Account Closure Request
Complete this form if you wish to terminate your margin loan account with us.
(If you wish to transfer your margin loan to another lender, please contact your lender. Submit this form after
your refinance is complete.)
Section 1 Borrower's Details
Name of borrower(s) on the BankSA Margin Lending Facility
Borrower(s) Client Reference Number
Section 2 Withdrawal of securities (if any)
Please tick () as appropriate
Convert the remaining shares to issuer sponsored
Transfer the remaining stock to the following broker. (To do so, you must instruct your broker or margin
lender, who will initiate this transaction.)
Broker name
Managed Funds
To redeem your managed funds, please complete and attach a Managed Funds Redemption Form,
available on our website
Transfer the managed funds into my/our names.
Section 3 Withdrawal of available funds (if applicable)
Please tick () one of the following two options
Pay to account give details below
Name of financial institution Branch name
BSB number Account number
Account name
Pay via cheque give details below
Name of payee
BSA02556 (03/11) Page 1 of 2
A Division of Westpac Banking Corporation ABN 33 007 457 141 AFSL 233714.
Section 4 Repaying your Loan (if applicable)
Please note that any outstanding loan balance (including accrued interest) must be repaid before we can action
this request. Please log on to or call us on 1300 304 065 to confirm this amount.
Please indicate your method of payment to repay your loan:
Cheque (Payable to BankSA Margin Lending) to be attached to this form
Deposit cash into our bank account
Account Name: St.George Bank Margin Lending
BSB: 332 096 Account Number: 599 000 006
Reference: You must include your Client Reference Number
Direct Debit your existing bank account (if applicable)
Complete and attach a Direct Debit Request Form available at
Section 5 Reason for closure (optional)
Name of borrower(s) on the BankSA Margin Lending Facility
Section 6 Authority
I/We confirm that the above details are true and correct.
By signing this form, you also authorise us to close your linked Cash Management Trust account (CMA),
if applicable.
Borrower/Trustee 1 Signature Borrower/Trustee 2 Signature
Date Date
/ /
/ /
Third party security provider’s signature 1 Third party security provider’s signature 2
Date Date
/ /
/ /
Company Borrower or Company Trustee
In all cases, either two directors, one director and one secretary or the sole director/secretary must sign.
Company Directory signature Company Director/Secretary signature (if applicable)
Date Date
/ /
/ /
Authorised Signatory’s Signature
/ /
Please send the completed form to:
BankSA Margin Lending
Reply Paid 1467
Royal Exchange NSW 1224
or fax to 1300 179 540 (International 61 2 9995 8292)
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