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Cook Islands Subsidiary Legislation |
COOK ISLANDS
FINANCIAL TRANSACTIONS REPORTING
(FORMS) REGULATIONS 2004
LAURENCE MURRAY GREIG, Chief Justice of the High Court of the Cook Islands
ORDER IN EXECUTIVE COUNCIL
At Avarua, Rarotonga this 18th day of February 2004
Present:
HIS HONOUR THE CHIEF JUSTICE OF THE HIGH COURT OF
THE COOK ISLANDS IN EXECUTIVE COUNCIL
PURSUANT to Article 7(1) and sections 10 and 11 of the Financial Transactions Reporting Act 2003, the Chief Justice of the High Court, acting
by and with the advice and consent of the Executive Council, hereby makes the following regulations.
__________
ANALYSIS
1. Title
2. Interpretation
3. Cash transaction report form
4. Electronic funds transfer report form
5. Suspicious transaction report form
Schedules
______________________________________________________________________________
REGULATIONS
1. Title - These regulations may be cited as the Financial Transactions Reporting (Forms) Regulations 2004.
2. Interpretation - In these regulations, unless the context otherwise requires -
"Act" means the Financial Transactions Reporting Act 2003.
3. Cash transaction report form - A financial institution required to report any cash transaction under section 10(l)(a) of the Act, must use the form set out in
Schedule 1 of these Regulations.
4. Electronic funds transfer report form - A financial institution required to report any electronic funds transfer under sections 10(1)(b) or 10(1)(c) of the Act, must use
the form set out in Schedule 2 of these Regulations,
5. Suspicious transaction report form - (1) A financial institution required to report any suspicious transaction under sections 11 or 12 of the Act, must use the form
set out in Schedule 3 of these Regulations.
(2) A financial institution must in addition to completing the form set out in Schedule 3, provide the following information to the
FIU -
(a) a copy of all records held by the financial institution concerning the transaction;
(b) without limiting the generality of paragraph (a):
(i) the name, and all contact details held by the financial institution, of every person known to the financial institution to have been involved in the conduct of the transaction, including every person on whose behalf that transaction was conducted; and
(ii) the dates relevant to the transaction;
(c) if an account provided by the financial institution is relevant to the transaction,-
(i) the type and identifying number of any account used by the financial institution for that transaction; and
(ii) a copy of the information and documents required by section 4 of the Act to be obtained and kept by the financial institution in respect of customers of that account; and
(iii) a copy of the documentary evidence that is mentioned in section 4 of the Act; and is a record (relating to that account) required by section 6 of the Act to be kept by the financial institution.
P. Arere
Clerk of the Executive Council
__________
SCHEDULE 1
Cook Islands Financial Intelligence Unit
CASH TRANSECTION REPORT (CTR) NZ $10,000 OR MORE
Please complete in INK and in CAPITAL LETTERS
| Reporting of "significant" cash transactions is required by law under Section 10(1)(a) of the Financial Transactions Reporting Act
2003. Penalties exist for failure to report or to supply full and correct information. |
| PART A – IDENTITY OF PERSON CONDUCTING THE SUSPICIOUS TRANSACTION |
| 1. Full name (title, given names and surname) __________________________________________________________________________ __________________________________________________________________________ Also known as: _____________________________________________________________ |
| 2. Date of birth: ___________________________________ Day/Month/Year | 3. Country of birth _______________________________ |
| 4. Occupation, business or principal activity __________________________________________________________________________ |
| 5. Business address (physical and PO Box) ___________________________________ PO Box: _______________________________ __________________________________________________________________________ Country: ______________________________ Phone: _____________________________ |
| 6. Residential address (cannot be a PO Box) __________________________________________________________________________ __________________________________________________________________________ Country: _____________________________ Phone: ______________________________ |
| 7. NON RESIDENT – Cook Islands conduct address __________________________________________________________________________ __________________________________________________________________________ Country: ___________________________________ Phone: ________________________ |
| 8. Give details if this person is a signatory to account affected by this transaction Account Title/Name: ________________________________________________________ Account No: ________________________ Branch: _______________________________ Financial Institution: ________________________________________________________ |
| 9. How was the identity of this person confirmed? ID Type: __________________________________________________________________ ID Number: _______________________________________________________________ Issuer: ____________________________________________________________________ |
| 10. Is a photocopy of ID document/s attached? |
| If more than one person involved please provide same details contained in Sections 1-11 for each person, where appropriate, and attach. |
| PART B – DETAILS OF PERSON/ORGANISATION ON WHOSE BEHALF THE TRANSACTION WAS CONDUCTED (If applicable) |
| 11. Full name of person/organisation __________________________________________________________________________ |
| 12. Business address (physical and PO Box) ____________________________________ PO Box: ______________________________ __________________________________________________________________________ Country: ____________________________ Phone: _______________________________ |
| 13. Occupation, business or principal activity __________________________________________________________________________ |
| 14. Give details if this person is a signatory to account affected by this transaction Account Title/Name: ________________________________________________________ Account No: ____________________________ Branch: ___________________________ Financial Institution:_________________________________________________________ |
| PART C – DETAILS OF THE TRANSACTION |
| 15. Date of transaction DAY MONTH YEAR |
| 16. Total amount of his transaction (include cash and any other components of the transaction – If a foreign currency is involved,
convert the amount to New Zealand dollars) NZ$ ___________________, ________ |
| 17. If a foreign currency was involved in this transaction, specify: Foreign Currency ___________________________________________________________ (eg Hong Kong Dollars) Foreign Currency Amount ____________________________________________________ (eg HKD$400,000) |
| 18. Cash paid IN | 19. Cash paid OUT |
| 20. Type of transaction(s) involved Transfer to another Financial Institution: Travellers cheques Foreign currency Bank cheque Account deposit/withdrawal Bank draft Securities Previous stones/metals/pearls etc | ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ |
| Other _____________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ | |
| 21. If a cheque/ bank draft/ money order/ telegraphic transfer/ transfer of currency or purchase or sale of any security was involved
in this transaction, please specify: Drawer/Ordering Customer: ___________________________________________________ ___________________________________________________________________________ Payee/Favouree/Beneficiary: ___________________________________________________ ___________________________________________________________________________ |
| 22. If another financial institution was involved in this transaction, please specify: Name of financial institution: __________________________________________________ __________________________________________________________________________ Branch: ____________________________________________________________________ Country: ___________________________________________________________________ |
| PART D – DETAILS OF THE RECIPIENT PERSON/ORGANISATION (if applicable) |
| 23. Full name of person/organisation ___________________________________________________________________________ |
| 24. Business address (physical and PO Box) _____________________________________ PO Box ______________________________ __________________________________________________________________________ Country: _____________________________ Phone: _______________________________ |
| 25. Occupation, business or principal activity ___________________________________________________________________________ |
| 26. Reason for transaction (eg payment for imports) ___________________________________________________________________________ ___________________________________________________________________________ |
| 27. Details of recipient account (if not already provided) Account/Title/Name: _________________________________________________________ Account No: ___________________________ Branch: _____________________________ Financial Institution: _________________________________________________________ |
| PART E – EXEMPLARY NOTES |
| 28. Give details of the nature and circumstances surrounding the transaction if required. PLEASE PRINT IN BLOCK LETTERS. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ |
| 29. Is additional information attached to this report? Please specify: ______________________________________________________________ |
| PART F – REPORTING FINANCIAL INSTITUTION |
| 30. Type of Financial Institution (eg bank) ___________________________________________________________________________ |
| 31. Name of Financial Institution ___________________________________________________________________________ |
| 32. Name of branch or office where transaction was conducted ___________________________________________________________________________ |
| 33. Business address (physical and PO Box) _____________________________________ PO Box ______________________________ __________________________________________________________________________ Country: _____________________________ Phone: _______________________________ |
| PART G – FINANCIAL INSTITUTIONS STATEMENT |
| 34. Details of authorised person: Given names and surname: ____________________________________________________ ___________________________________________________________________________ Job title: ___________________________________________________________________ Phone: __________________________________ Fax: ______________________________ |
| 35. This statement is made pursuant to the requirement that to report "significant" cash transactions under Cook islands laws on the
grounds detailed in this report. Signature of authorised person: Date: |
| 36. Financial Institutions internal reference number (if applicable) ___________________________________________________________________________ |
| Send completed forms to: | For assistance contact: |
| Head of FIU PO Box 3219 Rarotonga COOK ISLANDS |
________
SCHEDULE 2
Cook Islands Financial Intelligence Unit
ELECTRONIC TRANSFER REPORT (EFTR)
Please complete in INK and in CAPITAL LETTERS
| Reporting of electronic funds transfer, of over NZ$10,000, is required by law under Section 10(1)(b) and (c) of the Financial Transactions
Reporting Act 2003. Penalties exist for failure to report or to supply full and correct information. |
| PART A – DETAILS OF THE TRANSACTION |
| 1. Initiating office/branch ________________________________________________________________________ |
| 2. Date of -transmission/receipt |
| 3. Direction of transmission Into Cook islands |
| 4. Transaction reference reference number __________________________________________________________________________ |
| 5. Sending institutions details BIC (where applicable or) ____________________________________________________ Name of Bank: _____________________________________________________________ City: ___________________________________ Country: __________________________ |
| 7. Date funds available |
| 8. If a foreign currency was involved in this transaction, specify: Currency __________________________________________________________________ (eg Hong Kong Dollars) Amount of transaction _______________________________________________________ (eg HKD$400,000) |
| PART B – INVOVLED PARTY AND INSTITUTION DETAILS |
| 9. Ordering customer/organisation (SWIFT field 50) Name: ____________________________________________________________________ |
| Occupation, business or principal activity: _____________________________________ __________________________________________________________________________ __________________________________________________________________________ |
| Business/Residential address: (physical and PO Box) ______________________________________ PO Box: ____________________________ __________________________________________________________________________ Country: ________________________________ Phone: ___________________________ |
| Account details: Account Title/Name: ________________________________________________________ Bank: __________________________________ Branch: ___________________________ Account number: ___________________________________________________________ |
| Person who authorised transfer: Title: _____________________________________________________________________ Name: ____________________________________________________________________ Position with organisation: ____________________________________________________ |
| 10. Beneficiary Customer/organisation (SWIFT field 59) Name: ____________________________________________________________________ |
| Occupation, business or principal activity: _______________________________________ __________________________________________________________________________ |
| Business/Residential address: (Physical and PO Box) _______________________________________ PO Box: ___________________________ __________________________________________________________________________ Country: _______________________________ Phone: ____________________________ |
| Account details: Account Title/Name: ________________________________________________________ Bank: _________________________________ Branch: ____________________________ Account Number: ___________________________________________________________ |
| Person identified to receive payment (if applicable) Title: _____________________________________________________________________ Name: ____________________________________________________________________ Position with organisation: ____________________________________________________ |
| 11. Sender's Correspondent (SWIFT field 53) Name of Bank: _____________________________________________________________ City: ___________________________________ Country: __________________________ |
| 12. Receiver's Correspondent (SWIFT field 54) Name of Bank: _____________________________________________________________ City: ___________________________________ Country: __________________________ |
| PART C – ADDITIONAL PAYMENT DETAILS |
| 13. Details of payment (SWIFT field 70 – information for the beneficiary customer regarding the payment eg. Invoice number) __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ |
| 14. Sender to Receiver information (SWIFT field 72 – Additional information for the receiving institution – also known as Bank to Bank information) _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ |
| 15. Additional information (include Intermediary bank details, related reference number, ordering and beneficiary institutions (SWIFT field references – related reference number – 21, ordering institution – 52, intermediary – 56, beneficiary institution – 58) __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ |
| 16. Any other information deemed relevant __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ |
| 17. Is additional information attached to this report? No Yes Please specify: _____________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ |
| PART D – REPORTING FINANCIAL INSTITUTIONS |
| 18. Type of Financial institution (eg bank) __________________________________________________________________________ |
| 19. Name of Financial Institution __________________________________________________________________________ |
| 20. Name of branch or office where transaction was conducted __________________________________________________________________________ |
| 21. Business address (physical and PO Box) _______________________________________ PO Box ___________________________ __________________________________________________________________________ Country: ______________________________ Phone: _____________________________ |
| PART E – FINANCIAL INSTITUTION'S STATEMENT |
| 22. Details of authorised person: Given names and surname: ___________________________________________________ __________________________________________________________________________ Job title: __________________________________________________________________ Phone: _______________________________ Fax: ________________________________ |
| 23. This statement is made pursuant to the requirement to report suspicious transactions under Cook Islands laws on the grounds detailed
in Part E. Signature of authorised person: Sign here Date: |
| 24. Financial Institutions internal reference number (if applicable) __________________________________________________________________________ |
| Send completed forms to: | For assistance contact: |
| Head of FIU PO Box 3219 Rarotonga COOK ISLANDS |
________
SCHEDULE 3
Cook Islands Financial Intelligence Unit
SUSPICIOUS TRANSACTION REPORT (STR)
Please complete in INK and in CAPITAL LETTERS
| Reporting of suspicious transactions is required by law under Section 11(1) of the Financial Transactions Reporting Act 2003. Penalties
exist for failure to report or to supply full and correct information. |
| PART A – IDENTITY OF PERSON CONDUCTING THE SUSPICIOUS TRANSACTION |
| 1. Full name (title, given names and surname) __________________________________________________________________________ __________________________________________________________________________ Also known as: _____________________________________________________________ |
| 2. Date of birth: ______________________________________ Day/Month/Year | 3. Country of birth: __________________________________ |
| 4. Occupation, business or principal activity __________________________________________________________________________ |
| 5. Business address (physical and PO Box) ______________________________________ PO Box: ____________________________ __________________________________________________________________________ Country: ______________________________ Phone: _____________________________ |
| 6. Residential address (cannot be a PO Box) __________________________________________________________________________ __________________________________________________________________________ Country: _______________________________ Phone: ____________________________ |
| 7. NON RESIDENT – Cook Islands conduct address __________________________________________________________________________ __________________________________________________________________________ | |
| COOK ISLANDS | Phone: ___________________________ |
| 8. Give details if this person is a signatory to account affected by this transaction Account Title/Name: ________________________________________________________ Account No. ____________________________ Branch: ____________________________ Financial Institution: ________________________________________________________ |
| 9. How was the identity of this person confirmed? ID Type: __________________________________________________________________ ID Number: _______________________________________________________________ Issuer: ____________________________________________________________________ |
| 10. Is a photocopy of ID document/s attached? Yes No |
| If more than one person involved please provide same details contained in Sections 1-11 for each person, where appropriate, and attach. |
| PART B – DETAILS OF PERSON/ORGANISATION ON WHOSE BEHALF THE TRANSACTION WAS CONDUCTED (if applicable) |
| 11. Full name of person/organisation __________________________________________________________________________ |
| 12. Business address (physical and PO Box) ______________________________________ PO Box: ___________________________ __________________________________________________________________________ Country: ______________________________ Phone: _____________________________ |
| 13. Occupation, business or physical activity __________________________________________________________________________ |
| 14. Give details if this person is a signatory to account affected by this transaction Account Title/Name: ________________________________________________________ Account No: ___________________________ Branch: ____________________________ Financial Institution: ________________________________________________________ |
| PART C – DETAILS OF THE TRANSACTION |
| 15. Type of transaction (eg deposit) __________________________________________________________________________ |
| 16. Date of transaction Day Month Year |
| 17. Total amount of this transaction (include cash and any other components of the transaction – If a foreign currency is involved,
convert the amount to New Zealand dollars) NZ$ ___________________________________ . ______________ |
| 18. If a foreign currency was involved in this transaction, specify: Foreign Currency ___________________________________________________________ (eg Hong Kong Dollars) Foreign Currency Amount ____________________________________________________ (eg HKD$400,000) |
| 19. If a cheque/bank draft/money order/telegraphic transfer/transfer of currency or purchase or sale of any security was involved
in the transaction, please specify: Drawer/Ordering Customer: __________________________________________________ Payee/Favouree/Beneficiary: __________________________________________________ |
| 20. If another financial institution was involved in this transaction, please specify: Name of financial institution: _________________________________________________ _________________________________________________________________________ Branch: ________________________________ Country: ___________________________ |
| 21. |
| PART – DETAILS OF THE RECIPIENT PERSON/ORGANISATION |
| 22. |
| 23. |
| 24. |
| 25. |
| 26. |
| PART E – GROUNDS FOR SUSPICION |
| 27. |
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