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Financial Transactions Reporting Act 2003 - Financial Transactions Reporting (Forms) Regulations 2004

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
Financial Intelligence Unit
Phone: (+682)29182
Fax: (+682)29183
Email: cifiu@oyster.net.ck

________

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
Financial Intelligence Unit
Phone: (+682)29182
Fax: (+682)29183
Email: cifiu@oyster.net.ck

________

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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