AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch

For Individual/Joint/Sole Proprietors
Complete sections 1 and 2

DateDDMM20YY

Companies, Partnerships, Trusts and Other Entities
Complete sections 1 and 3
SECTION 1
Customer information
Customer’s name
Customer number
Account nameAccount number
Authority for Operations
To: Australia and New Zealand Banking Group Limited, Solomon Islands Branch (Bank)	In the case of a company or an incorporated entity, I/we certify that the following resolution was passed at a meeting of the Board of Directorsof the Customer onDDMMYYYY

and that it has been recorded in the minutes book of the Customer.

For all others, I/we certify that I/we have authorised the following.
Resolved/Authorised that:(A)
Any 1 signatory; or
Any 2 signatories; orOther (please specify)		

to act fully and effectively in all dealings, matters and transactions (including withdrawals) in respect of the above account with the Bank.

Page 1

AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch(B) the following persons be included amongst the persons authorised to operate the account:
Signatory 1

Signatory 2First nameFirst nameMiddle name(s) (if applicable)

Middle name(s) (if applicable)

Surname

SurnameAny other name commonly known as

Any other name commonly known as

Date of birth

DDM

M

YY

Y

Date of birth

Y

DDMM

YY

Y

Y

Place of birth (town and country)

Place of birth (town and country)

Nationality/Citizenship(s)Nationality/Citizenship(s)Tax Identification Number

Tax Identification Number

Full residential address (Do not provide a PO Box or in-care-of address)Street

Full residential address (Do not provide a PO Box or in-care-of address)
StreetSuburb

Suburb

CityCityCountry

PostcodeCountry

Phone number

Phone number

Mobile number

Mobile number

Email address

Email address

Employment date

DDMM

YYYY

Employment datePostcode

DDM

Employer name

Employer name

Employer address

Employer address

Office/Title

Office/Title

Signature

Signature

Signatory Customer Number

Signatory Customer Number

Customer Identification and Verification complete

M

Y

YY

Y

Customer Identification and Verification complete

Page 2

AMENDMENT TO ACCOUNT AUTHORITYAustralia and New Zealand Banking Group Limited, Solomon Islands Branch(B) the following persons be included amongst the persons authorised to operate the account: (cont.)
Signatory 3

Signatory 4First nameFirst nameMiddle name(s) (if applicable)

Middle name(s) (if applicable)

Surname

SurnameAny other name commonly known as

Any other name commonly known as

Date of birth

D

DM

M

YYY

Date of birth

Y

DDM

M

YYYY

Place of birth (town and country)

Place of birth (town and country)

Nationality/Citizenship(s)Nationality/Citizenship(s)Tax Identification Number

Tax Identification Number

Full residential address (Do not provide a PO Box or in-care-of address)
StreetFull residential address (Do not provide a PO Box or in-care-of address)
StreetSuburbSuburbCity

City

Country

PostcodeCountry

Phone number

Phone number

Mobile number

Mobile number

Email address

Email address

Employment date

D

DM

M

Y

Y

Y

Y

Employment datePostcode

D

D

M

Employer name

Employer name

Employer address

Employer address

Office/Title

Office/Title

Signature

Signature

Signatory Customer Number

Signatory Customer Number

Customer Identification and Verification complete

MYYYY

Customer Identification and Verification complete

Page 3

AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch(C) the authority for the following persons to operate the account is hereby revoked:
Authority Revoked 1

Authority Revoked 2First nameFirst nameMiddle name(s) (if applicable)

Middle name(s) (if applicable)

Surname

Surname

Customer number

Customer number

Office/Title

Office/Title

Authority Revoked 3

Authority Revoked 4First nameFirst nameMiddle name(s) (if applicable)

Middle name(s) (if applicable)Surname

Surname

Customer number

Customer number

Office/Title

Office/Title

This authority
supercedes and replaces
is in addition toJoint account holder
Full nameFull nameSignature

Signature

Date

DDMM

20YY

Date

DDMM

20Y

Y

BANK USE ONLY
Received byDate received

DDM

M

20Y

Y

Reviewed byDate reviewed

DDM

M

20Y

Y

Forwarded to Client Enablement by

D DM M
Date

20Y

Y

Client Enablement checks and update by

D DM M
Date

20Y

YAmendment Form filed with Customer records
Page 4AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch

SECTION 3 FOR COMPANIES, PARTNERSHIPS, TRUSTS AND OTHER ENTITIESCOMPANY WITHOUT SEAL
Dated thisday of20

SIGNED for and on behalf ofby

Signature of Director

Signature of Director/Secretary

Name of Director

Name of Director/Secretary

Australia and New Zealand Banking Group Limited, Solomon Islands Branch 09/2322975

Page 5

AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch

COMPANY WITH SEAL
Dated thisday of

20

THE COMMON SEAL ofwas affixed in accordance with its Articles of Association in the presence of:*Signature of Director

Signature of Director/Secretary

Name of Director

Name of Director/Secretary*Care should be taken to ensure the seal is affixed and attested in accordance with the company’s Articles of Association.

Australia and New Zealand Banking Group Limited, Solomon Islands Branch 09/23

22975

Page 6

AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch

PARTNERSHIP
Dated thisday of20

EXECUTED by the PARTNERS OF
Signature

Signature

Name of Partner

Name of Partner

SignatureSignature

Name of Partner

Name of Partner

Signature

Signature

Name of Partner

Name of Partner

Australia and New Zealand Banking Group Limited, Solomon Islands Branch 09/2322975

Page 7

AMENDMENT TO ACCOUNT AUTHORITY
Australia and New Zealand Banking Group Limited, Solomon Islands Branch

TRUST
Dated thisday of20

EXECUTED by the TRUSTEES OF
Signature

Signature

Name of Trustee

Name of Trustee

Signature

Signature

Name of Trustee

Name of Trustee

Australia and New Zealand Banking Group Limited, Solomon Islands Branch 09/2322975

Page 8