Page 2 of 2
Salary Packaging Cardholder Application Form
5. IDENTIFICATION KNOW YOUR CUSTOMER VERIFICATION
It is a legislative requirement that cardholders complete an identity verification check before the card is activated. If you do not currently hold a valid
identification record with ANZ, you will need to complete identification and verification (NB: cardholders who hold other ANZ products and have been
identified previously may not be required to be identified again. The address you were previously identified with ANZ must be the same as your
current address that you have detailed on this form).
You must have a valid identification record with ANZ before your card will be activated.
The easiest way to do this is by visiting an ANZ Branch with the identification documentation outlined in the accompanying flyer.
PLEASE ENSURE YOU HAVE COMPLETED IDENTIFICATION PRIOR TO SUBMITTING THIS APPLICATION. YOUR CARD WILL NOT BE ACTIVATED
UNTIL YOUR IDENTITY HAS BEEN SUCCESSFULLY VERIFIED BY ANZ.
ALL CARDHOLDERS (BOTH PRIMARY AND SECONDARY) WILL NEED TO COMPLETE IDENTIFICATION.
Please advise which of the following is applicable:
Primary
Cardholder
Additional
Cardholder
I am an existing ANZ customer for a product other than Salary Packaging. (NB: By ticking this box you may still be required
to be re-identified by ANZ, subject to existing account and identification status. Account details with ANZ must be the
same as the details listed on this form)
I have been to an ANZ Branch for the purposes of an identity verification check
I have been identified by ANZ through other means (E.g. certified documents)
6. ACCOUNT AUTHORITY
If a Primary Card, by use of the Card, I accept that I will be liable to ANZ for any credit extended arising out of the use of the Card, including the use of the Card by an Additional
Cardholder, and agree to all applicable terms and conditions included within ANZ Commercial Card Terms and Conditions for the ANZ Salary Packaging Card or ANZ Meal
Entertainment Card which can be viewed at anz.com/aus/ratefee/default.asp?section=SBS
I declare that the details contained on this application form are true and correct and request that ANZ issue the card to me. I acknowledge that additional rules may be imposed by my
salary packaging provider regarding the use of this card and a copy of these rules have been made available to me. I hereby declare to abide by such rules and variations which are
made by salary packaging provider from time to time. Also, I have read and understood (and agree to) the declaration below.
Primary Cardholder Signature (Mandatory) Date DD/MM/YYYY
Print Name
If an Additional Card, by use of the Card, I agree to all applicable terms and conditions included within ANZ Commercial Card Terms and Conditions for the ANZ Salary Packaging Card
or ANZ Meal Entertainment Card which can be viewed at anz.com/aus/ratefee/default.asp?section=SBS
I declare that the details contained on this application form are true and correct and request that ANZ issue the card to me. I acknowledge that additional rules may be imposed by my
salary packaging provider regarding the use of this card and a copy of these rules have been made available to me. I hereby declare to abide by such rules and variations which are
made by salary packaging provider from time to time. Also, I have read and understood (and agree to) the declaration below.
Additional Cardholder Signature Date DD/MM/YYYY
Print Name
7. DECLARATION
ANZ’s collection, use and disclosure of personal information
Australia and New Zealand Banking Group Limited ABN 11 005 357 522 (ANZ) is collecting the
Cardholder’s information in order to provide the Cardholder with the ANZ Salary Packaging Card
and for the purposes described in the product terms and conditions. Without this information,
ANZ will not be able to provide the Cardholder with the Card.
By signing this Salary Packaging Cardholder Application Form, the Cardholder acknowledges
and agrees that ANZ may disclose your information (which may include information about your
credit history and credit worthiness obtained from a credit reporting body) to:
• any agent, contractor or service provider ANZ engages to carry out or assist its functions
and activities, including the salary packaging service provider;
• an organisation that assists ANZ to identify, prevent or investigate any fraud, unlawful activity
or misconduct (or suspected fraud, unlawful activity or misconduct);
• any related entity of ANZ;
• any third party providing you with a product or service in relation to the ANZ product; and
• the Cardholder’s Employer
ANZ may disclose information to recipients (including service providers and related entities)
which are (1) located outside Australia and/or (2) not established in or do not carry on business
in Australia. You can find details about the location of these recipients in ANZ’s Privacy Policy
and at www.anz.com/privacy.
Privacy Policy
ANZ’s Privacy Policy (www.anz.com/privacy) also contains information about:
• any laws that require or authorise ANZ to collect certain information from you;
• how to access your information and seek correction of your information; and
• how you can raise concerns that ANZ has breached the Privacy Act or an applicable Code
and how ANZ will deal with these matters
Further information
Your product terms and conditions booklet and our ANZ Privacy Policy contain further information
about our handling of the information we collect during the course of your relationship with ANZ.
If you have provided information about someone else, please show them a copy of this clause so
that they may understand how ANZ may use and disclose their information.
ANZ is the issuer of the Salary Packaging Card
Your employer or salary packaging provider has entered into an arrangement with ANZ for ANZ to
issue Salary Packaging Cards to eligible and approved cardholders. By signing this form, you
acknowledge that ANZ is not responsible for the deduction of the nominated amount listed in
section 1 or for making any changes to this amount. Any questions, concerns or request for
changes to this amount must be referred to your employer. ANZ accepts no liability in connection
with your salary deduction arrangements.
ANZ will make your salary deduction available for use on your selected Salary Packaging Card
once your application is approved and ANZ has processed your salary deduction from your
employer or salary packaging provider.
You are only eligible to use the Salary Packaging Card while you are employed by your employer
listed in section 2. Upon termination of your employment (either by you or your employer), your
eligibility ceases and ANZ may in its discretion immediately cancel your Salary Packaging Card and
return any available funds to your employer or salary packaging provider. Your employer may then
deal with any returned funds in accordance with your employment contract or arrangement. You
must immediately notify ANZ (either directly or indirectly via your salary packaging provider) if
your employment is terminated.
You acknowledge that ANZ’s responsibility is to make salary deductions from approved
cardholders available for use on their Salary Packaging Cards once ANZ has processed them.
ANZ is not responsible for, and accepts no liability for, salary deductions until such time as they
are received and processed by ANZ.
ANZ accepts no liability for acts or omissions of your employer or any salary packaging provider in
any way connected with your Salary Packaging Card that in any way causes loss or damage to you.
Australia and New Zealand Banking Group Limited (ANZ) ABN 11 005 357 522. Australian Credit Licence Number 234527. Item No. 74020 03.2014 W374484