Tower TOWER KiwiSaver

Registered name of company (as shown in your certificate of incorporation)*:	This field is required
Number of staff:	This field is required

IRD number

IRD number*:

Contact details

Address of registered office*:	This field is required
Address for correspondence*:	This field is required
Company contact*:	This field is required
Job title:	This field is required
Telephone (work):	Please select 0304060709021027029 This field is required
Fax:	Please select 0304060709021027029 This field is required
Email*:	This field is required

Associated company details

Associated company:	This field is required
IRD number:	(Required under clause 47 (1)(b)(i) of the KiwiSaver Act 2006)
Associated company:	This field is required
IRD number:	(Required under clause 47 (1)(b)(i) of the KiwiSaver Act 2006)

Authority

	On behalf of (the Company) we wish to appoint TOWER Managed Funds Limited as our provider of choice as detailed under clause 46(1) of the KiwiSaver Act 2006.
Name of delegated authority*:	This field is required
Job Title*:	This field is required
	Date: