Individual Shareholder Registration Form

Once you have completed all the details, please get and upload the Bank Verified Stamp or upload a Bank Deposit Slip

The first three boxes must be filled in and then the whakapapa from the side the shares came from (e.g. if it is your mother fill in all the boxes on your mother's side). If you are a life interest holder please use your spouse's whakapapa.

Pursuant to the Privacy Act 1993 the following is brought to your attention:

I hereby declare that:

1. All the information contained in this registration form and whakapapa is true and correct.
2. I understand that the information I provide will be held by Omataroa Rangitaiki No.2 Trust, their employees and the Trustees of the blocks in which you are registered in their role as administrator or Trustee to process this registration.
3. Failure to provide requested information may result in your update request form not being processed.
4. You have the right of access to, and correction of, information held about you subject to the provisions of the Privacy Act 1993.

By signing you confirm that you have read and understood the notes to this form.

Personal identification required for ALL requests:

Only a copy of the following can be accepted as personal identification:

• Driver's license or passport, birth certificate; or
• Other photo identification (Note: only valid if signature and name is also on ID); or
• Two forms of other ID (e.g. Community Services Card/Bank Card with name embossed/printed and signature included.

• Succession order
• Maori Land Court Minutes/Date of the MLC meeting

• Should your name change, need alteration, or correction, we require confirmation from the Maori Land Court that this has been processed prior to updating our records.

• Provided you can be identified as an owner, we will endeavour to pay any accumulated funds on the 20th of the month following receipt of your completed form. If your bank details have changed contact the office immediately to update our records.