ANZ INTERNET BANKING
AUTHORISED USER REGISTRATION FORM

Complete this form to register as an Authorised User of a customer registering or already registered for ANZ Internet Banking. Once you havecompleted all sections of this form, lodge the original copy at your local ANZ branch. Note, for security reasons, send this form separately to otherdocumentation. This form can be completed online and printed for signing. If you are not completing this form online, print in BLOCK LETTERS.
SECTION 1: CUSTOMER DETAILS
Provide below information regarding the customer which has authorised you to be an Authorised User to access its ANZ accounts using
ANZ Internet Banking.
Name of customer
Trading name (if applicable)
Contact person
Telephone number

Facsimile number

SECTION 2: AUTHORISED USER DETAILS
Provide the Authorised User number, for which your Function Level and Access Level and Authorisation Limit are listed by the customer on an
ANZ Internet Banking Business Registration Form (Section 5), or on an ANZ Internet Banking Business Maintenance Form (Section 4).
Authorised User Number
SurnameGiven names
Date of BirthTelephone number

SECTION 3: SECURITY CODE
Nominate an ANZ Internet Banking security code below which is required when contacting ANZ regarding ANZ Internet Banking. Your security code
can be letters or numbers, or a combination of both.
Security code (between 6 and 14 characters)
Note:This is not your ANZ Internet Banking password.
If you are also registered for ANZ Internet Banking as a personal customer, you must also use this security code when contacting ANZ Internet
Banking Support in relation to personal accounts linked to ANZ Internet Banking as a personal customer.
SECTION 4: CONFIDENTIAL INFORMATION AND PRIVACY
Information you provide to Australia and New Zealand Banking Group Limited (“ANZ”) will be kept strictly confidential and will be securely held by
ANZ and/or by any ANZ Group Member which term includes ANZ’s head office and its branches, agents, representative offices, regional offices oraffiliates, or any related corporation of ANZ anywhere in the world (“ANZ Group Member”).
ANZ will collect and use some of your information, including details about your transactions, your financial conditions, your account relationshipwith ANZ and /or your accounts(s) (herein collectively referred to as “Information”).
ANZ may, to the extent permitted law, collect your Information:• to assist in providing Information about a product or service;• to consider your request for a product or service;• to enable ANZ to provide a product or service;• to tell you about other products or services that may be of interest to you;• to perform other administrative and operational tasks (including risk management, systems development and testing, credit scoring, staff training
and market or customer satisfaction research);• to prevent and investigate any fraud or crime (or a suspected fraud or crime); and• as required by relevant laws, regulations and external payments systems, whether inside or outside the country where you live or where youraccount is held.
If you do not provide some or all of the information requested, ANZ may be unable to provide you with a product or service.
Australia and New Zealand Banking Group Limited, Cook Islands Branch
Australia and New Zealand Banking Group Limited, Fiji Branch
Australia and New Zealand Banking Group Limited, Solomon Islands Branch
Australia and New Zealand Banking Group Limited, Tonga Branch

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ANZ INTERNET BANKING
AUTHORISED USER REGISTRATION FORM

Disclosures by ANZ
To the extent permitted by law, by applying for the product or service, you agree that ANZ may use and disclose your Information to:• you, co-borrowers, your agents, authorised signatories, or customers you are an authorised signatory for;• your parents or guardians — if you’re under 18 years old;
• guarantors of any money you owe us;• brokers, custodians and other parties who introduced you to ANZ, are acting on your behalf, or are otherwise financially advising you;• any ANZ Group Member;• any service provider, agent or contractor which ANZ or any ANZ Group Member engages to carry out or assist its banking functions activities andservices — for example, mail houses, market research companies, cloud-service providers or data analysis companies;• marketing companies;• supervisors and advisors of our schemes;• any credit reporting company or debt recovery agencies;• regulatory bodies, government agencies, law enforcement bodies, taxation authorities and courts within and outside the country where you liveor where your account is held;• other parties ANZ is authorised or required to disclose information to by law of the country where you live or where your account is held or by lawof another country;• any reputable companies or organisations we have a continuing relationship with — including those we jointly offer products and services with,or anyone who offers loyalty programmes or services related to our accounts, products, or services;• other banks and financial institutions — if required when you send money from your account or receive money into it, to confirm or investigate
the transaction, and for verification and investigation into such transactions;• your authorised agents or your executor, administrator or legal representative;• any person where in ANZ’s view, disclosures are necessary or desirable for the purpose of allowing ANZ to perform its duties and exercise its
powers and rights under:– the ANZ Savings & Transactions Products Terms and Conditions,– the ANZ Electronic Banking Conditions and• any person or entity assisting us to investigate any concerns or complaints or manage any legal action; and• any other person or organisation as allowed by applicable law.
You agree and acknowledge that any ANZ Group Member may, to the extent permitted by law, transfer any Information to any party referred toabove to whom it is authorised to disclose the Information even though that party’s principal place of business is outside the country where youlive or where your account is held or that such information will be collected, held, processed or used by such party in whole or in part outside thecountry where you live or where your account is held.
To the extent permitted by law, you may access your Information by enquiring at any ANZ branch and you may also request that it be corrected.
A fee may be payable if you ask us to do this.
SECTION 5: AUTHORISED USER’S AGREEMENT
By signing below, I acknowledge and agree that:(1) I will be bound by the ANZ Electronic Banking Conditions when using ANZ Internet Banking and acknowledge having been given anopportunity to read, understand and accept the ANZ Electronic Banking Conditions;(2) I am authorised as an Authorised User of the customer listed in section 1 of this form to access its ANZ accounts using ANZ Internet Banking;(3) I agree that the contents of this Authorised User form are true and correct and that my signature below is evidence of my understanding of andconsent to all matters set out in this form, including the Confidential Information and Privacy statement above.
The ANZ Electronic Banking Conditions can be accessed online on ANZ’s website, at any ANZ branch and when you first log in to ANZ Internet Banking.
Full nameSignature
Date

Australia and New Zealand Banking Group Limited, Cook Islands Branch
Australia and New Zealand Banking Group Limited, Fiji Branch
Australia and New Zealand Banking Group Limited, Solomon Islands Branch
Australia and New Zealand Banking Group Limited, Tonga Branch

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AUTHORISED USER REGISTRATION FORM

BANK USE ONLY Retain original file in Customer’s file.
User ID

Customer number
100 point check completed

Documents & signatures verified by Signatures verified by

Forwarded to DCM byDate
2Name and phone number of person completing form

0Email of person completing this form

DCM USE
Date received

Actioned by
20Australia and New Zealand Banking Group Limited, Cook Islands Branch
Australia and New Zealand Banking Group Limited, Fiji Branch
Australia and New Zealand Banking Group Limited, Solomon Islands Branch
Australia and New Zealand Banking Group Limited, Tonga Branch 12/22 22368

Date actioned

Checked by20Page 3