FULL DISCHARGE AUTHORITY FORM
LOAN NUMBER: DATE:
SENDER: FAX: EMAIL:
BORROWER 1 FULL NAME: BORROWER 2 FULL NAME:
BORROWER 3 FULL NAME: BORROWER 4 FULL NAME:
ATTENTION: DISCHARGES (FAX: 02 9248 2312) (EMAIL: DISCHARGES@RESIMAC.COM.AU)
Security 1:
Security 2:
Security 3:
SECURITY ADDRESSES
SALE REFINANCE OTHER
Re-Locating Interest Rate Repaid
Investment Property Product Features Other Reason (not listed):
Hardship Service
Purchase New Owner Occupied Property Staff Concession
Down Sizing Additional Borrowings
REASON FOR DISCHARGE (PLEASE TICK APPROPRIATE BOX)
CONTACT NAME: LENDER / SOLICITOR / CONVEYANCER COMPANY:
POSTAL ADDRESS: PHONE NUMBER:
FAX NUMBER: EMAIL ADDRESS:
ESTIMATED SETTLEMENT DATE: ORIGINATOR FEES (IF APPLICABLE):
NEW LENDER / SOLICITOR / CONVEYANCER DETAILS
NAME IN PRINT (BORROWER 1) NAME IN PRINT (BORROWER 2) NAME IN PRINT (BORROWER 3) NAME IN PRINT (BORROWER 4)
SIGNATURE SIGNATURE SIGNATURE SIGNATURE
DATE DATE DATE DATE
DECLARATION
*NOTE: ON RECEIPT OF A COMPLETED FULL DISCHARGE AUTHORITY FORM, YOUR LOAN ACCESS CARD WILL BE SUSPENDED (IF APPLICABLE)
AUSTRALIAN CREDIT LICENCE 247283 PAGE 1 OF 1 23 MARCH 2012 (V12.1)
