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 banksamarginlending.com.au 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 banksamarginlending.com.au
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
7
7
Date Date
/ /
/ /
Third party security provider’s signature 1 Third party security provider’s signature 2
7
7
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)
7
7
Date Date
/ /
/ /
Authorised Signatory’s Signature
7
Date
/ /
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)
BSA02556 (03/11) Page 2 of 2
