NAB Connect Application Form
How to Apply
This form utilises the Adobe Reader software which will allow You to enter data directly into the form and save it to Your local drive as
required. To begin, save a copy of the form to Your computer. Then locate the file, open it and start entering data into the form. Save
the file as and when required.
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Read the terms and conditions for Your use of the NAB Connect Channel and Your selected Services before completing this
Application Form. Please go to nab.com.au/nabconnect/terms to see the terms and conditions.
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Complete this NAB Connect Application Form as follows:
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Complete each Section of the form.
To validate the form, click on the PRINT & SUBMIT ELECTRONICALLY button.
Please correct any errors/incomplete fields which will be highlighted in RED.
When the form is complete and error free, click on the PRINT & SUBMIT ELECTRONICALLY button. This will allow
You to print the form and then prompt You to submit the data in the form electronically to
https://nabconnect.nab.com.au/submitapplicationform.
Save the form as a PDF file, photocopy the completed Application Form and retain it for Your records.
Please mail Your completed and signed Application Form to:
National Australia Bank Limited
NAB Connect
Reply Paid 12060
Melbourne VIC 8006
Note: do NOT print this form using the Print menu above as this will NOT validate the contents of the form. Incomplete/handwritten
forms may be returned for correct completion and will result in a delay in processing Your application.
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Applications to use NAB Connect are subject to NAB approval. If approved, a NAB Connect welcome pack will be sent to the
address You nominate below.
For assistance on completing this Application Form, please contact the NAB Connect Client Centre on 1300 888 413.
Note: Before officially submitting this application form, You have the opportunity to check and modify the information
contained within it.
Once this form has been submitted, changes will only be accepted via the submission of an Additions / Amendments
Request Form. All submitted Additions / Amendments Request Forms require prior approval from Your Security Officer
PRINT & SUBMIT ELECTRONICALLY
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Section A
Customer Information
Applicant (“You”)
Full legal name (including details of any trust, if acting as trustee)
ABN, ACN or ARBN
Business address
Level/office number
Street number
Street name
State (select from list
Or enter manually)
Suburb
Postcode
Country
Postal address different to business address
Receipt of Electronic Notices
By selecting Yes below, You elect to receive important information (including changes to terms and conditions) from National
Australia Bank Limited by having to retrieve it from the NAB Connect Channel or, at our election, by email instead of being sent it in
paper form (eg mail or fax).
This means that, and You agree that, National Australia Bank Limited is taken to have provided this important information to You by
sending an email to the email address specified in Section H of this Application Form stating that the important information is available
for retrieval by You in the NAB Connect Channel. For more details, see clause 8 of the NAB Connect Terms and Conditions.
The nominated email address should be checked regularly and any changes to it notified to National Australia Bank Limited promptly.
Failure to do so may mean important information about NAB Connect is missed.
I elect to receive information relating to NAB Connect electronically via the NAB Connect Channel.
Yes
No
Marketing Information
How did You find out about NAB Connect?
Promotional code (if applicable)
Please select the business products that You currently use (if applicable).
National Online Business
National Online Corporate
NAB Internet Banking
Note: most of the information required to complete this form can be found in Your National Online application.
Reckon Limited, through its association with NAB, is pleased to offer You a free 12 month subscription to QuickBooks Accounting
2009/10 QBi series. Details of this offer are available at nab.com.au/nabconnect/offers
Would you like to accept this free QuickBooks offer?
Yes
No
PC Tools Pty Limited, through its association with NAB, is pleased to offer You a free 12 month subscription to Spyware Doctor.
Details of this offer are available at nab.com.au/nabconnect/offers
Would you like to accept this free Spyware Doctor offer?
Yes
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No
Section B
Your Accounts
Please list the NAB business accounts that are in Your business name and that You wish to access through NAB Connect. If You
wish to access NAB business accounts that are not in Your business name, You must list these in Section C and have the owner of
those accounts sign the third party authority form in Section P.
Note: No accounts can be linked to the Investments, Data File Download, Merchant Transaction Reporting, NAB Invoice Finance or
Corporate Card services. Not all accounts can be accessed through NAB Connect. Funds transfers from Your NAB Invoice Finance
account can only be conducted from within the NAB Invoice Finance Service. If You are unsure, please contact the NAB Connect
Client Centre on 1300 888 413.
BSB
Account number
Preferred name (optional)
Remove this account
Remove all accounts
Add account
Please enter below the details of any of Your NAB business credit card numbers. Of the Payments Services available, credit cards
can only be used for BPAY transactions.
Card number
Preferred name (optional)
Remove this card
Remove all cards
Add card
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Section C
Third Party Accounts
If You wish to access NAB business accounts that are not in Your business name, please list them below and have the owner of
these accounts sign the third party consent form in Section P.
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Please note that third party accounts/cards cannot be linked to the Data File Download Service, Investment Services, the
Merchant Transaction Reporting Service, NAB Invoice Finance or the Corporate Card Self Service; and
Not all account types can be accessed through NAB Connect.
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If You are unsure, please contact the NAB Connect Client Centre on 1300 888 413.
BSB
Account number
Legal entity name
Preferred name (optional)
Remove this account
Remove all accounts
Add account
Please enter below the details of any NAB business credit card numbers of third parties. Of the Payments Services available, credit
cards can only be used for BPAY transactions.
Card number
Legal entity name
Preferred name (optional)
Remove this card
Remove all cards
Add card
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Section D
Services
We have selected certain services for You. If You do not want any of these services, simply un-check the relevant box.
Account Reporting
Stop Cheque
Domestic Payments
Direct Credit1
Payroll1
Executive Payroll1
BPAY
International Payments
Customer Vouchers Online (CVOL)
Direct Debit1
Online Statements
NAB Payments
Term Deposits
Data File Download
These services should only be
selected with advice and consultation
from Your Business Banking Manager.
EB165/FX165 Merchant Reports2
Investments Administration3
NAB Invoice Finance4
Corporate Card Self Service
NAB Transact
1
2
3
4
Requires a Direct Entry User ID and forms part of the Domestic Payments Service.
Merchant Transaction Reporting Service - Domestic and Multi Currency Reports
Term Deposits Service
Eligibility and credit approval criteria apply.
You must agree to the terms and conditions that will apply to Your use of the NAB Connect Channel and Your selected services.
Please go to nab.com.au/nabconnect/terms to access a copy of the NAB Connect Terms and Conditions, the terms and
conditions for Your other selected services (other than NAB Invoice Finance, if selected), the NAB Connect Facsimile
Instruction Facility and then check the boxes below to indicate You agree to be bound by those terms and conditions.
Please note that You can save to a file or print each set of applicable terms and conditions for the NAB Connect Channel and
selected services when they are displayed, by using the appropriate controls on Your web browser.
By checking the boxes below for each applicable set of terms and conditions, You specifically agree that You have been given the
opportunity to view and retain those terms and conditions (by saving to a file or printing the document available by accessing them at
nab.com.au/nabconnect/terms). We will not send You a written copy unless You request a copy from us within 6 months.
I have reviewed the NAB Connect Terms and Conditions and agree that the Applicant will be bound by those terms.
Please note that Your application will not be processed unless You have checked all the boxes above.
Does the Applicant wish to send Additions/Amendments Request Forms by fax?
Yes
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No
Section E
Note:
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Accounts and Services
Please read the account restrictions in Sections B and C.
Only accounts previously agreed with Your Business Banking Manager can be linked to NAB Invoice Finance.
Would You like all applicable accounts to be available for use on all the services You have selected? If You select No, You will be
asked to nominate which accounts will be available for which service.
No
Yes
If You wish Your Users to have more customised access than the table below, please contact the NAB Connect Client Centre on
1300 888 413.
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Section F
Direct Entry User IDs
Please enter the Direct Entry User IDs that You will be using with Your nominated Direct Entry services.
The Direct Entry services are Direct Credit, Payroll, Executive Payroll and Direct Debit. Your Direct Entry User IDs cannot be used
with any other service. If You do not have a Direct Entry ID You cannot use these services in NAB Connect. Direct Entry services do
not apply to the NAB Invoice Finance Service.
Please enter Your Credit User ID/s, its associated legal entity name and select the service/s that You would like to use it with.
Credit User ID
Legal Entity Name
All Direct Entry
Applications
Payroll
Executive
Payroll
Direct Credit
Remove this User ID
Remove all User IDs
Add User ID
Please check this box to apply for a NEW Credit User ID. A Credit User Application Form will be printed when You print this
Application Form. Please ensure that You fill in the Credit User Application Form and return it together with this Application Form
to the address on page 1.
Note: A Direct Entry User ID belonging to the Applicant can only be used with the Accounts listed in Section B. A Direct Entry User ID
belonging to a Third Party can only be used with the Accounts listed in Section C for that Third Party.
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Section G
Data File Download
This section does not apply to the Services that You selected above.
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Section H
Users
Important: Your Security and Authorisation of Payments
The NAB Connect Channel offers a "Segregation of Duties" capability for payments.
This means that the Authorising User who authorises a payment must have a different User ID to the User who created the
payment. Used correctly, this capability can reduce Your exposure to fraud by requiring the use of 2 separate User IDs to
create and authorise a payment.
You do not have to use the Segregation of Duties capability if You don't want to. Instead, You can enable the same person
to create and authorise a payment using only one Authorising User ID.
You acknowledge that by choosing not to use the Segregation of Duties capability, You risk reducing Your level of security
and risk increasing the incidence of fraud being perpetrated against You.
Having "Segregation of Duties" in place, means that an Authorising User cannot authorise a payment that they themselves
have created. Do You want this "Segregation of Duties" capability in place for each of Your Authorising Users?
Yes
No
In this Section You must complete the details of Your Users and in later sections nominate which Services they may access through
NAB Connect and select whether they will be General Users or Authorising Users. This access is referred to as the User's 'Access
Profile'. You must complete the details for the Access Profile of each User on an individual basis. For further information on Access
Profiles and System Profiles, please refer to the NAB Connect Channel Terms and Conditions.
All Users will be issued a Security Token. The Security Token is required by all users to login to NAB Connect and by Authorising
Users to Authorise Payments. All Security Tokens will be delivered to Your Security Officer at the address listed in Section A.
Title
First name
Middle name
Last name
Job title
Work phone
Mobile phone
International contact details (if applicable)
Country code
Area code
Work phone
Mobile phone
Work email address*
(must be a business email address. Internet style accounts e.g. 'Hotmail' are not acceptable.)
* Please check these details carefully as this is the address to which NAB will send Your User their Security Token PIN.
Remove this user
Add another user
Preparation of this document was completed on 26 March 2009. National Australia Bank Limited ABN 12 004 044 937 AFSL230686
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Section I
Users and Services
The nominated user will have access to all the services and their applications You selected in Section D.
Preparation of this document was completed on 26 March 2009. National Australia Bank Limited ABN 12 004 044 937 AFSL230686
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Section J
Authorising Users
The nominated user will be the Authorising User for all Your Accounts in Section B and all Third Party Accounts in Section C.
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Section K
100 Point ID Check for Authorising Users
Prior to registering an Authorising User, NAB requires that they have been 100 point identified. If any of Your nominated Authorising
Users have not been identified by the NAB, prior to submitting Your application You and the nominated Authorising user(s) may visit
Your NAB Business Banking Manager with 100 points of identification for verification.
Documentation that contributes to 100 points of identification includes (but is not limited to):
Birth certificate
Citizenship certificate
International travel document (e.g. passport)
Drivers licence
Identification issued by a Government organisation
Your NAB Business Banking Manager will be able to confirm whether a nominated Authorising User has been 100 point identified by
the NAB. Any person who has a personal NAB account or credit card has been 100 point identified, however You should always
confirm this with Your NAB Business Banking Manager.
Important!
I understand that all Authorising Users need to be 100 point identified by the NAB.
Complete checklist for 100 point ID check for each Authorising User.
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Section L
Set Payment Authorisation Rules - All Payment Services
The nominated user will be the Authorising User and have the ability to authorise a Payment Instruction up to an unlimited value.
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Section M
Select Security Officer / Tax Invoice User
The nominated user will be the Security Officer as well as having access to view Tax Invoices for Your business.
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Section N
Payment Limits
The nominated user will be responsible for managing Your Payment Limits as well as Approving Breaches of Your Payment Limits.
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Section O
Billing Account
Please refer to the Fees and Charges Schedule for a detailed listing of the fees and charges for Your use of the NAB Connect
Channel and Your Services.
Please nominate the NAB account to be debited for all NAB Connect and Service fees and charges.
BSB
Account Number
Note: Your billing account cannot be a trust account or a loan account.
Preparation of this document was completed on 26 March 2009. National Australia Bank Limited ABN 12 004 044 937 AFSL230686
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Section P
Third Party Authority - Signatories for Third Party
This section does not apply.
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Section Q
Applicant Declaration and Execution
Each signatory who is identified below makes the following declarations for and on behalf of the Applicant:
A.
The Applicant acknowledges that it has been provided with the opportunity to view and retain (eg by saving and printing),
and each signatory has read and understood:
§
the NAB Connect Terms and Conditions;
§
the Fees and Charges Schedule and any other Schedules (as defined in the NAB Connect Terms and Conditions);
§
the terms and conditions and disclosure documents for each Service I have selected in this Application Form, other
than NAB Invoice Finance (together, 'NAB Connect Material).
The Applicant further acknowledges that by the signatories signing the NAB Connect Application Form the Applicant is
agreeing to be bound by the NAB Connect Material.
Further, the Applicant specifically agrees that it has been given the opportunity to retain the NAB Connect Material during the
e-Application process (for example, by printing or saving it) and that it will not be separately provided with a copy of the NAB
Connect Material without making a particular request for it.
B.
The Applicant acknowledges that any use of the NAB Connect Channel and the Services to access or attempt to access
accounts is also subject to the terms and conditions which apply to those accounts. See the paramountcy provisions in the
NAB Connect Material and the NAB Invoice Finance Facility Agreement, if applicable, for the order of precedence when
interpreting those terms and conditions.
C.
The Applicant declares that where Personal Information (as defined in the Privacy Act 1988 (Cth)) about an individual (such
as a User or contact person) has been or will be provided in this Application Form or as a result of the ongoing use of NAB
Connect, the Applicant has made or will make each such individual aware of the fact and:
§
that their Personal Information has been collected by the National Australia Bank Group organisation ('Group
Organisation') to which this application is addressed for the purpose of providing the NAB Connect Channel to
access the Services the subject of this application (including assessing the application) and managing and
administering the NAB Connect Channel and the Services and protecting against fraud;
§
that their Personal Information may be disclosed to other organisations involved in the provision, management or
administration of the NAB Connect Channel and the Services, or as required by law, or with their consent;
§
that the applicant may not be able to obtain the NAB Connect Channel and the Services the subject of this
application if that individual's Personal Information is not provided;
§
that the individual can gain access to their personal information by contacting the Group Organisation; and
§
the Group Organisation's contact details.
D.
The Applicant named in Section A appoints and authorises each other person named in this Application Form (and any
Additions/Amendments Request Form):
(a)
as a Security Officer to perform all aspects of that role on behalf of the Applicant; and
(b)
as a User, to use NAB Connect in relation to the Services, the accounts and the credit card numbers as set out in
this Application Form (and any Additions/Amendments Request Form).
E.
The Applicant authorises National Australia Bank Limited to assume that any person who uses an Authorisation Method
issued to a User to use NAB Connect is properly authorised to so use NAB Connect on behalf of the Applicant.
F.
Each signatory for the Applicant below acknowledges and declares that he or she has the necessary authority to bind the
Applicant named in Section A in respect of which he or she executes this NAB Connect Application form. The only Customer
enabled under this Application to use NAB Connect is the Applicant named in Section A of this Application form.
G.
By ticking the `Yes' box in Section A under 'Receipt of Electronic Notices', the Applicant elects to receive important
information (including changes to the disclosure documents and terms and conditions for a Service) from National Australia
Bank Limited by having to retrieve it from the NAB Connect Channel instead of being sent it in paper form (eg mail or fax) or
by email.
The Applicant agrees National Australia Bank Limited is taken to have provided this important information to the Applicant by
making it available for retrieval in the NAB Connect Channel. The Applicant acknowledges that the NAB will provide a notice
in the Channel when an Applicant's User logs on that the important information is available for retrieval from the Channel.
H.
The Applicant represents and warrants that:
(a)
it is the owner of all the accounts listed in Section B plus any accounts linked to the credit card numbers that are
also listed in Section B;
(b)
it has included in this Application Form in Section P an authority from the true owner of each of the accounts listed
in Section C plus any accounts linked to the business credit card numbers also listed in Section C.
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Section Q
Applicant Declaration and Execution continued
Applicant Declaration and Execution Signatories for the Applicant
Note: If You are a company, this Application Form must be signed by either two directors or a director and secretary unless You are a
single director and shareholder company in which case it must be signed by that single director. If You are e.g. a partnership or
association, this Application Form must be signed in accordance with Your partnership deed or association constitution.
Please enter the name and title of the signatories.
Name
Signature
Job title
Date
Name
Signature
Job title
Date
Add additional signatory
Security Officer
Name
Signature
Job title
Date
Remove security officer
Add additional security officer
PRINT & SUBMIT ELECTRONICALLY
Preparation of this document was completed on 26 March 2009. National Australia Bank Limited ABN 12 004 044 937 AFSL230686
V090728