
If a signature is being witnessed, please insert ‘Witness’ in the Title eld of the signature block.
For ANZ Business Customers only:
• For Company accounts, two directors or if there is only one director, that director and a witness must sign.
• For Partnerships and Trust accounts, all partners or trustees (as applicable) must sign.
• For Sole Trader accounts, the account owner must sign
ANZ DIRECT ONLINE
THIRD PARTY AUTHORISATION FORM
Page 6ANZ Bank New Zealand Limited 06/23 20084
Please tick all the boxes and sign below. By signing below you conrm you have completed the following required checks:
Customer Due Diligence requirements have been met.
The Authorisers that can transact are also authorised signatories, with authority to transact the Account Owner’s accounts under the Account
Owner’s ANZ Mandate, including whether they are required to act with ‘joint’ or ‘several’ authority.
Signatures have been checked and this form has been signed correctly.
The accounts listed on this form match the Account Owner’s SDA prole.
Sta Member Signature
Date
D D M M 2 0 Y Y
Important – this form will not be accepted until this section has been completed.
Once all checks are completed and you have signed above, please scan and email completed documentation to Customer Onboarding BGL.
7. ANZ BUSINESS SPECIALIST CHECKLIST
(BANK USE ONLY)
Sta Member Details
Surname
First name
Email
Branch no.
ANZ Customer Segment
Institutional
Private Bank
Business
Personal
ANZ DIRECT ONLINE
THIRD PARTY AUTHORISATION FORM