Page 1 of 8 PC2625 (01/15) 425352 Intranet
Business Telephone Banking – Registration Form
Our privacy policy is available at westpac.com.au or by calling 132 032 and covers how we handle your personal information.
Completed form
For fastest connection
Return to the branch for signature verification and approval
If you need help completing this form – please call Business Direct on 132 142.
Section 1 Service Owner
Please provide the full names of all individuals, trustees, business proprietor or organisations (company, society, club or association) and
ABN/ ACN/ARSN/ARBN if applicable. The Business Telephone Banking service will be established under the details entered below.
Full Name of Service Owner (eg. John Smith Pty Ltd or John Smith Trading As J S Plumbing)
Organisation 8 digit customer number ABN/ACN/ARSN/ARBN (if applicable)
Section 1a Mailing Address
Unit no. Street no. Street name or PO Box City, Town or Suburb
State Postcode Country (if not Australia)
Section 1b Contact Person
Please enter the details of the main Contact Person
Title (e.g. Mr. Mrs) Given name(s) Surname
Personal 8 digit customer number Contact phone number Email address
( )
Note 1: All mail relating to the service will be addressed to this person
Note 2: If the Contact Person does not have an existing 8 digit customer cumber they must visit a Westpac branch to obtain one.
Westpac Banking Corporation ABN 33 007 457 141 AFSL 233714
RESET
Page 2 of 8 PC2625 (01/15) 425352 Intranet
Section 2 Account and User Access Details
In this section, provide the details of up to two Users and nominate their levels of access to each account via Business Telephone
Banking.
Please note, when establishing Business Telephone Banking under your existing Personal customer number, all your existing personal
accounts need to be added to Business Telephone Banking. If not, your personal accounts will no longer be available when accessing
Business Telephone Banking. To perform all required business telephone banking functions, please ensure the correct level of access
is assigned to yourself and all other Users.
To add more than two Users or more accounts, complete a blank copy of the following page and add to this form.
Code Access Level for Users Business Telephone Banking
V
Value Access Allows a User to:
Conduct a balance enquiry;
Obtain transaction details and statements on the account;
debit the account by;
funds transfers
B
PAY payments
periodical payments
change contact details;
order cheque and deposit books;
order voucher retrievals;
request duplicate statement;
change the statement cycle;
make a tracing request;
stop cheques;
request Term deposit advices.
N
Non Value Access Allows a User to:
Conduct a balance enquiry;
Obtain transaction details.
NO
No Access
Note: If you are adding multiple accounts for different Third Parties, and either you or one or more of these Third Parties do
not wish for their details to be disclosed to the other Third Parties, you may add these accounts through a separate
Administration Form, once the Service has been established.
Page 3 of 8 PC2625 (01/15) 425352 Intranet
Section 2a User Details (User 1)
Given name(s) Surname User 1 personal 8 digit customer no.
Existing Westpac customers can find their customer number on any bank account statement. If the nominated User does not have an
8 digit customer number, they must visit a Westpac branch to obtain one.
List accounts to be accessed by User 1
Nominate the level of access that this User will be given to each account via Business Telephone Banking. The account access levels
are defined in the table on page 2.
To perform all required business telephone banking functions, please ensure the correct level of access is assigned to yourself and
all other Users. Please note, when establishing Business Telephone Banking under your existing Personal customer number, all
your existing personal accounts need to be added to Business Telephone Banking. If not, your personal accounts will no longer be
available when accessing Business Telephone Banking.
Account Name BSB Account Number
Access Level
Telephone
Banking
(Tick one
per account)
Is the Account
Name identical
to the Service
Owner Name?
V N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
Credit Card Owner Credit Card Number
V N NO Yes No
V
N NO Yes No
Please note the following access restrictions:
Account type
Maximum level of access
(Account Holder)
Maximum level of access
(other users)
Mortgages and personal credit cards Value Non value
Business Choice Billing accounts and
Employee Benefits Cards
Value Non Value
Business or Commercial credit cards Non Value Non Value
If ‘No’ is
selected,
ensure a Third
Party Access
Authority is
completed in
Section 4 for
each Third
Party Account
Holder
Page 4 of 8 PC2625 (01/15) 425352 Intranet
Section 2b User Details (User 2)
Given name(s) Surname User 1 Personal 8 digit customer no.
Existing Westpac customers can find their customer number on any bank account statement. If the nominated User does not have an
8 digit customer number, they must visit a Westpac branch to obtain one.
List accounts to be accessed by User 2
Nominate the level of access that this User will be given to each account via Business Telephone Banking. The account access levels
are defined in the table on page 2.
To perform all required business telephone banking functions, please ensure the correct level of access is assigned to yourself
and all other uses. Please note, when establishing Business Telephone Banking under your existing Personal customer number, all
your existing personal accounts need to be added to Business Telephone Banking. If not, your personal accounts will no longer be
available when accessing Business Telephone Banking.
Account Name BSB Account Number
Access Level
Telephone
Banking
(Tick one
per account)
Is the Account
Name identical
to the Service
Owner Name?
V N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
V
N NO Yes No
Credit Card Owner Credit Card Number
V N NO Yes No
V
N NO Yes No
Please note the following access restrictions:
Account type
Maximum level of access
(Account Holder)
Maximum level of access
(other users)
Mortgages and personal credit cards Value Non value
Business Choice Billing accounts and
Employee Benefits Cards
Value Non Value
Business or Commercial credit cards Non Value Non Value
If ‘No’ is
selected,
ensure a Third
Party Access
Authority is
completed in
Section 4 for
each Third
Party Account
Holder
Account Name BSB Account Number
Access Level
Telephone
Banking
(Tick one
per account)
Is the Account
Name identical
to the Service
Owner Name?
V N NO Yes No
V N NO Yes No
V N NO Yes No
V N NO Yes No
V N NO Yes No
V N NO Yes No
V N NO Yes No
Credit Card Owner Credit Card Number
V N NO Yes No
V N NO Yes No
Please note the following access restrictions:
Account type
Maximum level of access
(Account Holder)
Maximum level of access
(other users)
Mortgages and personal credit cards Value Non value
Business Choice Billing accounts and
Employee Benefits Cards
Value Non Value
Business or Commercial credit cards Non Value Non Value
If ‘No’ is
selected,
ensure a Third
Party Access
Authority is
completed in
Section 5 for
each Third
Party Account
Holder
Page 5 of 8 PC2625 (01/15) 425352 Intranet
Section 3 Third Party Access Authority
This section is to be completed by Third Party Account Holders to authorise access to their accounts, through Business Telephone
Banking, which are listed in Section 2, in accordance with the terms of this authority.
A Third Party account is an account which is in a different name to the Service Owner. Westpac’s Business Telephone Banking primary
relationship is with the Service Owner, hence additional Account Holders whose accounts are linked to this service are considered
Third Parties to that relationship, regardless of ownership, control or signatories for those Account Holders.
Please ensure that each separate Account Holder that is different to the Service Owner completes and signs an authority in
this section.
Execution of Third Party Access Authority
It is mandatory for the Executive Officers of each Third Party Account Holder to complete this section.
We agree that:
(a) The Service Owner (through its Executive Officers) is authorised to appoint and/or remove User(s)’ access to my/our accounts
listed in Section 2; and/or
(b) Westpac is authorised to act upon all instructions and requests made by the authorised Service Owner, through its User(s), to effect
transactions on my/our account(s) listed in Section 2 via Business Telephone Banking;
(c) Westpac is authorised to treat any transaction on my/our account(s) listed in Section 2 and effected via Business Telephone
Banking made by the authorised Service Owner, through its User(s), as a transaction that is undertaken with my/our authority
without Westpac being required to verify my/our authority in any case;
(d) Westpac is not required to check the accuracy of any instructions, requests to effect transactions, notifications or requests made
by the authorised Service Owner, through its User(s), effected via Business Telephone Banking on my/ our account(s) listed in
Section 2;
(e) In consideration of Westpac so acting I/we release Westpac from all actions, suits, proceedings, claims, costs and demands that
may be made, brought or incurred by or against Westpac arising from any unauthorised or incorrect instructions or requests to
effect transactions through Business Telephone Banking on my/our account(s) listed in Section 2;
(f) This authority applies to the access of my/our account(s) listed in Section 2 through Business Telephone Banking. It is in addition to
and not in substitution for any other Notice of Authority provided to Westpac concerning the operations on any account(s) held by
us. Amendments to other authorities that we may have with Westpac now or in the future shall not affect this authority which is to
continue in full force and effect until Westpac receives a written notice of cancellation of this authority;
(g) By a legally constituted meeting of the Third Party Account Holder(s) or Directors of the company (as the case may be), authority
was given to Westpac and the authorised Service Owner to act in accordance to the terms of this authority.
The Third Party Account Holder gives authority to Westpac and the authorised Service Owner to act in accordance with the terms
of this authority.
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Section 3 Third Party Access Authority – Continued
Each separate Third Party whose accounts are linked to this service must complete and sign a Third Party Account Holder section
on this page. This page allows two Third Party Account Holders to sign the form. If you require space for more Third Parties or
signatories, please copy a blank version of this page and attach it to the end of this form.
Third Party Account Holder #1
(name of the Account Holder that owns the account(s) and is granting access via this authority e.g. John Smith Pty Ltd or John Smith Trading as J Smith Plumbing)
8 Digit Customer Number
(8 Digit Customer Number of the Third Party Account Holder)
This authority is signed for and on behalf of the Third Party Account Holder
Account Holder / Executive Officer #1
(e.g. Sole Trader, Partner, Director, Trustee)
Account Holder / Executive Officer #2
(e.g. Sole Trader, Partner, Director, Trustee)
Name Name
Position Position
Signature
Date
Signature
Date
/ /
/ /
Personal 8 digit customer number
Personal 8 digit customer number
Third Party Account Holder #2
(name of the Account Holder that owns the account(s) and is granting access via this authority e.g. John Smith Pty Ltd or John Smith Trading as J Smith Plumbing)
8 Digit Customer Number
(8 Digit Customer Number of the Third Party Account Holder)
This authority is signed for and on behalf of the Third Party Account Holder
Account Holder / Executive Officer #1
(e.g. Sole Trader, Partner, Director, Trustee)
Account Holder / Executive Officer #2
(e.g. Sole Trader, Partner, Director, Trustee)
Name Name
Position Position
Signature
Date
Signature
Date
/ /
/ /
Personal 8 digit customer number
Personal 8 digit customer number
Page 7 of 8 PC2625 (01/15) 425352 Intranet
Section 4 Authorisation and Acknowledgement – Service Owner
Executive Officer(s) of the Service Owner must read and sign this section
Acknowledgement
I/We acknowledge that I/we have read the Business Telephone Banking Terms and Conditions.
I/We agree that the accounts that have been listed on this form are to be added to the authorised Business Telephone Banking
service detailed on this Authority.
I/We undertake to ensure that we will inform the Third Party Account Holder(s) as soon as practicable should any changes be made
to the User(s), their access revoked or the individual cease to be an employee of the authorised Service Owner of this Business
Telephone Banking service.
I/We declare that the information that has been provided in this form is to the best of our knowledge and belief true and accurate.
Signed for and on behalf of the Service Owner
Account Holder / Executive Officer #1
(e.g. Sole Trader, Partner, Director, Trustee)
Account Holder / Executive Officer #2
(e.g. Sole Trader, Partner, Director, Trustee)
Name Name
Position Position
Signature
Date
Signature
Date
/ /
/ /
Personal 8 digit customer number
Personal 8 digit customer number
Note: if you require space for more signatories, copy a blank version of this page and attach to the end of this form.
Page 8 of 8 PC2625 (01/15) 425352 Intranet
Section 5 Westpac Use Only
Verified and Approved By (Westpac Approving Officer)
Verifying
Branch Stamp
Required
Name
Position
Salary no. BSB Fax no.
Signature
Date
/ /
Westpac Employee Checklist (Branch)
Are all required signatures present and verified against the Account Opening Form(s)?
Is the customer requesting access to one or more Third Party accounts? (i.e. Are the Account Names listed in sub-sections 2a and
2b, and/or additional attachments, different to the Service Owner’s name) – If yes, please ensure that Section 3 is completed and
signed by each Third Party.
Have you completed all fields in the ‘Verified and Approved by’ section above? (If this section is incomplete, this request will be
returned to you for completion)
Have you placed your branch stamp in the ‘Verified and Approved by’ section above? (If this section is not stamped, this request
will be returned to you for completion)
Are all Users (new and existing) identified appropriately with the identification status of ‘WBC Identified’?
If establishing Business Telephone Banking under their personal customer number that all personal accounts requiring access
have been added to the Business Telephone Banking registration form. If not, these accounts will not be available to use and
view accessing Business Telephone Banking.
Westpac Use Only
Once the ‘Westpac Employee Checklist’ has been completed and all signatures have been verified,
please fax this application to the Access Authorities Team on 1300 655 471.
NOTE: If the persons signing the form cannot produce an 8 digit Customer Number, please confirm if they are existing Westpac
customers. If they are not please identify the customer accordingly and issue a new 8 digit Customer Number.
Important Note: This document is a permanent customer record and must be retained for the period stated in the
Records Management policy