Client Onboarding Form - The Practice Consultants Limited

Full Name*
First Middle Last
Title
How would you like us to refer to you? For example Mr, Mrs, Doctor etc.
Date of Birth*
DD slash MM slash YYYY
Your Residential Address*
Address 1 Address 2 City Postcode
Email*
Phone Number*
What is your company structure?*
- Sole Trader
- Private Limited Company or LLP
- Public Limited Company
- Trust

Personal Identity Verification
By law, we are required to see proof of identity for all new and some existing clients. Please upload a scan of one of the following documents:
Valid passport
New Zealand firearms licence
New Zealand certificate of identity
Upload your personal identity document here*
Max. file size: 100 MB.
Personal Address Verification
By law, we are required to see proof of residential address for all new and some existing clients. Please upload a scan of one of the following documents:
Bank, Building Society or Home Loan Statement
Dated with 3 months. Must include account number and show recent activity. No general correspondence.
Credit Card Statement
Dated within 3 months. Must include account number and show recent activity. No general correspondence.
Utility Bill
Dated within 6 months E.g. Gas, electricity, water. Must show address for service and/or account number. No general correspondence.
Telephone Bill
Dated within 6 months E.g. Landline or mobile pay monthly (excluding pay as you go). Must show address for service and/or account number. No general correspondence.
Goverment Letter
Dated within 12 months. E.g. Council Tax statement. Must show address for service and/or account number. No general correspondence.
Tenancy Agreement
Dated with 12 months. Must state full name and full property address. Issued by local council, housing association, solicitor or reputable letting agent.
Home or Motor Insurance Certificate
Dated within 12 months. Must state insured address or registered address for vehicle and policy number. No general correspondence.
Upload your personal address document here*
Max. file size: 100 MB.

Private Limited Companies and LLPs
Full Company Name*
IRD Number*
Registered Address*
Your company's registered address
Address 1 Address 2 City Postcode
Is your registered address the same as your place of business?*
- Yes
- No
Place of business*
Please add the address of your company's place of business
Address 1 Address 2 City Postcode
Certificate of incorporation*
Max. file size: 100 MB.
Latest Annual Return with details of current company officers*
Max. file size: 100 MB.
Other shareholders/members*
- Yes
- No
Aside from yourself, are there any shareholders/members who ultimately own or control more than 25% of the shares or voting rights (directly or indirectly including bearer shares) in your company?
Personal Identity Verification for other Shareholders/Members
By law, we are required to see proof of identity for all shareholders/members who ultimately own or control more than 25% of the shares or voting rights (directly or indirectly including bearer shares) in your company. Please upload a scans of one of the following documents for all shareholders/members with 25% of the shares or voting rights:
Valid passport
New Zealand firearms licence
New Zealand certificate of identity
Upload personal address documents for other shareholder/members here*
Drop files here or
Max. file size: 100 MB.
Public Limited Companies
Full Company Name*
IRD Number*
Registered Address*
Your company's registered address
Address 1 Address 2 City Postcode
Verification documents*
Please upload one of the following documents:
- A printout from the web-site of the relevant regulator or exchange
- Written confirmation of your company's regulatory or listing status from the regulator or exchange

Max. file size: 100 MB.

Trusts
Trustees*

Pleas list all trustees, click the + to add each person
Beneficiaries*

Pleas list all beneficiaries, click the + to add each person
Trust deed*
Max. file size: 100 MB.
Other trustees/beneficiaries*
- Yes
- No
Aside from yourself, are there anybody else with a vested interest in 25% or more of the capital and/or those who exercise control over the Trust.
Personal Identity Verification for other Trustees/Beneficiaries
By law, we are required to see proof of identity for all trustees/beneficiaries with a vested interest in 25% or more of the capital and/or those who exercise control over the Trust. Please upload a scans of one of the following documents for all trustees/beneficiaries meeting these criteria:
Valid passport
New Zealand firearms licence
New Zealand certificate of identity
Upload personal address documents for other shareholder/members here*
Drop files here or
Max. file size: 100 MB.

Confirmation
Please sign below*
I confirm that the information given in this form is true, complete and accurate.

Step 1 of 5

Personal Identity Verification

Personal Address Verification

Private Limited Companies and LLPs

Personal Identity Verification for other Shareholders/Members

Public Limited Companies

Trusts

Personal Identity Verification for other Trustees/Beneficiaries

Confirmation

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