Fillable Certified Copies Identification Form (Commonwealth Bank of Australia)

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Certified Copies Identification Form (Commonwealth Bank of Australia)

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Certified Copies Identification Form
Purpose of this form
The Commonwealth Bank of Australia is required by the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 to verify your
identity. This form will assist the Bank to verify your identity and may be used where you are not able to present original identification
documents to the Bank. This form is not intended to be used as an application for any of the Bank’s products or services.
Instructions for completion
• You must arrange for a prescribed person to complete Section 3 of this form
• This prescribed person is a person described in Section 5 on pages 2-3 and 3-3
• You must show the prescribed person original identification documents, as well as the copies to be certified
• Return this completed form along with the original certified copies of the identification document(s) to the Bank or your
nearest branch.
• If your identification cannot be verified using this form you are requested to visit a branch of the Commonwealth Bank of
Australia to be identified
• Please note that the Bank will not accept scanned or photocopies of the certified documents(s)
It is an offence under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 for you or the
prescribed person to make a false or misleading statement.
Section 3 – Details of prescribed person
Prescribed person’s full name
Prescribed person’s
day time phone number
Prescribed person’s category (refer listing in Section 5 on page 2) Prescribed person’s business name
Notes of guidance for completing this form: To be an acceptable prescribed person you must be a person listed overleaf.
Please complete all information in black ink. You (being the prescribed person) need to examine the person’s original identification
documents and certify the copy of the document by writing: ‘I certify this to be a true and correct copy of the original
document’, then record your signature, print your full name and date.
Signature of prescribed person
✗
Authenticating stampDate document(s) certified
Prescribed person’s business or workplace address
State Postcode
Form continues on next page
Section 1 – Customer Details
Full name (including any middle names) Other name(s) known by (if any) Date of birth
Title
Mr Mrs Miss Ms Other
Residential address (PO Box is not acceptable)
State Postcode Country (if not Australia)
Section 2 – Are you a resident of Australia
If No,
What is the purpose of operating an account with the Commonwealth Bank of Australia?
NoYes
CID/File reference number
003-210 110518 (CBA1382) Page 1 of 3
DD/MM/YYYY
( )
DD/MM/YYYY
To comply with identification standards you can choose to provide documents described and listed under Option A OR Option B.
Documents must be current/not expired unless specified otherwise.
If your identification documents are not in English then a translation of each document is required. All translations must be
completed by a translator who is accredited by the National Accreditation Authority for Translators and Interpreters Ltd (NAATI) or
an equivalent.
Option A: 1 x Primary Photographic Identification (is sufficient ID by itself)
•
Australian Passport (which has not been expired for 2 years or more)
• Australian or New Zealand drivers licence
• Proof of Age card - Australian State or Territory
• NSW Birth Card or NSW Photo Card
• International Passport/ Travel Document/ National Identity card
*
• Australian Government issued Firearms licence (all States)
Option B: Choose from 2 x Primary non photographic ID or 1 x Primary non photographic ID and 1 x Secondary ID
•
Australian drivers licence (without photo)
• Australian or foreign birth certificate or extract
• Australian or foreign citizenship certificate
• Centrelink pension or healthcare card OR
Secondary Identification
•
Australian Defence Force Identity Card (excluding Spouse card)
• A notice from the Commonwealth / State or Territory issued to the person and containing their name and residential address, and
records the provision of financial benefits to that person (issued within the proceeding 12 months)
• Australian Tax Office (ATO) notice containing name and residential address (issued within the proceeding 12 months)
• A utilities notice from a local government body (e.g. council rates bill) or utility (e.g. gas, electricity or water bill) provider showing name
and residential address, and records provision of services to that person (issued within the preceding 3 months)
• Overseas drivers licence
• Commonwealth / State or Territory security guard / crowd safety officer identity card
* issued by a foreign government, the United Nations (UN) or an agency of the UN
Who is a prescribed person?
For persons based in Australia:
1. A person who, under a law in force in a State or Territory, is
currently licensed or registered to practise in one of the following
occupations: Chiropractor; Dentist; Legal practitioner; Medical
practitioner; Nurse; Optometrist; Patent attorney; Pharmacist;
Physiotherapist; Psychologist; Trademarks attorney; Veterinary
surgeon
2. A person who is enrolled on the roll of the Supreme Court of
a State or Territory, or the High Court of Australia, as a legal
practitioner (however described)
3. An officer with, or authorised representative of, a holder of an
Australian financial services licence (AFSL), having 2 or more
years of continuous service with one or more licensees
4. An officer with, or a credit representative of, a holder of an
Australian credit licence (ACL), having 2 or more years of
continuous service with one or more licensees
5. Agent of the Australian Postal Corporation who is in charge of an
office supplying postal services to the public
6. Australian Consular Officer, within the meaning of the Consular
Fees Act 1955. This includes a person appointed to hold or act
in any of the following offices of the Commonwealth (of Australia)
in a country or place outside Australia: Consul-General; Consul;
Vice-Consul; Trade Representative; Consular Agent
7. Australian Diplomatic Officer, within the meaning of the Consular
Fees Act 1955. This includes a person appointed to hold or
act in any of the following offices of the Commonwealth (of
Australia) in a country or place outside Australia: Ambassador;
High Commissioner; Minister; Head of a Mission; Commissioner;
Charge d’Affaires; Counsellor, Secretary or Attache at an
Embassy, High Commissioner’s office, Legation or similar
8. Bailiff
9. Bank officer with 2 or more continuous years of service
10. Building society officer with 2 or more years of continuous service
11. Chief executive officer of a Commonwealth court
12. Clerk of a court
13. Commissioner for Affidavits
14. Commissioner for Declarations
15. Credit union officer with 2 or more years of continuous service
16. Employee of the Australian Trade and Investments Commission
who is: in a country or place outside Australia; and authorised
under paragraph 3 (d) of the Consular Fees Act 1955; and
exercising his or her function in that place
17. Employee of the Commonwealth who is: in a country or place
outside Australia; and authorised under paragraph 3 (c) of the
Consular Fees Act 1955; and exercising his or her function in that
place
18. Fellow of the National Tax Accountants’ Association
19. Finance company officer with 2 or more years of continuous service
20. Holder of a statutory office not specified in another item on this list
21. Judge of a court
22. Justice of the Peace
23. Magistrate
24. Marriage celebrant registered under Subdivision C of Division 1 of
Part IV of the Marriage Act 1961
25. Master of a court
26. Member of Chartered Secretaries Australia
27. Member of Engineers Australia, other than at the grade of student
28. Member of the Association of Taxation and Management
Accountants
29. Member of the Australian Defence Force who is: an officer; or
a non-commissioned officer within the meaning of the Defence
Force Discipline Act 1982 with 2 or more years of continuous
service; or a warrant officer within the meaning of the Defence
Force Discipline Act 1982
30. Member of the Institute of Chartered Accountants in Australia,
the Australian Society of Certified Practising Accountants or the
Institute of Public Accountants
31. Member of: the Parliament of the Commonwealth; or the
Parliament of a State; or a Territory legislature; or a local
government authority of a State or Territory.
Section 5 – Prescribed person’s categories (occupation or other persons)
Section 4 – Acceptable identification standard (personal customer)
Page 2 of 3
003-210 110518 (CBA1382)
Section 5 – Prescribed person’s categories (occupation or other persons) (continued)
For persons based overseas:
Advise customers who are outside Australia that identification documents can be certified overseas by:
1. A legal pra
ctitioner who holds a current practicing certificate under a law in force in a State or Territory in Australia
2. Commonwealth Bank of Australia officers at offshore branches with 2 or more years continuous service with Commonwealth Bank of
Australia
3. Officers of any other Australian bank or other Australian financial institution that holds either an AFSL or ACL (being either a bank,
building society or credit union) or Australian finance company with offices outside Australia where the officer has 2 or more years’
service with the relevant Australian financial institution or the relevant Australian finance company
4. A judge, magistrate, registrar or deputy registrar of an overseas court
5. An Australian consular or diplomatic officer who holds one of the following positions: Consul-General; Consul; Vice-Consul; Trade
Representative; Consular Agent; Ambassador; High Commissioner; Minister; Head of a Mission; Commissioner; Charge d’Affaires;
Counsellor, Secretary or Attache at an Embassy, High Commissioner’s office, Legation or similar.
6. A member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the
Institute of Public Accountants with 2 or more years of continuous membership.
7. A person authorised as a notary public in a foreign country
8. Employee of the Australian Trade and Investment Commission who is: in a country or place outside Australia; and authorised under
paragraph 3 (d) of the Consular Fees Act 1955; and exercising his or her function in that place
9. Employee of the Commonwealth who is: in a country or place outside Australia; and authorised under paragraph 3 (c) of the Consular
Fees Act 1955; and exercising his or her function in that place.
32. Minister of religion registered under Subdivision A of Division 1 of
Part IV of the Marriage Act 1961
33. Notary public
34. Permanent employee of the Australian Postal Corporation with 2
or more years of continuous service who is employed in an office
supplying postal services to the public
35. Permanent employee of: the Commonwealth or a
Commonwealth authority; or a State or Territory or a State or
Territory authority; or a local government authority; with 2 or
more years of continuous service and the person is not already
specified in another item on this list
36. Person before whom a statutory declaration may be made under
the law of the State or Territory in which the declaration is made
37. Police officer
38. Registrar, or Deputy Registrar, of a court
39. Senior Executive Service employee of: the Commonwealth or
a Commonwealth authority; or a State or Territory or a State or
Territory authority
40. Sheriff
41. Sheriff’s officer
42. Teacher employed on a full-time basis at a school or tertiary
education institution
43. Member of the Australasian Institute of Mining and Metallurgy
003-210 110518 (CBA1382) Page 3 of 3
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Certified Copies Identification Form (Commonwealth Bank of Australia)

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Completed 16 April 2021

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