CuStOMEr IdEntIFICAtIOn FOrM

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					Orbis MIS - Orbis/SM Australia Equity Fund
Orbis MIS - Orbis Global Equity Fund




CuStOMEr IdEntIFICAtIOn FOrM                 ORBIS
                    (Sole trader)
                        c u s t o m e r i d e n t i f i c at i o n f o r m


You only need to complete this Customer Identification Form if you are a new investor in either the Orbis/
SM Australia Equity Fund or the Orbis Global Equity Fund.

Equity trustees Limited, as responsible entity/trustee for the Funds (as applicable) have certain obligations
under Australia’s Anti-Money Laundering and Counter terrorism Financing Laws. Please read Section 2 for
more details.

Your application cannot be processed until the information and supporting identification documents
requested in this form are received. From time to time, additional information and supporting documentation
may be requested.

If you have any queries about this form, please contact Orbis:-

 +61 (0) 2 8224 8600                 clientservice@orbisfunds.com.au                 +61 (0) 2 8224 8601

Please post this signed and completed form, certified copies of the relevant identification documents requested
for your investor type and your original application form (found at the end of the Orbis/SM Australia Equity
Fund’s Product disclosure Statement dated 4 April 2007 or the Orbis Global Equity Fund’s Information
Memorandum dated 28 June 2005) to the Funds’ Administrator:

        State Street Australia Limited
        Unit Registry Services
        Level 7, State Street Centre
        338 Pitt Street
        Sydney NSW 2000




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Section 1       Sole trader

Sole Trader Details
 Mr/Mrs/Ms/dr/Other                                             date of Birth
 Given names                                                    Surname
 Australian tax File number (or reason for exemption)
 Country of residence for tax purposes (if not Australia)
 Business name (if any)
 Australian Business number (if applicable)


Residential address (not a PO Box address)
 Address


 Suburb                                                         State                          Postcode
 Country

Principal place of business (not a PO Box address)
 Address


 Suburb                                                         State                          Postcode
 Country



    identification documentS      for a   Sole trader
    If you have completed this section you must enclose a certified copy of any OnE of the following current
    documents with this completed form:
    •	 driver’s licence (must contain your photo); Or
    •	 Passport (only pages containing your photo, current date of passport and signature required); Or
    •	 Any Id card issued under a state or territory law in Australia or an overseas regulatory organisation which
       contains your photo, date of birth and signature.




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Section 2          a m l , P r i va c y , d e c l a r at i o n S   and   S i g n at u r e S

The Anti-Money Laundering and Counter-Terrorism Financing Act 2006
the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 (AML/ CtF Act) is aimed at combating
money laundering and the financing of terrorism in Australia. Equity trustees Limited (EQt), as a responsible entity
or trustee for the Funds (as applicable), is required under the AML/CtF Act to collect and verify certain information
about you as an investor before EQt issues you with units in the relevant Fund. Additionally the AML/CtF Act
requires EQt to monitor investor transactions and consequently EQt may require investors, from time to time, to
provide additional identification information.

Where EQt has reasonable grounds to believe that your proposed transaction will breach Australian anti-money
laundering or counter-terrorism financing laws, your transaction may be delayed or disallowed and EQt and Orbis
Investment Management (Australia) Pty Ltd, Orbis Investment Advisory Pty Ltd and Orbis Investment Management
Limited (together Orbis) are not liable for any loss you suffer (including consequential loss) resulting from compliance
with these laws.

Privacy
When you complete this form, EQt will be collecting personal information from you for the primary purpose of
processing and administering your investment in the relevant Fund in compliance with the AML/ CtF Act.
EQt or Orbis may disclose your personal information to other parties involved in providing services to, administering
or managing the Fund.

Declarations and Signature
I/We declare that all details in this form (and the application form found at the end of the Product disclosure Statement
dated 4 April 2007 for the Orbis/SM Australia Equity Fund (PdS) or the Information Memorandum dated 28 June
2005 for the Orbis Global Equity Fund (IM)) are true and correct. I/We acknowledge that EQt or Orbis are not
responsible for the delays in receipt of monies caused by the postal service or the applicant’s bank.
By signing this form, I/we acknowledge that I/we have read and understood this form, the relevant application form,
the PdS, the supplementary PdS dated 19 March 2009 or the IM (as applicable) and agree to be bound by the terms
of such documents. Where appropriate, I/we have obtained my/our own independent financial investment advice prior
to investing in either Fund. If this is a joint application each of us agrees our investment is held as joint tenants.
I/We acknowledge and agree that where EQt determines that I/we are ineligible to hold units in either Fund or have
provided misleading information in this form or the relevant application form, I/we appoint EQt as my/our agent
to submit a withdrawal request on my/our behalf in respect of all of my/our units in the relevant Fund.




name of applicant                             Signature of applicant                          date
Capacity (please tick if applicable)       director  secretary  executive officer  authorised signatory


name of applicant                             Signature of applicant                          date
Capacity (please tick if applicable)       director  secretary  executive officer  authorised signatory
 Company Seal
 (If applicable)




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checkliSt
      Have you completed your details as a sole trader?
      Have you provided certified copies of your identification documents?
    Have you signed this form (Section 2)?
Please post this signed and completed form, all relevant identification documents and your original application form
(found at the end of the PdS or IM) to the Fund’s Administrator:
          State Street Australia Limited
          Unit Registry Services
          Level 7, State Street Centre
          338 Pitt Street
          Sydney NSW 2000

PerSonS authoriSed          to   certify identification documentS
For Australian Residents
(1)     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).
(2)     A judge of a court.
(3)     A magistrate.
(4)     A chief executive officer of a Commonwealth court.
(5)     A registrar or deputy registrar of a court.
(6)     A Justice of the Peace.
(7)     A notary public (for the purposes of the Statutory Declaration Regulations 1993).
(8)     A police officer.
(9)     An agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the
        public.
(10) A 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.
(11) An Australian consular officer or an Australian diplomatic officer (within the meaning of the Consular Fees
     Act 1955).
(12) An officer with 2 or more continuous years of service with one or more financial institutions (for the purposes
     of the Statutory Declaration Regulations 1993).
(13) A finance company officer with 2 or more continuous years of service with one or more finance companies
     (for the purposes of the Statutory Declaration Regulations 1993).
(14) An officer with, or authorised representative of, a holder of an Australian financial services licence, having 2
     or more continuous years of service with one or more licensees.
(15) A member of the Institute of Chartered Accountants in Australia, CPA Australia or the national Institute of
     Accountants with 2 or more years of continuous membership.

For Overseas Residents
(1)     A police officer (please include officer number and rank/position).
(2)     A Justice of the Peace (please include registration number (or equivalent)).
(3)     A judge of a court.
(4)     A magistrate.
(5)     A registrar or deputy registrar of a court.
(6)     An Australian consular officer or an Australian diplomatic officer (within the meaning of the Consular Fees
        Act 1955).




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                                             ORBIS




           LEvEL 2, ChALLIS hOUSE, 4-10 MARTIN PLACE, SYDNEY NSW 2000, AUSTRALIA
tELEPHOnE: +61 (0)2 8224 8600 . FACSIMILE: +61 (0)2 8224 8601 . EMAIL: CLIEntSErvICE@OrBISFundS.COM.Au



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