POA Signatory Authority

As POA, the person named is authorised to withdraw cash; sign Account Transfers, Bank of St Helena Cheques and International Remittances; Set up Standing Orders and Direct Debits; and receive Statements. Customers are advised that POA can authorise other individuals to undertake transactions on the named account(s) they authorised to open, close or amend an Account without written instruction from the Account Holder.

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All compulsory fields are marked with ‘*’.

Details of the person who will sign POA

Title

Dr/Mr/Mrs/Miss etc

Name

First

Middle

Last

Date of Birth

Nationality

Country of Residence

Home Address

Address Line 1

City

State / Province / Region

Postal Code

Home Telephone Number

Mobile Telephone Number

Work Telephone Number

POA Signature (if signature is not legible, you may upload a copy of your signature in the upload box below)

Clear Signature

Application can not be accepted without a signature.

Signature upload (if required)

Drag & Drop Files, Choose Files to Upload

Date *

Authorisation

Account Holder Details

Until further notice from me/any one of us, please accept the signature of the person named to undertake transactions on the account(s) detailed

How many Accounts will this apply to?

Details will be provided below

As POA the person named in Section 1 is authorised to withdraw cash; sign Account Transfers, Bank of St Helena Cheques and International Remittances; Set up Standing Orders and Direct Debits; and receive Statements. CUSTOMERS COMPLETING AND SIGNING ANY FORMS AS A POA AUTHORITY MUST INDICATE THEIR POA ON THE ACCOUNT BY WRITING POA AUTHORITY ALONGSIDE THEIR SIGNATURES. Customers are advised that POA Authorities can authorise other individuals to undertake transactions on the named account(s), and are they authorised to open, close or amend an Account without written instruction from the Account Holder.

Are any of these Joint accounts?

Account Holder