Authority To Act

Asset Ownership

Are you signing up as a Business or Property Client?*

How do you operate?*

Your Details

Personal IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

First Name*

Middle Name

Last Name*

Date of Birth*

Email Address*

Mobile Phone Number*

Address

Home Address

Street Address Address Line 2 City Post Code

Joint Details

Personal IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

First Name*

Middle Name

Last Name*

Date of Birth*

Email Address*

Mobile Phone Number*

Home Address*

Street Address Address Line 2 City ZIP / Postal Code

Do you currently have an accountant?*

Yes
No

Please provide their details*

Business Entity Details

Entity IRD Number*

Example: 123-456-789 or 012-345-678

Entity Name*

(As listed in New Zealand Companies Office)

Does this entity have any additional shareholders/settlors other than yourself?*

Yes
No

Please add a Full Name and IRD Number for each additional shareholder

If you have more than five additional shareholders, please email
info@lighthousefinancial.co.nz and provide their full names and IRD Numbers.

Property Entity Details

Entity IRD Number*

Example: 123-456-789 or 012-345-678

Entity Name*

(As listed in New Zealand Companies Office)

Does this entity have any additional shareholders/settlors other than yourself?*

Yes
No

Please add a Full Name and IRD Number for each additional shareholder

If you have more than five additional shareholders, please email
info@lighthousefinancial.co.nz and provide their full names and IRD Numbers.

Is the entity GST registered?*

Yes
No
Don't Know

Payment Period*

One Monthly
Two Monthly
Six Monthly

Reporting Basis*

Payments Basis
Invoice Basis
Hybrid Basis
Don't Know

Services

Learning Hub

Services

Learning Hub

Please provide as much information as possible below

Asset Ownership

Your Details

Address

Joint Details

Business Entity Details

Property Entity Details

AML/CFT Identification Requirements

Bank Account Details

Inland Revenue Requirements