Fillable Identication form How to complete this form Step (Australian National University)

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Identication form How to complete this form Step (Australian National University)

On average this form takes 13 minutes to complete

The Identication form How to complete this form Step (Australian National University) form is 2 pages long and contains:

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  • 6 check-boxes
  • 49 other fields

Country of origin: AUSTRALIA
File type: PDF

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Page 1 of 2
|
ING IM020
|
03/20
ING is a business name of ING Bank (Australia) Limited
|
ABN 24 000 893 292
|
AFSL and Australian Credit Licence 229823
List A
• Australian Drivers Licence (must be current, show current
residential address and photograph)
• Proof of Age Card / NSW Photo Card (must be current and
show date of birth and photograph)
• An Australian Passport (either a current passport or a
passport that expired within the last 2 years)
• International Passport (current, containing a photograph
and a signature and accompanied by a translation from
a Professional Translator accredited by the National
Accreditation Authority for Translators and Interpreters if
not in English)
List B
• Pension Card (must be current and issued by Centrelink
entitling financial benefits)
• Australian Tax Oce Tax Assessment Notice (issued in the
last 12 months and shows current residential address)
• A water rates or council rates notice (issued by a local
government body or utilities provider within the last 3
months showing current residential address)
• A landline telephone, gas or electricity notice (issued by a
utilities provider within the last 3 months and shows current
residential address)
• A bank statement (issued by an Australian bank in the last
12 months. Please note printouts of online statements are
not accepted)
• A government financial benefits notice; eg Centrelink (issued
in the last 12 months and shows current residential address)
• Medicare Card (must be current)
• Birth Certificate or Birth Extract (issued by a State or Territory
in Australia)
• A Citizenship Certificate (issued by the Commonwealth
of Australia)
Choose 2 documents from the lists below. At least 1 must be from List A.
The documents must verify the following details as provided in Step 1:
- Applicant’s full name; and
- Residential address or date of birth
Mr Mrs Ms Miss Other (please specify)
Surname First name Middle name
Date of birth (DD/MM/YYYY)
/ /
Residential address
Unit number Street number Street name
Suburb State Postcode
How to complete this form
Step 1 Record details of the person being identified
Step 2 Collect the required identification documents (originals only)
Step 3 Record the identification documents provided and verify that the person’s details match the identification documents
Step 4 Sign the form
Step 5 Provide a copy of the identification documents and the completed Identification Form to ING
Identification form
Step 1: Applicant details
Step 2: Collect the required identification documents
Page 2 of 2
|
ING IM020
|
03/20
ING is a business name of ING Bank (Australia) Limited
|
ABN 24 000 893 292
|
AFSL and Australian Credit Licence 229823
Record details of each identification document viewed (COPIES OF ALL DOCUMENTS MUST BE PROVIDED TO ING)
LIST A DOCUMENT
Document type
Name verified? Yes No
Document number Date of birth verified? Yes No
Document issue date Residential address verified? Yes No
Document expiry date Photograph verified? Yes No
LIST A OR LIST B DOCUMENT
Document type Name verified? Yes No
Document number Date of birth verified? Yes No
Document issue date Residential address verified? Yes No
Document expiry date Photograph verified? Yes No
Step Verification Information
Has verification been achieved? Yes No
Is there a need to file a Suspicious Matter Report? Yes No
Date identification took place (DD/MM/YYYY) / /
By signing this form I confirm that;
I have interviewed the above mentioned applicant Face to Face and sighted the original identification documents outlined
above; or
I have interviewed the above mentioned Applicant via video technology and have sighted the Applicant and the
identification documents outlined above using that technology. I further confirm that the identification documents in the
video appear to be the same documents as the copies that have been provided to me and that the likeness of the Applicant is
reasonably identical to the Applicant’s image in those identification documents.
Signature of Introducer / Broker / ING employee
Name of Introducer / Broker / ING employee
Broker number
Date (DD/MM/YYYY) / /
Note: It is an oence under the Anti-Money Laundering / Counter-Terrorism Financing Act 2006 to provide a false or misleading statement,
produce a false or misleading document, to receive an ING product in a false name or to fail to disclose any other name or names you are
commonly known by.
Step 3: Verification Information
Step 4: Summary
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Identication form How to complete this form Step (Australian National University)

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Completed 6 August 2021

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