FS-74 New Examiner or Reactivation Form

Instructions

Please attach proof of bank account which is current and obtained within the last twelve months. The documentation must show the bank logo, bank account name matching examiner name and bank account number and must be in English where possible. The following are examples of acceptable proof of bank accounts:

Bank deposit slip
Bank statement
Void cheque
Letter from the bank confirming the account number and the account holder details (date, stamped and signed by bank)
Screenshot of internet banking page with visible URL (the examiner's name must not be an editable field in the internet banking page)

For overseas accounts, please ensure the relevant bank codes have been included eg IBAN, routing number, Swift code

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Have you been an examiner for UoA before?

Yes No

Enter Examiner ID number

This is the number in the University Finance system - PeopleSoft Financials

First name

Last name

Phone number

Address 1

Address 2

City

State

(if applicable)

Country

Postal code

Are you a New Zealand resident?

Yes No

IRD number

Please attach a completed IR330C form

Upload File

The form can be accessed at: https://www.ird.govt.nz/-/media/project/ir/home/documents/forms-and-guides/ir300---ir399/ir330c/ir330c-2019.pdf

What is your Country of Tax Residence?

Will the Examiner be present in New Zealand?

Yes No

If yes, date of arrival

Date of departure

Method of payment

Payment to NZ bank account Payment to overseas bank account

Bank account number

e.g. 12-1234-1234567-12

Bank account number

Bank name

Bank ID (if Japanese Yen)

Branch ID (if Japanese Yen)

Bank ID (if Canadian Dollar)

Branch ID (if Canadian Dollar)

Bank address

Please select which region your bank is located in from the options below

Australia USA Europe / UK Other

Enter BSB number

Enter ABA routing number

Enter IBAN code

Swift code - to locate swift codes worldwide go to https://www.theswiftcodes.com/

Enter swift code

To locate swift codes worldwide go to https://www.theswiftcodes.com/

Please attach proof of bank account

Must be a PDF, JPG, GIF or PNG file

This must show the bank logo, bank account name matching examiner name and bank account number

Faculty contact

Please state the full name or email address of the person from whom you received this application form

Additional information

e.g. Student name, ID

Please attach any additional documentation

Upload File