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Form of Application for a Crown Wholesale Funding Guarantee Facility Deed

Page updated 5 Jan 2009

[Letterhead of Applicant]

Date:

To:
Secretary to the Treasury
Level 5
No. 1 The Terrace
Wellington
NEW ZEALAND

Application for Crown Wholesale Funding Guarantee Facility

We refer to the Crown Wholesale Funding Guarantee Scheme announced by the Minister of Finance on 1 November 2008 and hereby apply to be considered for a Crown Wholesale Funding Guarantee Facility Deed with Her Majesty the Queen in right of New Zealand.

The information listed in the schedule below is attached in support of our application.

We represent and warrant to you that, as at the date of this application:

  1. the information contained in or accompanying this application is accurate, complete and not misleading (including by omission) in any respect;
  2. we are solvent and able to pay our debts as they fall due; and
  3. we are not in breach of any prudential supervision direction, notice or requirement under the Reserve Bank of New Zealand Act 1989 or otherwise in any material respect.

Name of Applicant by:

___________________________
Director/Authorised Signatory
Name:

___________________________
Director/Authorised Signatory
Name:

Schedule

The information provided by an applicant should include (as applicable):

  1. Full legal name.
  2. Incorporation details.
  3. Details of ownership structure.
  4. Details as to the size of lending and borrowing activities in New Zealand.
  5. Credit rating.
  6. Applicant's constitution.
  7. If the applicant is a locally incorporated bank, a copy of the applicant's most recent disclosure statement.
  8. If the applicant is not a bank, a copy of any trust deed for the applicant.
  9. Details as to capital structure and capital ratio.
  10. Details of material related party exposure of the applicant.
  11. Details of any security over the applicants assets.
  12. Copies of all relevant documents for the debt issuance programmes in respect of which the applicant is considering using the Crown wholesale funding guarantee facility, including:
    • dealer agreements;
    • issue and paying agency agreements;
    • trust deeds and deed polls;
    • guarantees;
    • offering documents; and
    • amending or supplemental agreements.
  13. A summary of wholesale securities currently on issue by the applicant, including volume and value.
  14. A summary of market or regulatory disclosure requirements applicable to the debt issuance programmes in respect of which the applicant is considering using the Crown wholesale funding guarantee facility.
  15. Evidence of the authority of the signatories to the application.
  16. Full details of the relevant contact person for the application.
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