Company Client Application form

Initial Information Sheet

Company Client Application & Macquarie Cash Management Account
Please Note: The following is a data collection form. Please complete the required details below and hit submit at the bottom of the page. Your data collection form will be emailed through to myself for review, if you’ve missed any required data I’ll call you to obtain the extra details. Otherwise, our back office will complete your account application forms and we will send a hard copy by post to you for your review and signature. Thank you for your interest and I look forward to working with you as an Investor Signals’ client.

Regards Leon Hinde
Company Details
Company Name
Company Type

ProprietaryPublic
Company ABN / ACN:
Country of Incorporation
Is the Company a foreign entity for tax purposes?

No - Enter Company TFN below or reason for exemptionYes - Enter country of domicile below
Company TFN
Country of domicile
ARBN or foreign registration number
Number of Directors
Nature of the business activity
Approval to perform Company search on your behalf to verify Company details, Directors and Owners

YesNo
Principal place of office

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Registered Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Is your postal address the same as the registered address?

YesNo
Postal Address

Street Address / P O Box

Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mailing address you would like correspondence sent to for this account

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Officer Details
Number of Directors*
Maximum of 4 Directors
Company Officer 1 (Sole Director, Director or Secretary)
Corporate Title
Company Officer 1 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
CO1 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
RESIDENTIAL ADDRESS DETAILS OFFICER 1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Company Officer 2 (Director or Secretary)
Corporate Title
Company Officer 2 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
CO2 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
RESIDENTIAL ADDRESS DETAILS OFFICER 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Company Officer 3 (Director or Secretary)
Corporate Title
Company Officer 3 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
CO2 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
RESIDENTIAL ADDRESS DETAILS OFFICER 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Company Officer 4 (Director or Secretary)
Corporate Title
Company Officer 4 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
CO2 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
RESIDENTIAL ADDRESS DETAILS OFFICER 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Beneficial Owners

List Individuals who whether directly or through other companies or trusts own more than 25% of the Company:-
Number of Owners *
Maximum of 4 Owners
Owner 1
Owner 1 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of Citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
01 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
Residential Address Details Owner 1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Owner 2
Owner 2 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
O2 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
Residential Address Details Address 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Owner 3
Owner 3 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
O2 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
Residential Address Details Address 3

Street Address

Street Address Line 3

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Owner 4
Owner 4 Full Name

TitleGiven NamesSurname
Any other name known by
Date of Birth

DayMonthYear
Country of birth
Country of citizenship or lawful permanent residency
Occupation
Mother’s Maiden Name
O2 Are you a foreign citizen or resident for tax purposes?

No - Enter TFN belowYes - Enter country of residence below
TFN
Country of residence
Residential Address Details Address 4

Street Address

Street Address Line 4

CityState / Province

Postal / Zip CodeCountry
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
Chess Sponsorship
We reccommend setting up a new HIN number. Please set up a new HIN for my account

Yes, I agreeNo thanks, I will supply my HIN and transfer my share holdings to my new account
HIN Number
Macquarie Cash Management Account

Direct Debit/Credit Authority to settle trades and credit dividends to
Do you have a Macquarie Cash Management Account?

YesNo
Account Name
BSB
Account Number
If you answered no above, a Macquarie Cash Management Account will be established for you. Please indicate your preferences below:

Free online bank statementsPrinted statements sent to your nominated postal address at $2.50 per statementI require a cheque book to be sent to me
Postal address for bank statements

Street Address / P O Box

Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact details for the Macquarie Cash Management Account
Email address
(Where confirmation notes will be mailed)
Mobile Number
Home or Business Number

Country CodeArea CodePhone Number
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Initial Information Sheet

Company Details

Company Officer Details

Company Officer 1 (Sole Director, Director or Secretary)

Company Officer 2 (Director or Secretary)

Company Officer 3 (Director or Secretary)

Company Officer 4 (Director or Secretary)

Beneficial Owners

Owner 1

Owner 2

Owner 3

Owner 4

Chess Sponsorship

Macquarie Cash Management Account

Contact details for the Macquarie Cash Management Account