New Zealand Application
Application Form & Due Diligence
Due Diligence
To enable us to assess your eligibility for a Bailment Facility/Distribution Program we require information about the Company’s identity as well as the financial situation and commitments. With the information provided in this document we will carry out preliminary credit and AML checks required as part of our due diligence process.
If you do not provide us with this information or answer the questions truthfully, we will not be able to properly assess your proposal.
Please complete each part of the attached form giving as much information as possible to assist us in the processing of your proposal.
Application Form
To comply with Australia’s Anti-Money Laundering and Counter-Terrorism Financing (AML/CTF) legislation, Mitchcap must collect certain information from prospective borrowers and their beneficial owners supported by CERTIFIED COPIES of relevant identification documents for all borrowers and their beneficial owners.
You must complete this form for AML identification purposes and:
A Mitchcap employee may sight the original identification documents, certify then and scan or photocopy, alternatively;
Send the required CERTIFIED copies of the ORIGINALS (not scanned or faxed) with each page certified to us. This means the certifier must see the original documents. The certified documents may be sent to us in PDF format. Certified documents are required for the Trust, the Applicant AND the individuals.
To support this due diligence form, certified copies of identification documents must be provided. In order for the documents to meet the certification requirement a copy must be clearly certified as being a true copy of the original. Each certified document must show clearly the words “certified true copy of the original”, be signed by the certifying officer and have the name, address and details of the certifying officer.
Persons who may certify documents include Justices of the Peace, lawyers, accountants, bank managers, police, ministers of religion, pharmacists, legally qualified medical practitioners, Australia Post permanent employees with more than 2 years continuous employment in a Post Office and officers or authorised Representatives of an AFS licensee or Australian Credit Licensee with more than 2 years continuous service with more than one licensee.
In some circumstances additional identification and verification checks may be required.
BUSINESS LOAN DECLARATION AND CONSENTS
TO: Mitchcap Pty Ltd.
The applicant declares that the National Credit Code will not apply to any credit bailment facility that may be arranged by Mitchcap Pty Ltd.
The directors named below, together with the guarantors named, have each read this document, completed the required sections, authorise the required anti-money laundering and terrorist financing identification and verification processes to be completed and agree to the Privacy Agreement as set out in this document. A full copy of our Privacy Policy is available at www.mitchcap.com.au
DECLARATION, CONSENTS AND ACKNOWLEDGEMENT
To: Mitchcap Pty Ltd.
By completing and submitting this Application Form together with the declarations and consents it contains We agree that:
We have this Application Form and wish to apply for a bailment facility/Distribution Program with Mitchcap.
All the details in this Application Form are true and correct;
If requested, We will undertake to provide additional information and assistance to comply with all reasonable requests to facilitate the compliance with the AML/CTF, FATCA, CRS or any equivalent laws in any overseas jurisdiction;
We have provided original or certified copies of appropriate identification documents in accordance with AML/CTF Requirements. Copies of the appropriate identification document(s) have been attached to this Application Form;
Mitchcap may collect, store, use and disclose our personal information in accordance with the Privacy Act 1988 (Cth) and Trustee’s privacy policy.
Further, by completing and submitting this Application form We acknowledge and agree:
Mitchcap may accept or reject the application in whole or in part, and has absolute discretion to enter into a bailment facility as it thinks fit;
We have received the Privacy Act collection statement printed above and consent to our personal information being uses and disclosed in accordance with the Privacy Policy; andWe may be asked to provide any information or records for the purposes of compliance with its obligations under the AML and We agree to comply with any request.
MITCHCAP PTY LTD PRIVACY POLICY – ACKNOWLEDGMENT AND CONSENT
This acknowledgment and consent relates to the Privacy Policy of Mitchcap Pty Ltd (ACN 630 819 760) and our related entities.
By signing, I acknowledge that I have been provided with a printed copy or an email link to the Privacy Policy, and given the opportunity to read and understand it. I consent to my information being collected, held and used as permitted in the Privacy Policy. If I am providing personal information of any other person, I affirm that I have their consent to do so, on the same terms.
By executing this document, we acknowledge and confirm that we are authorised directors (or are a director and company secretary) of the entity set out above, we have read and understood this document and, by signing electronically/attaching our electronic signatures to this document, intend for the entity set out above, to be bound by the terms of this document.
- Primary Contact Person
- Applicant Company
- Applicant/s for Bailment Facility
- Supporting Documentation
A Company requires an individual to act on its behalf for the purposes of the proposed bailment. This person may be a director, company secretary or other officer of the Company. This individual will be subject to AML identification and certification requirements unless the individual is a director of the company and so already subject to the AML requirements. Nomination of the individual as the Primary Contact Person will be evidence of the Borrower’s authorisation to act on behalf of the Company
