Certification of Identification Documents
Bring this form into a branch or send this form to:
ADCU, PO Box H151, Australia Square NSW 1215
Complete this form if you are acting as a certifier of copies of identification documents required for a person applying for membership with ADCU. To qualify as a certifier,
you must be a person who falls into one of the categories shown on the next page. To certify copies of documents, please complete as follows:
•
•
Examine the original identification documents.
Make copies of the documents and certify them as being true copies
(as shown in the example at the end of this page).
•
•
Attach the certified copies to this form.
Complete and sign this form.
Note: If more than one person requires identification to be certified, please complete one form per person.
Please use a black or blue pen.
1. Certifier Details
Title
Certifier Given Name/s
Surname
Registration No. (if applicable)
Occupation
Residential Address or Business Address (PO Box is not acceptable)
State
Postcode
Contact details
Home Phone Work Phone
2. Documents being certified Details
(a) On the next page are categories of certifiers.
You must be a person who falls into one of those categories.
Write here the number that corresponds to your occupation
or qualification.
Mobile
3. Certifier’s Statement
I have examined the original identification documents
listed above.
I have certified a copy of each of the documents in the
manner shown below.
I have attached the certified copies to this form.
(b) On the next page are categories of documents.
ADCU membership requires:
•
1 document from category A
Certifier Signature
or
•
I understand that it is an offence, under the Anti-Money
Laundering and Counter-Terrorism Financing Act 2006, to give
false and misleading information.
1 document from category B AND
1 document from category C
List here details of the documents to be certified.
Date
Document Category
A
B
C
Type of Document
This is an example of the certification to be noted
on each document.
Full name of person it relates to
Document Category
A
B
C
Type of Document
Full name of person it relates to
of the
a true copy
is
is
th
at
ertify th
d.
This is to c
I have sighte
h
ic
h
w
,
al
in
orig
Date
011
12 April 2
Name
John Smith
Signature
e Peace
Justice of th
999999
Title
Registration No.
(eg. JP No.)
PO Box H151, Australia Square NSW 1215 | Ph: 1300 13 23 28 | Fax: 02 9240 4140 | Email: [email protected] | www.adcu.com.au
Australian Defence Credit Union Limited ABN 48 087 649 741 AFSL No. 237 988 Australian credit licence number 237 988
CIDD0312
Page 1 of 2
Categories of certifiers (required to answer question 2a)
No.
Description
1
Legal practitioner on the roll of the Supreme Court of a State or Territory,
or the High Court of Australia
2
A person who, under a state or territory law, is currently licensed or
registered to practice in one of the following occupations:
•
chiropractor
•
dentist
•
legal practitioner
•
medical practitioner
•
nurse
•
optometrist
•
patent attorney
•
pharmacist
•
physiotherapist
•
psychologist
•
trade marks attorney
•
veterinary surgeon
3
Australia Post agent in charge of an office supplying postal services to
the public
4
Australian Consular Officer or Australian Diplomatic Officer (within the
meaning of the Consular Fees Act 1955)
5
Bailiff
6
Bank officer with two or more years of continuous service
7
Building society officer with two or more years of continuous service
8
Chief executive officer of a Commonwealth court
9
Clerk of a court
10
Commissioner for Affidavits
11
Commissioner for Declarations
12
Credit union officer with 2 or more years of continuous service
13
Employee of the Australian Trade Commission who is:
•
in a country or place outside Australia; and
•
authorised under paragraph 3(d) of the Consular Fees Act 1955;
and
•
exercising his or her function in that place
No.
Description
22
Master of a court
23
Member of Chartered Secretaries Australia
24
Member of Engineers Australia, other than at the grade of student
25
Member of the Association of Taxation and Management Accountants
26
Member of the Australian Defence Force who is:
•
an officer; or
•
a non-commissioned officer within the meaning of the Defence
Force Discipline Act 1982 with two or more years of continuous
service; or
•
a warrant officer within the meaning of that Act
27
Member of the Institute of Chartered Accountants in Australia, the
Australian Society of Certified Practising Accountants or the National
Institute of Accountants
28
Member of:
•
the parliament of the Commonwealth; or
•
the parliament of a state; or
•
a territory legislature; or
•
a local government authority of a State or Territory
29
Minister of religion registered under Subdivision A of Division 1 of Part IV
of the Marriage Act 1961
30
Notary public
31
Australia Post permanent employee with two or more years of continuous
service who is employed in an office supplying postal services to the
public
32
Permanent employee of:
•
the Commonwealth or a Commonwealth authority; or
•
a State or Territory or a State or Territory authority; or
•
a local government authority
with two or more years of continuous service
33
Person before whom a statutory declaration may be made under the law
of the state or territory in which the declaration is made
34
Police officer
35
Registrar, or deputy registrar, of a court
36
Senior executive service employee of:
•
the Commonwealth or a Commonwealth authority; or
•
a State or Territory or a State or Territory authority
14
Employee of the Commonwealth who is:
•
in a country or place outside Australia; and
•
authorised under paragraph 3(c) of the Consular Fees Act 1955;
and
•
exercising his or her function in that place
37
Sheriff
15
Fellow of the National Tax Accountants’ Association
38
Sheriff’s officer
16
Finance company officer with two or more years of continuous service
39
17
Holder of a statutory office not specified in another item in this Part
Teacher employed on a full-time basis at a school or tertiary education
institution
18
Judge of a court
40
Member of the Australasian Institute of Mining and Metallurgy
19
Justice of the peace
41
20
Magistrate
An officer with, or authorised representative of, a holder of an Australian
financial services’ licence, having two or more continuous years of service
with one or more licensees.
21
Marriage celebrant registered under Subdivision C of Division 1 of Part IV
of the Marriage Act 1961
42
An officer with, or a credit representative of, a holder of an Australian
credit licence, having 2 or more years of continuous service with one or
more licencees.
Categories of documents (required to answer question 2B)
Category A Documents
Photo ID issued by the Australian Defence Force:
•
Permanent/reserve forces identification card
•
Australian Defence Force driver’s licence
•
Australian Defence Force spouse pass
Photo driver’s licence issued by a state or territory or foreign government*
Photo ID proof of age card issued by a state or territory government (In
NSW, only a NSW Photo Card is acceptable. The ‘NSW Proof of Age’ card is
no longer valid and should not be accepted as proof of identity.)
Current passport (or expired within last 2 years) issued by the
Commonwealth
Passport, with photo of the person, issued by a foreign government, the
United Nations, or a UN agency.*
National ID card, with photo and signature of the person, issued by a foreign
government, the United Nations, or a UN agency*
Category B Documents
Birth certificate issued by a state or territory
Birth extract issued by a state or territory
Citizenship certificate issued by the Commonwealth
Category C Documents
A notice that:
•
was issued to an individual by the Commonwealth, a State or Territory
within the preceding twelve months;
•
contains the name of the individual and his or her residential address; and
•
records the provision of financial benefits to the individual under a law of
the Commonwealth, State or Territory (as the case may be)
A notice that:
•
was issued to an individual by the Australian Taxation Office within the
preceding 12 months;
•
contains the name of the individual and his or her residential address; and
•
records a debt payable to or by the individual by or to (respectively) the
Commonwealth under a Commonwealth law relating to taxation
A notice that:
•
was issued to an individual by a local government body or utilities provider
within the preceding three months;
•
contains the name of the individual and his or her residential address; and
•
records the provision of services by that local government body or utilities
provider to that address or to that person
A notice that:
•
was issued to a minor by a school principal within the last three months
•
contains the name of the minor and their residential address; and
•
records the period of time the minor attended the school
Pension card issued by the Department of Human Services
Birth certificate issued by a foreign government or the UN*
Citizenship certificate issued by a foreign government *
*A document written in a language that is not understood by the person
carrying out the identification procedure must be accompanied by an English
translation prepared by an accredited translator.
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