CommBiz Account Authority Form

(Personal Accounts)
Service ID: Request Number:
102395709 102395709-0

Name of account Account number

Angelique mendes 269274981944

Part A – Electronic Method of Operation in CommBiz

Your organisations listed account(s) will be available on this CommBiz Service to view, change, request and
transact on in accordance with the Electronic Method of Operation and by the Users defined in this form.

The Electronic Method of Operation is a set of electronic rules for how the listed account(s) will operate on
CommBiz including monetary bands and the number of Authorisers required. The listed account(s) in this request
will operate as set out in the below. Any previous Electronic Method of Operation, for the account(s), on a
CommBiz Service (including CommBiz IPFX) will be over-ridden.

Need help completing this form?

Visit www.commbank.com.au/commbiz-account-authority

Monetary band Rule for numbers of Authorisers required

Band Lower limit ($) Upper limit ($) List A & List B & List C & List D & List E
1 0.00 No Limit Rule 1 1 - - - -

002-473 210622 Page 1 of 3

Service ID: Request Number:
102395709 102395709-0

Part B – Persons authorised to operate on account(s) in CommBiz

Your organisation agrees that the following person(s) will be the Authoriser(s) on your organisation's account(s),
listed in this request.
An Authoriser is a person you’ve nominated to authorise changes, requests and transactions, on your organisation’s
account(s) that have been linked to CommBiz, in accordance with the Electronic Method of Operation.

Identifying Authorisers:
Users who are already Authorisers on the accounts listed in Part A or have already been identified on CommBiz,
won’t need to sign this form.
Users who are being appointed as new Authorisers and aren’t identified on CommBiz will need to sign this form and
provide additional information so we can identify them. If the User banks with:
• CommBank – the User can provide their CommBank BSB and Account Number in the Reference account field
then confirm their details are correct and sign in the signature field.
• A different financial institution – the User will need to confirm their details are correct and sign in the Signature
field. The User will also need to complete and return the Certified Copies Identification Form.

Authorisers Declaration and consent

I, a nominated Authoriser, for the account(s) listed, understand and acknowledge that the law:
• requires me to provide true and correct information including any names by which I am commonly known by;
• prohibits giving, using, producing false names, misleading information or documents in connection with the
provision of financial services; and
• prohibits making, possessing or using false documents in connection with the identification procedure.
By signing this form, I declare that all my details shown below are complete and correct. I also consent to the bank
taking steps to verify my personal details. My signature below indicates my acknowledgement and consent to use
and disclosure of my personal information as detailed in the section on ‘Privacy’ in the Terms and conditions for this
account.

Authoriser
Full name (as shown on identification documents) Date of birth
Ms Angelique Mendes 02/01/2002
Other names known by (if any)

Official position
Patisserie
Full residential address (PO Box not acceptable)
18 dufton ct
Greenvale VIC 3059 Australia

Telephone number Mobile number List Reference account

( ) 61 426225611 A 294832434852
Email address
Angeliquemendes661@gmail.com
Signature

Bank use only

Document type Document number Name on document Place of issue Issue date Expiry date
DD/MM/YYYY DD/MM/YYYY

DD/MM/YYYY DD/MM/YYYY

DD/MM/YYYY DD/MM/YYYY

002-473 210622 Page 2 of 3

Service ID: Application ID:
102395709 102395709-0

Part C – Declaration and acknowledgements

I/We hereby request the Bank to recognise and act upon this authority or any variation of this authority until the
Bank receives notice in writing or via CommBiz, electronic instruction from us, or any one of us, of the cancellation
or variation of this authority.
We authorise the Bank, through the use of CommBiz to:
• enable and allow any Authoriser to have electronic access to our accounts;
• transact on our accounts pursuant to electronic instructions apparently given by any Authoriser, according to
this form;
• enable and allow any other person authorised by any Administrator to have electronic access to our accounts.
“Authoriser” means each person listed in this form to operate on one or more of our accounts using CommBiz until
their authority is revoked by us.
102395709-0
“Administrator” means each person enabled in the CommBiz Service
to administer preferences and entitlements.
For the purpose of this form words denoting the singular include the plural and vice versa.
I/We have read the CommBiz Terms and conditions and/or (if applicable) the CommBiz - International Payments
and Foreign Exchange Product Disclosure Statement, being available from www.commbiz.com.au . I/We agree
that operation on, and access to, our accounts through CommBiz is subject to the CommBiz Terms and
conditions and/or (if applicable) the CommBiz - International Payments and Foreign Exchange Product Disclosure
Statement, and the Bank’s usual terms and conditions applicable to my/our accounts.

Name of Account holder

Signature of account holder Date

DD/MM/YYYY

Name of Account holder

Signature of account holder Date

DD/MM/YYYY

Name of Account holder

Signature of account holder Date

DD/MM/YYYY

(Where the account/s identified in this form is/are held jointly, all parties must sign in the panels above irrespective
of the method of operation on the account/s.)
Please return by mail to:

CommBiz
Reply Paid 332
Silverwater NSW 2128

002-473 300920 Page 3 of 3