7.138 Investor tax file number 123456784 7.140 Non-resident investor tax identification number 895423789 7.147 Australian address line 1 C/- BARTHOLOMEW & KIDD – 7.147 Australian address line 2 PO BOX 945 – 7.148 Australian suburb, town or locality PERTH 7.149 Australian or territory WA 7.150 Australian postcode 6001 Date of change of residency status from resident to 7.151 00000000 resident (DDMMCCYY) 7.152 Overseas address line 1 217 HOCKEY STREET – 7.152 Overseas address line 2 APARTMENT 28 – 7.153 Overseas suburb, town or locality MONTREAL 7.154 Overseas state or province QUEBEC 7.155 Overseas postal code H1A OA1 7.156 Overseas country CANADA 7.157 Non-resident investor overseas country code CAN Non-resident investor country of residence for tax 7.158 CANADA purposes Date of change of residency status from non-resident to 7.159 03032015 resident (DDMMCCYY) investor data record (extract) reporting period the investor was a resident 2 – Reference name Content number 7.138 Investor tax file number 123456784 7.147 Australian address line 1 C/- ELISE ERIKSEN – 7.147 Australian address line 2 11/21 CARPATHIA AVENUE – 7.148 Australian suburb, town or locality CITY 7.149 Australian state or territory WA 7.150 Australian postcode 6015 Date of change of residency status from resident to non-resident 7.151 00000000 (DDMMCCYY) 7.152 Overseas address line 1 Blank fill – 7.152 Overseas address line 2 Blank fill – Blank fill 7.153 Overseas suburb, town or locality Blank fill 7.154 Overseas or province 7.155 Overseas postal code fill 7.156 Overseas country Blank fill 7.157 Non-resident investor overseas country code Blank fill 7.158 Non-resident investor country of residence for tax purposes Blank fill 7.159 Date of change of residency status from non-resident to resident 03032016
7.138 Investor tax file number 123456784 7.140 Non-resident investor tax identification number 895423789 7.147 Australian address – line 1 C/- BARTHOLOMEW & KIDD 7.147 Australian address – line 2 PO BOX 945 7.148 Australian suburb, town or locality PERTH 7.149 Australian or territory WA 7.150 Australian postcode 6001 7.151 Date of change of residency status from resident to (DDMMCCYY) 00000000 7.152 Overseas address – line 1 217 HOCKEY STREET 7.152 Overseas address – line 2 APARTMENT 28 7.153 Overseas suburb, town or locality MONTREAL 7.154 Overseas state or province QUEBEC 7.155 Overseas postal code H1A OA1 7.156 Overseas country CANADA 7.157 Non-resident investor overseas country code CAN 7.158 Non-resident investor country of residence for tax purposes CANADA 7.159 Date of change of residency status from non-resident to resident (DDMMCCYY) 03032015 investor data record 2 (extract) – reporting period the investor was a resident Reference number name Content 7.138 Investor tax file number 123456784 7.147 Australian address – line 1 C/- ELISE ERIKSEN 7.147 Australian address – line 2 11/21 CARPATHIA AVENUE 7.148 Australian suburb, town or locality CITY 7.149 Australian state or territory WA 7.150 Australian postcode 6015 7.151 Date of change of residency status from resident to non-resident (DDMMCCYY) 00000000 7.152 Overseas address – line 1 Blank fill 7.152 Overseas address – line 2 Blank fill 7.153 Overseas suburb, town or locality Blank fill 7.154 Overseas or province Blank fill 7.155 Overseas postal code fill 7.156 Overseas country Blank fill 7.157 Non-resident investor overseas country code Blank fill 7.158 Non-resident investor country of residence for tax purposes Blank fill 7.159 Date of change of residency status from non-resident to resident 03032016 resident