Westpac New Account Application Form – Fill Out and Use

2.Type of Account Required

NRO	Current Account	Savings Account	Other (Please Specify)
Account
NRE	Current Account	Savings Account	Other (Please Specify)
Account
Term	NRO Deposit	NRE Deposit	Other (Please Specify)
Deposit

Currency

Details for Term Deposit

Amount (In Figures)

Amount (In Words )

Deposit Term: _______Years _______Months _______Days

Interest Payment:

Credit to Account

Capitalise with Principal

Maturity Instructions

Rollover Principal and Interest

Rollover Principal Only

Do not Renew Deposit (Credit Settlement Account)

Settlement Account (Principal, Interest and Maturity Proceeds)

Account Number

Account Type

Bank Details

Purpose of Account

Savings Account

Transactions

Investments

Other ➤ (Specify:__________________________________________________ )

Expected Turnover in the Account (INR)

0 – 500,000

500,001 – 1,000,000

1,000,001 – 5,000,000

5,000,001 – 10,000,000

> 10,000,000

Source of Funding

Salary

Business

Sale of Property

Investments

Inheritance

Savings

Other ➤ (Specify: _____________________________ )

Mode of Funding

Cheque

Bank Cheque

Wire Transfer

Account with Westpac, Mumbai

Other ➤ (Specify: _____________________ )

Details of Funding (Provide details such as Cheque Number / Reference Number / Westpac Account Number, Amount and Currency)

Signature of Primary Applicant

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P/C 2487 (05/14) 394954

3.Joint Applicant

Mode of Operation

Either or Survivor

Joint

Other ➤ (Specify:____________________________________________________________________________ )

Relationship to Primary Applicant

Existing Customer

Account No. or Customer No.

Country of Residence

No

Yes

Title

Full Name of Joint Applicant (Given names and Surname)

ID Document/Passport Number

Date of Expiry of Passport (dd/mm/yyyy)

PAN Details (If Available):

Yes ➤ Details below

No➤ PAN

/

/

Date of Birth (dd/mm/yyyy)

Nationality

Gender (Male/Female)

Marital Status (Married/Single)

/

/

Educational Status/Qualifications

Resident Status (NRI/PIO etc.)

Number of Years in the Foreign Country

Current Residential Address

City

Country

Postcode

Permanent Address (If different from Residential Address)

City

Country

Postcode

Type of Residence

Duration of Stay at Current Residence

Self Owned

Company Provided

Rented

Other ➤ (Specify: _______________________)

Nature of Employment

Duration in Current Business

Gross Annual Income (INR)

Salaried

Self Employed

Other ➤ (Specify: _______________________)

Name of Employer

Nature of Business/Job

Designation/Occupation

Country Code

STD

Country Code

STD

Email Address

Signature of Joint Applicant

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5.Details of Accounts with Other Banks (Required only when opening a Current Account)

	Name of the Bank and Address	Type of Facility	Details of Credit Facilities
			(Description and Amount)
		Current Account
		Credit Facility
		Current Account
		Credit Facility
		Current Account
		Credit Facility
		Current Account
		Credit Facility
		Current Account
		Credit Facility

6.Privacy Consent & Customer Acknowledgement

I/We agree that the Bank (and any other members of the Westpac Group) (the ‘Parties’) may disclose information about me/us or my/our accounts or any product/services/transactions I/we acquire from the Bank (for example, but not limited to, my/our account number(s), the amount of payments including interest paid or credited to the account(s), the account balance(s) or value(s), my/our name, address, country of residence and my/our social security number/taxpayer identification number or similar data (if applicable), and as made available to them (‘ Information’):

•to each other, any service provider engaged by a Party (a ‘Service Provider’), or a person who acts on my/our behalf in relation to any product (such as my/our adviser);

•to domestic and overseas regulators or other government agencies;

•as required or permitted by any law in any jurisdiction or under any treaty or other agreement entered into by the Bank (or other member of the Westpac Group) with authorities in any jurisdiction; or

•with my/our consent.

I/We acknowledge that sometimes the person that my/our Information is disclosed to may be located outside India, such as (but not limited to), in the United States of America, Singapore and Australia. If a Party transfers my/our Information to a country that does not require a level of data protection that is equivalent to the protection provided under the laws in my/our country, the Party will implement and will procure that its Service Providers implement additional safeguards in order to adequately protect the privacy and security of my/our Information.

I/We hereby declare that if my/our account is established I/We agree;

•to my/our Information being disclosed to the persons described in the manner set out in this section, including by transferring my/our Information to a person outside of India;

•to provide any additional information or documents the Bank requests from me/us in order to comply with a Party’s reporting obligations pursuant to law;

•that my/our Information may be used by the above persons for account administration, planning, product development and research purposes;

•to waive any rights to limit or prevent disclosure to tax authorities, under applicable data protection, bank secrecy or similar laws, rules and regulations in respect of the information a Party reports to comply with its reporting obligations;

•that to the greatest extent permitted by applicable law (including applicable rules and regulations), a Party will not be liable to me/us for any loss I/ we may suffer as a result of the Party complying with legislation or agreements with governments or tax authorities in accordance with this condition, unless that loss is caused by the Party’s wilful default of this section or fraud;

•that this consent will override any inconsistent term or consent provided by me/us under any agreement with the Bank, whether before or after the date hereof.

•that if I/we do not provide a Party with information or documents the Party needs or do not provide a waiver of confidentiality rights where needed, the Bank may (i) withhold amounts, including interest, to be paid or credited to me/us; or (ii) close my/our account, terminate or redeem or determine my/our product/services and/or end the Bank’s contractual or other relationship with me/us;

•that if none of the foregoing is acceptable to me/us, I/we accept that the Bank will not be able to take further steps in respect of an account with the Bank, with no liability in that regard.

I/We understand that I/we can access most personal information that the Parties hold about me/us (sometimes there will be a reason why that is

not possible, in which case I/we will be told why).

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To find out what sort of personal information the Parties have about you, or to make a request for access, please contact your Relationship Manager. The Westpac Group means Westpac Banking Corporation and its related bodies corporate. I/We agree:

•to be bound by the terms and conditions which apply from time to time to this account opened by me/us with the Bank;

•the Bank may charge to this or any other account(s) I/we may conduct with the Bank or recover from me/us any bank fees, government charges, taxes or duties imposed on transactions on/or which relate to my/our account(s); and

•that documents presented for identification purposes may be verified by the Bank with an appropriate authority.

7.Our Reporting Obligations on US Persons

The Bank is required to identify certain US persons in order to meet account information reporting requirements under local and international laws.

US Tax Residents (Please tick where applicable.)

Individual:	I/We certify that I am/we are a US tax resident or US citizen; or
Entity:	I/We certify that the entity or any office bearer* or any individual who holds an interest in the entity of more than 25% (a “Controlling
	Person”) is/are a US tax resident or US citizen.

Non-US Tax Residents

Where I/we have not certified that I/we are a US tax resident (by ticking one of the above boxes), by completing this application I/we certify that I/we or (where I/we are applying on behalf of an entity) the entity and/or any Controlling Person is/are not a US citizen or US tax resident.

I/we acknowledge and agree that I/we may be contacted to provide the Bank with further information.

If at any time after account opening, information in the Bank’s possession suggests that I/we, the entity and/or any Controlling Person may be a US citizen or US tax resident, I/we may be contacted to provide further information on my/our US tax status and/or the US tax status of the entity and/or any Controlling Person. Failure to respond may lead to certain reporting requirements applying to the account.

*Director of a company, partner in a partnership, trustee of a trust, chairman, secretary or treasurer of an association or co-operative.

8.Declarations for Account Opening

I/We, the undersigned (‘Customer’) certify and declare that all information provided in this application form is true, correct and accurate to the best of knowledge and belief of the Customer. The Customer hereby undertakes to, forthwith, inform Westpac Banking Corporation (‘the Bank’) in writing of any changes to the information provided in this application form or otherwise. The Customer understands and agrees that the banking accounts (‘Accounts’) are being opened by the Bank on the basis of the statements/declarations made in this application form. If any of the statements/ declarations made herein or otherwise are found to be incorrect, false, untrue or misleading in any manner whatsoever, the Bank shall be entitled to exercise, in its sole discretion, any rights and remedies available to the Bank including but not limiting to closing the Account, suspending operations in the Accounts, non-payment of interest etc.

The Customer hereby declares that they have read and understood the terms and conditions applicable to the Accounts as specified in the account terms and conditions document (a copy of which has been sent to the Customer and is in Customer’s possession). The Customer accepts and agrees to be bound by the said terms and conditions including those excluding/limiting the Bank's liability. I/We understand that the Bank may, at its absolute discretion, discontinue any of the services completely or partially with notice (personal or public) to the Customer.

Further, the Customer hereby declares that he/she is a non resident Indian or a resident joint holder in case of NRO accounts and the Customer is not resident of any jurisdiction where opening or maintaining of the Account is prohibited by law or regulations of such jurisdiction and by laws and regulation of India.

The Customer hereby declares that he/she is permitted by laws and regulations to open, hold and maintain the Accounts and is legally competent to execute, contract and carry out all banking transactions. The obligations with respect to the Account and operations of the Account are subject to all applicable laws (including, without limitation, any governmental acts, orders, decrees, guidelines, rules and regulations including Reserve Bank of India (‘RBI’) regulations, fiscal exchange control regulations, Foreign Exchange Management Act, 1999, Foreign Contribution Regulation Act etc). The Customer understands and confirms that the Bank will be entitled at all times, to act in accordance with applicable laws, without requiring to provide prior intimation of such actions to the Customer. Any and all limits/constraints imposed by applicable law shall apply to the Account and related facilities/services.

In the event of any change in the residential status of the Customer, the Bank reserves the right to close the Account after giving notice to the Customer.

The Customer agrees to deposit into the Account only such monies that the Customer is legally entitled to deposit and are allowed to be deposited in the Accounts in accordance with prevalent laws and regulations.

The Customer hereby understands and acknowledges that the Bank is entitled to information with regard to source of any monies being deposited in the Account. The Customer undertakes to on demand, without demur or protest, inform the Bank of the source of any monies.

The Customer hereby declares that the transactions relating to foreign exchange routed through the Bank do not involve, and are not designed for the purpose of any contravention or evasion of the provisions of Foreign Exchange Management Act, 1999 or of any rule, regulation, notification, direction or order made there under. The Customer also hereby agrees and undertakes to give such information/documents as will reasonably satisfy the Bank about the transactions in terms of above declaration.

Nomination required:	No		Yes		(If yes, please submit the nomination form)

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I/We acknowledge that I/we have received a copy of:

•the terms and conditions that apply to this account; and

•the fees and charges that apply to this account.

I/We believe the details on the pages of this form to be true and correct.

Mode of Operation
Either or Survivor	Joint	Other ➤ (Specify: ________________________________________________________________________________ )

Title		Full Name of Introducer (Westpac Banking Corporation Customer) (Given names and Surname)

Account No. or Customer No.

I confirm that I have been an account holder with Westpac Banking Corporation for over 6 months. I confirm that I personally know the applicant(s) detailed above for more than six months and confirm his/her identity, occupation and address.

Date (dd/mm/yyyy)By (Signature – Introducing Customer)

/	/				7
Bank Use Only
Branch Number			Account Number				Relationship Management Type			Special Condition Group
Account Classification			Statement Cycle				Next Statement Date			Manager Number

NameSalary NumberDate (dd/mm/yyyy)Signature

/ /		7

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