Update Details - Ngāti Whakaue Tribal Lands

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Shareholder Name

Also known as

Home Phone

Mobile Phone

Address

ID (Driver's Licence or Passport)

Identification Type

Date of Birth

I.R.D Number

I received my shares from (Name)

Relationship to me

My Siblings are:

Please attach a pre-printed bank deposit slip OR fill in the details below and have your Bank verify the section below.

Bank Deposit

Name of Bank

Bank Details

Bank Account Name

Branch

Bank Account Number

Declaration: I confirm that all information given above is true and complete.