Fillable Form 2.: Customer Authority Forms for an HSBC (Australian National University)

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Form 2.: Customer Authority Forms for an HSBC (Australian National University)

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File type: PDF

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Customer Authority Forms for an HSBC Account
To add an HSBC account to The BankLink Service you need to complete two forms – the usual BankLink one,
and a separate HSBC form. To make it easier BankLink has combined the two, so that when you complete
the details below, they are populated correctly on both forms.
Follow these steps to sign an HSBC account up to The BankLink Service:
1. Complete the details below to ensure that all the spaces on the attached autho
rity forms are correctly
filled out
2.
Print the forms out
3. Sign and date the BankLink Customer Authority, and page two of the HSBC form
4. Keep this page for your records and send the forms to your accountant
BankAccountName(AccountTitle) Service Start Month and Year
BankandBranch
SortCode  AccountNumber Client Code/Cost Code
Account Signatories (please enter full names)
Service Frequency: Monthly Weekly (where available) Daily (where available)
Please supply the account above as a Provisional Account if it is not available from the bank
Address Line 1
Address Line 2
Address Line 3
Address Line 4
Postal Code
Practice Name Practice Code
Keep this page for your records and send the forms to your accountant
20
Name of Account Signatory 1
Name of Account Signatory 2 (if required)
✔
Reset Form
BankLink
(A Division of Media Transfer Services UK Limited)
Send completed form to:
BankLink
9 Devonshire Square
London EC2M 4YF
Name of Account
Client Code
Account Number
Cost Code
BANKLINK CUSTOMER AUTHORITY
To:
The Manager, and The General Manager,
Media Transfer Services UK Limited
(“BankLink”)
(Bank) (Branch)
(“the Bank”)
1. I/We hereby AUTHORISE the Bank and BankLink (acting as a data processor) as at and from the first of 20 to forward all data and
information (whether in written, computer readable or any other format) relating to my/our banks account/s designated above to each other and to
(“my/our advisors”) Practice Code
2. About your personal information: I/We UNDERSTAND that my/our personal data and information will be transferred outside of Europe (including to New
Zealand and Australia) for the purposes of BankLink and its service partners processing my/our data in order to provide the BankLink services. I/We
understand that my/our personal data will be kept secure and confidential and that BankLink will not pass my/our details to third parties other than for
the provision of the BankLink services. I/We UNDERSTAND that information about BankLink's privacy practices and policy can be found at:
3. I/We UNDERSTAND that:
www.banklink.co.uk/privacy
a) no agency, partnership, joint venture or any other type of similar relationship exists between the Bank and BankLink and that the Bank accepts no
responsibility for the actions of BankLink, my/our advisors or any other third party;
b) neither the Bank nor BankLink will, subject to any prohibition or limitation imposed by law, be liable for delays, non-performance, failure to perform,
processing errors or any other matter or thing arising out of this authority or any agreement which the Bank or BankLink may have with my/our
advisors and which occur for reasons beyond the control of respectively the Bank or BankLink, as the case may be, nor will the liability of the Bank
and/or BankLink (whether jointly, severally or jointly and severally) include or extend to any loss of profit or any special, indirect or consequential
loss or damage suffered by me/us.
4. I/We have the right, power and authority, and have taken all actions necessary, to execute and deliver this customer authority form. I/We confirm and
agree that where the customer is a company or LLP a resolution of the company/LLP has been passed to approve the terms of this customer authority
form in the best interests of the company/LLP.
5. I/We CONFIRM and agree that this customer authority form does not in any way limit or affect the existing authorities to the Bank for operations on the
aforegoing Account(s).
6. I/We ACKNOWLEDGE that the Bank will receive a commission from BankLink for disclosing the data and information referred to above, and that the Bank
is under no obligation to me/us to supply the data and information referred to above to BankLink, and may cease to do so without notice to me/us.
7. This authority is terminable by any or both of the Bank or BankLink at any time where seven (7) days notice is given to me/us on any grounds thought fit,
without rendering the Bank and/or BankLink liable in any way. Where required for legal or security reasons the Bank shall be entitled to suspend the
service immediately.
8. Any revocation of this authority by me/us will not take effect until 14 days after written notice of the revocation is received by the Bank from me/us.
By signing below:
• I/We consent to my/our data being used as detailed in the 'about your personal information' section above.
• I/We authorise the Bank and BankLink to act in accordance with this customer authority form.
Dated this …………… day of ……………………………………………. 20……….
………………………………………………………………………………… ………………………………………………………………………………
(Account signatory) (Account signatory)
………………………………………………………………………………… ………………………………………………………………………………
(Witness) (Witness)
Additional information to assist BankLink processing
Please supply the account above as a Provisional Account if it is not available from the Bank
Service frequency:
Monthly
Weekly (where available)
Daily (where available)
✔
(Print name)
(Print name)
Accounts and Services
Amendment Schedule
For Bank Use Only: CIN
10 June 2009
Indicates mandatory field
Customer Details
Full Customer Name
Address
Postal Code
Principal Contact
Section 1
Agreement Authorisation
I/We refer to the HSBCnet Customer Agreement between the Customer and the Principal Bank and confirm that the Accounts
and Services Schedule shall be amended in accordance with the attached Accounts and Services Schedule and that the Terms
and Conditions shall be supplemented by the Terms and Conditions attached (if any) which shall be deemed to form part of
the HSBCnet Customer Agreement as of the date set out below.
Signed for and on behalf of the Customer
Full Name in BLOCK Letters
Job Title
Signature of Authorised Representative
Date
Full Name in BLOCK Letters
Job Title
Signature of Authorised Representative
Date
E-mail Confirmation on the HSBCnet Amendment Schedule
If you would like to receive confirmation about the completion of the amendment, please specify
the e-mail address of the contact person(s) here:
E-mail address 1
E-mail address 2
Amendment reference
Page 1 of 4
MEDIA TRANSFER SERVICES UK LTD
9TH FLOOR
3 HARDMAN STREET
MANCHESTER
M3 3HF
KATHRYN APPLETON
KATHRYN APPLETON
CLIENT SERVICES ADMINISTRATOR
LEAVE BLANK
LEAVE BLANK
clientservices@banklink.co.uk
LEAVE BLANK
LEAVE BLANK
1074493796
For Bank Use Only: CIN
10 Jun e 2009
Customer Details
Full Customer Name
Principal Bank
(ie Customer’s Bank)
Section 2
Full Name in BLOCK Letters
Job Title
Signature of Authorised Representative
Date
Full Name in BLOCK Letters
Job Title
Signature of Authorised Representative
Date
Customer Associate Letter of Authority
To: Principal Bank From: Customer Associate
Account Holding Bank(s) (named on the Customer Associate Accounts and Services Schedule)
The Customer has entered into an agreement with the Principal Bank (the ‘Customer Agreement’) under which the Customer may use the
HSBCnet system from time to time (the ‘System’) to access, viewon certain bank accounts. We have appointed theCustomer as our agent
to access our accounts defined in the attached Accounts and Services Schedule, any other accounts referred to inClause 13.1 of the Customer
Agreement, or such other accounts as may be notified to you by the Customer or Customer Associate fromWLPHWRWLPHWKHµ$FFRXQW¶LQ
accordance with this Customer Associate Letter of Authority.
1. We hereby authorise the Principal Bank and the Account Holding Bank to provide the Customer with access to the
Accounts, in accordance with this Customer Associate Letter of Authority.
2. We confirm the Customer is entitled to viewon and use the other services available via the System from time to time in relation to
the Accounts. We confirm the Customer is entitled to agree, on our behalf, applicable terms from time to time, relating to the access and
use of the Accounts.
3. We represent and warrant that we have full legal and corporate authority to appoint the Customer for the purposes stated herein.
We shall be bound by all actions of the Customer taken in respect of the Accounts and shall ratify and confirm all things done by the
Customer on our behalf in accordance with the purposes stated herein.
The appointment of the Customer shall remain in full force and effect until the day following seven days after the Principal Bank
receives written notice of revocation, signed by our authorised signatory or signatories, or until termination of the appointment of the
Customer by operation of law.
We have taken all necessary action to authorise the entering into of this Customer Associate Letter of Authority, the person(s)
who sign below have been duly authorised to sign this Customer Associate Letter of Authority, and the Customer Associate Letter of
Authority and such authorisations are in accordance with the applicable constitutional documents of the Customer Associate.
This Customer Associate Letter of Authority is governed by and will be construed in accordance with the Governing Law set out in
the section entitled Principal Bank and Governing Law. The parties irrevocably submit to the non-exclusive jurisdiction of the courts
of that named jurisdiction in respect of any proceedings which may be initiated in connection with this Customer Associate Letter
of Authority.
Signed for and on behalf of the Customer Associate
Customer Associate
This Customer Associate section should be completed for each separate legal entity
whose accounts will be reported on HSBCnet for the Customer to access. You may
copy this section if you have more than one Customer Associate.
Customer Associate Details
Enter the Full legal name of the customer associate whose accounts are to be loaded to
the customer’s HSBCnet portfolio
Customer Associate
Name
Address
Postal Code
Page 2 of 4
1074493796
MEDIA TRANSFER SERVICES UK LTD
HSBC BANK PLC
For Bank Use Only: CIN
10 June 2009
Section 3
Page 3 of 4
Customer Associate Accounts and Services Schedule
Customer Associate Name
Please enter the name of the account holding bank for the accounts listed below. You may copy this page
if you have accounts with more than one bank.
Account Holding Bank
Please indicate below which of your accounts you wish to make available through HSBCnet and for
which Services.
Account Details
Country/Bank/Branch Name Bank Code Account Number Currency Account Title
Note: Please cross through any unused boxes
Tick one of the following options. Print additional pages if your require more than one type of amendment.
If you wish to ADD the accounts listed below to your HSBCnet profile, please tick this box
If you wish to CHANGE the services available on the accounts listed below, please tick this box
If you wish to DELETE the accounts listed below from your HSBCnet profile, please tick this box
If you select ‘Change’, the services specified will supersede the existing services entitlement for the
relevant accounts.
Services
BTR
✔
✔
1074493796
HSBC BANK PLC
GBP
For Bank Use Only: CIN
10 June 2009
Page 4 of 4
Standard Tariff E-trade Monthly Fee
Restricted Tariff Set-up Fee
N.B. (Please complete the invoicing form if default prices are not applicable, in the absence of
information, default pricing will apply)
Billing Account (sort code-account number)
Billing Address: As per page 1
RM Code
Section 4
Relationship Manager Sign Off – For Bank Use Only
Customer Name
CIN Number
(Delete as appropriate)
Customer Type
Sales Manager
Limits
Approved daily BACS limit
Approved daily Priority Payments/
Currency Transfer/Daylight
Overdraft limit
STC limit
Max
£750,000.00 - only applicable for STC clients
Sterling and Currency Limits
Currency Limits MUST be expressed in all currencies where the customer has an account and has requested
payment functionality. Each currency net debit limit may be equal to but not more than the Approved daily
Priority Payments/Currency Transfer/Daylight overdraft limit. Use the bank’s current notional rates.
Currency Code Net Debit Limit
G B P
Sales Manager Code
Authorisation: I confirm that :
• The agreement and any/all Customer Associate Letters of Authority have been signed in accordance
with the customers’ respective bank mandates and HSBCnet signing rules
• All required KYC Checks have been completed
• The limits stated in this section have been approved/sanctioned and are to be placed on HSBCnet
RM Signature
Print Name
Date
RM Location/Sort Code
RM Telephone Number
Telephony Training
Training Visit
GTE/SDC Omnibus Counter Indemnity and associated Facility Letter is in place (tick if applicable).
E-GTE/SDC Fee £
£
£
£
£
£
Get Rate Supplementary Details
New customer to HSBC?
Number of foreign exchange payments per annum
Average size of foreign exchange payment
Get Rate Limits
Daily Transaction Limit
(within Daily Priority Payment Limit) – Cannot exceed GBP500,000
A foreign exchange payment is any payment sent in a currency which is different to the currency of the account
from which it is made eg a GBP payment from a euro account or a euro payment from a US dollar account.
£
CMBM/CMCB/CMCM/CMCS/CMMS
GBFI/GBCO/GBMN/GBPS/GBMS/CMBB/
Yes No
MEDIA TRANSFER SERVICES UK LTD
1074493796
1074493796
N\A
N\A
PETER RUTLAND
400899
400226-22493969
A89
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Form 2.: Customer Authority Forms for an HSBC (Australian National University)

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Completed 29 July 2021

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