A sample Disclosure Certificate is set out below



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Customer Information Certificate – Trust other than Standard Trust

This Customer Information Certificate is to be used for trusts other than Standard trusts. This includes:

• Self Managed Super Fund (SMSF) – a trust structure that can be used to manage retirement savings on behalf of its members and is regulated by the Australian Taxation Office (ATO).

• Registered Managed Investment Scheme – a scheme registered with ASIC to which people make contributions and in return acquire rights to benefits produced by the scheme, where the contributions are to be pooled, or used in a common enterprise, to produce financial benefits for the people who hold interests in the scheme. All registered managed investment schemes must hold an Australian Registered Scheme Number (ARSN) issued by ASIC.

• APRA Regulated Trust – a trust that is licensed and subject to regulatory oversight by the Australian Prudential Regulation Authority (APRA), in relation to its activities as a trust.

• Government Superannuation Fund – a trust that is a superannuation fund for Government employees established by legislation often referred to as public sector superannuation funds.

Note: Custodian/nominee/manager/agent information is required where there is an arrangement under which a custodian/nominee/manager/agent has been formally appointed by the trustee/Responsible Entity (RE) to act on its behalf

in a limited capacity or in a specific manner. This includes providing to the Bank the applicable agreement which sets out

the arrangement.

|Please note that this certificate may have been pre-populated with information that the Bank has previously collected from |

|the customer. In completing this form you are responsible for completing any blank sections, checking the accuracy of any |

|pre-populated section, informing us if any of the information is not correct and supplying the correct information in substitution. |

| |Bank use |

| |only (initials) |

|1 |Is the trust/fund a SMSF, a registered managed investment | Yes ( Go to 2 |      |

| |scheme, an APRA regulated trust or a government |No ( Complete the Customer Information Certificate for a | |

| |superannuation fund as defined above? |Standard Trust | |

|2 |Full name of the trust/fund (e.g. The XYZ Managed Fund or The|      |      |

| |XYZ Managed Investment Scheme) | | |

|3 |Full name of trustee(s) or full name of the Responsible |      |      |

| |Entity (RE) for a registered managed investment scheme | | |

|4 |Are all trustee(s)/RE existing Westpac customers? | Yes |      |

| | |No ( Complete the applicable Customer Information Certificate | |

| | |for any trustee/RE who is not an existing Westpac customer | |

|5 |In respect of the trust/fund, do the trustee(s)/RE have a | Yes (       (insert registered business name) |      |

| |business name, other than the trustee/RE name(s), registered |No | |

| |with ASIC? (select one) | | |

|6 |For the purposes of the product/service (e.g. account) being | No/Not applicable ( Go to 9 |      |

| |offered to the trust/fund by the Bank, has a |Yes (select one) | |

| |custodian/nominee/manager/agent been appointed to act on |Custodian ( Go to 7 | |

| |behalf of the trustee/RE in accordance with a |Nominee ( Go to 7 | |

| |custodian/nominee/ management/agent agreement? |Manager ( Go to 7 | |

| | |Agent ( Go to 7 | |

|7 |Full name of custodian/nominee/manager/agent |      |      |

|8 |Is the custodian/nominee/manager/agent an existing Westpac | Yes |      |

| |customer? |No ( Complete the applicable Company Customer Information | |

| | |Certificate | |

|9 |Full address of the principal place of business of the |      |      |

| |trust/fund (not a PO box) | | |

|10 |Country in which the trust/fund was established |      |      |

|11 |Does the trust/fund have an ABN? | Yes (insert ABN) (       |      |

| | |No | |

|12 |Is the trust/fund a tax resident of any country outside of | Yes |      |

| |Australia? |No ( Go to 14 | |

|13 |Country(ies) outside of Australia in which the trust/fund is |Country of tax residence:       |      |

| |a resident for tax purposes and country’s associated Tax |TIN:       | |

| |Identification Number (TIN)* |OR | |

| | |TIN not issued by this country | |

| |*A TIN is an identifying number or equivalent used for tax |TIN pending issue by country's tax authority | |

| |purposes. If a ‘TIN’ is not available, please specify the |Country of tax residence:       | |

| |reason against the appropriate country. |TIN:       | |

| | |OR | |

| |Note: If the trust/fund has more than 3 countries in which it|TIN not issued by this country | |

| |is a tax resident, please provide the details on a separate |TIN pending issue by country's tax authority | |

| |paper. |Country of tax residence:       | |

| | |TIN:       | |

| | |OR | |

| | |TIN not issued by this country | |

| | |TIN pending issue by country's tax authority | |

|14 |Is the trust/fund a self-managed super fund (SMSF) regulated | Yes ( Go to 21 |      |

| |by the ATO? |No ( Go to 15 | |

|15 |Is the trust/fund licensed and subject to regulatory | Yes ( Go to 16 |      |

| |oversight by the Australian Prudential Regulation Authority |No ( Go to 17 | |

| |(APRA), in relation to its activities as a trust/fund? | | |

|16 |The registration number issued by APRA to the Registrable |      |      |

| |Superannuation Entity (RSE), i.e. registration number issued | | |

| |to the trust/fund | | |

|17 |Is the trust/fund a Registered Managed Investment Scheme, | Yes ( Go to 18 |      |

| |i.e. a scheme registered with ASIC and holds an Australian |No ( Go to 19 | |

| |Registered Scheme Number (ARSN)? | | |

|18 |ARSN |      |      |

|19 |Is the trust/fund a Government superannuation fund, i.e. a | Yes ( Go to 20 |      |

| |superannuation fund for Government employees established by |No ( Go to 21 | |

| |legislation? | | |

|20 |Name of the legislation establishing the Government |      |      |

| |superannuation fund | | |

|21 |Full name of person providing this certificate |      |

|22 |Capacity of person providing this certificate | Trustee/RE/Custodian/Nominee/Manager/Agent/Company Director |

| |(select appropriate box) |Trustee/RE/Custodian/Nominee/Manager/Agent/Company Secretary |

| | |Authorised representative (e.g. solicitor, accountant) |

|23 |Certification |

| |I hereby certify that: |

| |1. I am authorised to complete this certificate on behalf of the Customer; |

| |2. The details included in this certificate are true and correct as at the date of this certificate; |

| |3. All documents in the possession or control of the Customer that verify the information in this certificate have been supplied to the Bank and |

| |all documents so supplied are true and correct as at the date of this certificate; and |

| |4. I acknowledge that the Bank will rely on this certificate to determine whether to provide services to the Customer in compliance with the law. |

|24 |Signature of person providing this certificate |( |

|25 |Date |   /    /      |

Privacy Statement: The personal information the Bank is collecting from you on this form will be used to satisfy the Bank’s identification requirements under the Anti-Money Laundering & Counter-Terrorism Financing Act and Rules. If you do not provide all the information requested, the Bank may not be able to provide any product or service to the Customer. The Bank will use and disclose your personal information to other members of the Westpac Group, anyone the Bank engages to do something on its behalf, and other organisations that assist us with our business which may include organisations located outside of Australia and to government agencies and regulators, in some cases offshore. Details are in the Bank’s privacy policy. The Bank’s privacy policy, available at .au or by calling 132 032 (or from overseas +61 2 9293 9270), contains information about how the Bank handles your personal information, how you can access the personal information the Bank holds about you and seek its correction, how you may complain about a breach of the Australian Privacy Principles and how the Bank will deal with your complaint.

You agree that where you have provided personal information about other individuals in this form you will tell those individuals that you have supplied their information to the Bank and make them aware of the contents of this Privacy Statement and that for each Beneficial Owner whose email address has been provided to the Bank you have made them aware of, and obtained their consent to, the Bank contacting them by email for the purpose of each Beneficial Owner electing to proceed with the Bank conducting online verification of their identity to satisfy the Bank’s identification requirements.

Westpac Group means Westpac Banking Corporation and its related bodies corporate.

Note: It is an offence under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 to knowingly provide false or misleading information or knowingly produce a false or misleading document. Penalty: Imprisonment for 10 years.

Our Reporting Obligations: We are required to identify tax residents of a country(ies) other than Australia in order to meet account information reporting requirements under local and international laws.

If at any time after account opening, information in our possession suggests that you, the entity and/or any individual who holds ownership and/or control in the entity of 25% or more (Controlling Person/Beneficial Owner) may be a tax resident of a country(ies) other than Australia, you may be contacted to provide further information on your foreign tax status and/or the foreign tax status of the entity and/or any Controlling Person/Beneficial Owner. Failure to respond may lead to certain reporting requirements applying to the account.

By completing this application you certify that if at any time there is a change to the foreign tax status details for you, the entity and/or any controlling persons/beneficial owner, you will inform the bank. You also certify that if at any time there is a change of a controlling person/s/beneficial owner/s in your entity, you will inform the bank.

A controlling person/beneficial owner refers to the individual(s) that directly or indirectly owns a legal interest in the entity of 25% or more and/or exercises actual effective control over the entity, whether from an economic or other perspective such as through voting rights. In addition, in the case of a trust, a controlling person/beneficial owner includes the settlor(s), trustee(s), appointer(s), protector(s), beneficiary(ies) or classes of beneficiaries and in the case of an entity other than a trust, the term includes persons in equivalent or similar positions.

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Westpac Banking Corporation ABN 33 007 457 141

AFSL and Australian credit licence 233714

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