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Questions marked with
*
are required
Type of account
*
A Standard Account
A Joint Account
1. Your name & contact details
Mr
Mrs
Miss
Ms
Male
Female
What are your phone numbers and email address?
*
Please provide two contact numbers.
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2. Your address
What is your home address?
*
My home address is also my postal address
What is your postal address?
*
3. Your personal details
What is your date of birth?
*
Are you employed?
Have you or your join Applicant ever been declared bankrupt or gone through the No Asset Procedure?
*
Yes
No
If yes, in what year?
Are you a NZ resident?
*
Yes
No
IRD Number
*
Do you pay tax?
*
Yes
No
What is your tax rate?
*
10.5% (income $0-$14,000)
17.5% (income $14,000-$48,000)
33% (income $48,000+)
4. Outside of NZ
Are you a US citizen
*
Yes
No
Are you a tax resident of country other than New Zealand?
*
Yes
No
If you are a tax resident of country other than New Zealand, please provide which country and your Individual Identification Number number
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
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Argentina
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Austria
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Chile
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El Salvador
Equatorial Guinea
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Ghana
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Guinea
Guinea Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
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Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kuwait
Kyrgyz Republic
Laos
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Lebanon
Lesotho
Liberia
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Liechtenstein
Lithuania
Luxembourg
Macau
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Madagascar
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Malaysia
Maldives
Mali
Malta
Mauritania
Mauritius
Mexico
Moldova
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Mongolia
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Montserrat
Morocco
Mozambique
Namibia
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
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Oman
Pakistan
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Portugal
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Qatar
Reunion
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Satellite
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Sudan
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Tajikistan
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Togo
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Virgin Islands (US)
Yemen
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If you are a tax resident of country other than New Zealand, please provide your Individual Identification Number number
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