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Read our policy for details.
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What is your name?
Title
--
Mr
Mrs
Ms
First name
Middle name
Last name
Preferred name
*This information needs to match your ID
What are your contact details?
Your email address
Your mobile number
What is your home address?
Home address
Is this also your postal address?
Yes
No
Postal address
Your Details
When were you born?
Date of birth
Where were you born?
Birth Country
--
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Congo-Brazzaville)
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic (Czechia)
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Citizenship
--
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Congo-Brazzaville)
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic (Czechia)
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Are you (or are you immediately related to) a senior member of New Zealand or foreign government, the judiciary, the military, or an ambassador?
Yes
No
If yes, please explain further:
What are your tax details?
IRD number
Prescribed Investor Rate (PIR)
10.5%
17.5%
28.0%
What is my PIR?
If you are unsure of your IRD number and/or your PIR we recommend you seek professional advice or contact Inland Revenue.
Are you a US citizen or US tax resident?
Yes
No
If you are unsure of your US citizenship or tax residency status, please contact us. FACTA is US legislation directed as reducing tax evasion by US taxpayers which is in force in New Zealand. As a result, we have a legal obligation to ask each time an investment is made whether the applicant has any US connections. If you select ‘Yes’ we will seek further information to clarify your status and enusre you comply with legal obligations.
How much would you like to invest?
Investment amount ($5,000 min)
How often do you intend to deposit into your account?
Please choose at least one option
Regular
Now and then
Lump sum (one-off)
How often do you intend to withdrawal from your account?
Please select at least one
Regular
Now and then
Lump sum (one-off)
What is the purpose of your investment?
We're legally required to ask this question.
Accumulation of wealth
Retirement
Income stream
Other
Describe your purpose
What is the source of your funds?
We're legally required to ask this question.
Inheritance/Windfall
Property sale
Asset/Business sale
Personal income
Accumulated savings
Superannuation
Other
Details of Source of Funds
You may be required to provide proof of the source of your funds.
How would you like to receive your monthly distribution?
Reinvest it
Direct credited to my bank account
What is your bank account number?
How did you hear about Norfolk?
Select as many that apply
Print ads
Online advertising
Online search
Social media
Referral
TV/Video advertising
Radio
Other
Thanks, you’re nearly there.
I have downloaded, read, and understood
the Product Disclosure Statement (PDS)
I confirm that the information I have provided is all true.
Information in this form is collected to comply with the Anti-Money Laundering and Countering Financing of Terrorism Act 2009. It will be held by Norfolk Mortgage Management Limited and may be shared with third parties for compliance. You can request to see your personal information by contacting us.
What’s next?
We use SmartID, a secure service, to verify your ID. This check is required to comply with NZ regulations.
You'll receive a text message to your mobile with a unique link from SmartID to start the ID check.
Make sure you have your NZ Driver's license or Passport ready.
The process is simple and usually takes less than 5 minutes.
Finish
Download the Investment Guide
First Name
Last Name
Email
Submit and Download
