• Thank you for choosing Collinson Forex Limited (CFX). This form and our Terms and Conditions together form our agreement with you. We collect information to meet our obligations under applicable AML/CFT laws in New Zealand and Australia and FATCA and CRS tax reporting requirements. If we cannot complete required customer due diligence, we may be unable to provide or continue services.

    Complete Sections A, B, D, F, G and H. Complete Section C only if you are applying as a sole trader. Complete Section E only if someone else will operate the account or if you are transacting for another person.

  • Account Application Form - Individual & Sole Trader

  • A. Applicant Details

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  •  -
  • B. Identification

  • Identity Document Type*
  • Expiry Date*
     / /
    2 digit day, 2 digit month, 4 digit year
  • C. Sole Trader Details

    Complete this section only if you are applying to trade as a sole trader. A sole trader is not a separate legal person, so we must identify both you and the business.
  • Date Business Commenced
     / /
    2 digit day, 2 digit month, 4 digit year
  • D. Nature and Purpose of the Relationship

  • Products Required*
  • * Forward FX is a derivative under the Financial Markets Conduct Act 2013. You must also provide a Large Wholesale Investor Certificate or an Eligible
    Investor Certificate. Contact us for the criteria.

  • Source of funds and source of wealth are different things. We need both. Source of funds is the origin of the money moving through this account. Source of wealth is how your overall assets were accumulated.

  • E. Persons Authorised to Operate the Account

    Complete this section only if someone other than you will operate the account. We must verify the identity of each authorisedperson and their authority to act. Please confirm/attach the authority to act.
  • Authorised Person 1

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  •  -
  • Would you like to add another authorised person?*
  • Authorised Person 2

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  •  -
  • F. Tax Residency Self-Certification (FATCA and CRS)

    This information is collected under the Tax Administration Act 1994 for CRS and FATCA purposes. You must provide accurate and upto-date information. Penalties may apply if you provide false or misleading information, fail to provide required information, or fail to notify us of a material change.
  • Please list all your other countries of tax residency:*
    Rows
  • Are you a US person?
  • A US person includes a US citizen (including one resident outside the US), a US permanent resident or green card holder, a US tax resident, a person born outside the US to a US parent, and a person who spends a significant number of days in the US each year.

  • G. Documents to Attach

    • Identity document for you, and for each authorised person
    • Proof of residential address, where we ask for it
    • Authority to act for AP (email confirmation from you is acceptable)
    • Evidence of source of funds or/and source of wealth, where we ask for it
    • Sole traders: evidence of the business, such as an NZBN or ABN record
    • Wholesale or eligible investor certificate if forward FX is required
    • IRS Form W-9 if a US person
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  • H. Declarations and Acknowledgement

  • Our Obligations:

    1. Collinson Forex Limited is a reporting entity under the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 (NZ) and is supervised by the Department of Internal Affairs. Collinson Forex Limited is also registered with AUSTRAC and is subject to the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 (AU) in respect of the designated services it provides. Where the requirements of the two regimes differ, we apply the more stringent requirement.
    2. We are required to verify your identity, the identity of any person acting on your behalf together with their authority to act, and the identity of any person on whose behalf you receive our services. We verify your address according to the level of risk involved. If we are unable to complete the required customer due diligence, we may be unable to establish or continue the business relationship or carry out transactions.
    3. In circumstances prescribed by law we must carry out enhanced customer due diligence and obtain senior management approval before acting. This includes verifying source of funds and source of wealth.
    4. We screen you, and any person named in this form, against sanctions lists, politically exposed person data and adverse media sources, at onboarding and on an ongoing basis. Where a sanctions match is confirmed or suspected we may refuse, delay, block or freeze a transaction or the relationship, and we may be required to report the matter to, and act on the direction of, the relevant authority. We may be unable to explain our reasons.
    5. We are required to report suspicious activities and prescribed transactions to the Commissioner of Police through the New Zealand Police Financial Intelligence Unit, and to report to AUSTRAC where the Australian regime applies. We are prohibited by law from telling you whether a report has been made, is being considered, or what it contains. We will neither confirm nor deny that a report has been made.
    6. We conduct ongoing customer due diligence and account monitoring throughout the relationship. We may ask you for further information or documentation at any time, whether about a particular transaction or about the relationship generally, including source of funds and source of wealth. Failure to respond to a reasonable request within the time we specify may result in your application being declined, a transaction being refused or delayed, or the relationship being restricted or terminated.
    7. We use third party providers to verify identity electronically and to screen for sanctions, politically exposed persons and adverse media. Details are matched against records held by the issuer of the identity document or the official record holder. Electronic verification does not always succeed, and we may ask for documents instead. Where the law permits, we may also rely on a third party to conduct customer due diligence.
    8. We may collect information from other sources where the law permits, including New Zealand and overseas company and business registers, identity verification and screening providers, sanctions and politically exposed person databases, publicly available sources, and banks or counterparties involved in transactions.
    9. We may disclose information to the Department of Internal Affairs, the Police Financial Intelligence Unit, AUSTRAC where applicable, Inland Revenue and overseas tax authorities under FATCA and CRS, other members of our designated business group, our banks, correspondents and payment counterparties, our auditors and advisers, and anyone else where the law requires.
    10. Personal information is collected to comply with our anti-money laundering, countering financing of terrorism and sanctions obligations and to provide our services. It is held by Collinson Forex Limited and handled in accordance with the Privacy Act 2020 (NZ) and, where the Australian regime applies, the Privacy Act 1988 (AU). You may ask for access to, and correction of, personal information we hold. Where a suspicious activity report has been made, we cannot give access to any information about it, including whether it exists, and there is no right to have it corrected.
    11. We must keep customer due diligence records for at least 7 years after the relationship ends, and transaction records for at least 7 years after the transaction. We may keep them for longer where another obligation requires it.
    12. We may decline an application, refuse or delay a transaction, or restrict or terminate the relationship where reasonably necessary to comply with applicable law or to manage money laundering, terrorism financing, proliferation financing or sanctions risk. We may not be able to give reasons where disclosure is prohibited or restricted by law. To the maximum extent permitted by law we will not be liable for loss arising from action taken in good faith to comply with our legal or regulatory obligations.
    13. We have reporting obligations under FATCA and CRS, and you consent to us disclosing the relevant information to Inland Revenue and, through it, to overseas tax authorities.

     

    2. Your Declarations:

    14. The information given in this form and in any supporting document is true, complete, accurate and not misleading. You acknowledge that giving false or misleading information may be an offence.
    15. You transact on your own account and not for an undisclosed third party, except as disclosed in Section D and agreed by us in writing.
    16. To the best of your knowledge and belief, after due enquiry, funds used in transactions with us are not derived directly or indirectly from criminal activity, and will not be used to finance terrorism or proliferation, to evade tax, or to breach or circumvent any sanctions measure or currency control.
    17. You will tell us in writing within 10 working days of any change to the information in this form, including a change to your name, residential address, occupation, nationality, tax residence, authorised persons, or the nature of your business. Where a change affects the tax residency self certification in Section F, you will give us an updated self-certification within 30 days of the change.
    18. You will give us any information or documentation we reasonably request under clause 6 within the time we specify.
    19. If you give us incorrect or incomplete information, you will reimburse us for loss we reasonably suffer as a direct result. This does not apply to loss caused by our own error or breach.
    20. You are authorised to give us the personal information of each individual named in this form, and each of them has been made aware of this privacy statement.
    21. You have read and understood this form, and accept that we may take the actions described in clauses 4, 6 and 12.

     

  • Signature

    The information given in this form is true, correct and complete. I am/we are authorised to sign this application and have read the declarations and acknowledgements above.
  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: