AML Online Verification Consent - Lindsay and Associates

Lindsay & Associates Chartered Accountants

AML Online Verification Consent

I hereby consent to Lindsay & Associates (including David Lindsay and staff of Lindsay & Associates) collecting, using, and disclosing my personal information for the following purposes:

Verifying any information that I give to you (or information that you may collect from other sources) with third parties and third party databases/systems for the purposes of fraud prevention or the Anti Money Laundering and Countering Financing Terrorism Act 2009.

I authorise any third party to provide my personal information to you for the above purposes.*
- Yes
Are you signing for yourself or another party?*
- Myself
- Other Party (E.g. Trustee/Director or Holder of Power of Attorney)
Where signing for yourself:
Name*
First Last
Date of Birth*
DD slash MM slash YYYY
Address*
Street Address Suburb City ZIP / Postal Code Country
Signature*
Date*
DD slash MM slash YYYY
Where signing for another party:
Full Name of Other Party (E.g. XYZ Trust or ABC Company)*
Signature*
Capacity*

(E.g. As Trustee, beneficiary, director, shareholder)
Date*
DD slash MM slash YYYY

Lindsay & Associates Chartered Accountants

Where signing for yourself:

Where signing for another party:

Lindsay & Associates