A Wise Partnership

Distributor Agreement

DISTRIBUTOR AGREEMENT

Name of Distributor (Agency Office)(Required)

Business Name(Required)

ABN(Required)

Business Address(Required)

Postal Address (if different from above)

Contact Number(Required)

Name of Principal(Required)

Email Address(Required)

How many staff will act as distributors?

Staff Member #1

Staff Member #2

Staff Member #3

Staff Member #4

Staff Member #5

Are you currently a Distributor of another Licensee (Insurance Provider/Distributor)?(Required)

Yes

Other Licensee's Name

AFS Licence No. (If known)

FINANCIAL DETAILS FOR COMMISSION PAYMENT

Bank/Institution Name

Account Name

BSB

Account Number

Agreement(Required)

I agree to these terms and conditions

o I declare the information provided by me in this application is true and correct to the best of my knowledge and belief.
o I undertake to advise CoverWise REI P/L and PSC Connect P/L of any changes to the information provided by me in this application whilst acting as a Distributor.
o I understand that as a distributor of CoverWise, I can arrange insurance, but I am unable to provide advice.
o Confidentiality
o Data security

RCTI AGREEMENT

Recipient Created Tax Invoices Agreement

This Agreement is required under RCTI 2000/1, A New Tax System (Goods and Services Tax) Act 1999 Classes of Recipient Created Tax Invoice Determination (No. 1) 2000.

The purpose of this Agreement is to evidence that you have authorised The Licensee to raise Recipient Created Tax Invoices in respect of payments made by the Licensee to you.

Please review and complete the following

Supplier Name(Required)

ABN(Required)

Terms and Conditions

Agreement(Required)

I acknowledge this agreement

“Supplies” or “Supply” is the provision of services for which the Distributor is paid

“RCTI” is recipient created tax invoice

“Recipient” is the entity PSC Connect Pty Ltd named above as “Licensee”

“Supplier” is the entity named above as “Supplier Name”

Any terms capitalised in this Agreement and not defined above have the same meaning as set out in the Distributor Agreement of the same date between the Recipient (referred to as “Licensee”) and Supplier (referred to as “Distributor”).

The Recipient and Supplier agree:
a. The recipient can issue tax invoices in respect of the supplies;
b. The supplier will not issue tax invoices in respect of the supplies;
c. The supplier acknowledges that it is registered for GST at the time of entering into this agreement, and that it will notify the recipient if it ceases to be so registered;
d. The recipient acknowledges that it is registered at the time if entering into this agreement and that it will notify the supplier if it ceases to be registered for GST purposes, or if it ceases to satisfy any of the relevant requirements of the legislation, determinations, rulings and other requirements required to allow the issuing of RCTIS, that are in-force from time to time;
e. The recipient agrees to indemnify the supplier for any liability for GST or penalty that may arise from an understatement of the gst payable on any supply for which it issues an RCTI;
f. The above terms are modified in accordance with current gst law and tax rulings as required for the issuance of a RCTI from time to time; and
g. This agreement will continue between the supplier and the recipient until the distribution agreement of the same date between the recipient (referred to as “licensee”)

Distributor Agreement