Account switching consent form

Please complete and return this form along with the supporting documents to support@challenger.com.au Or mail to: Challenger Bank Limited, PO BOX 297, Flinders Lane, Melbourne VIC 8009. If you require assistance in completing this form, please contact us on 1300 221 479

Section 1 – Account holder details

Customer number

BSB number

First & middle name

Surname

Section 2 – Old

Challenger bank account

704165

account

details

Please close the following account:

Account number

BSB number

Account Name

Section 3 – Customer instructions

Street address

Suburb State

Postcode

Account number

Switch all regular payments to the above account and send me the list for my records OR

Send me the regular payments list by post and I’ll outline which payments to switch myself. If this option is chosen, please fill in postal address below

Send me the regular payments list via post:

Postal address

Challenger Bank Limited, PO Box 297, Flinders Lane, Melbourne VIC 8009. (ABN 54 087 651 750, AFSL/Australian Credit Licence 245606)

Section 4 – Consent to switch direct debts to bank and privacy acknowledgement

I/we consent to our old financial institution compiling a regular payments list, and giving the list to Challenger, showing regular payments to and from my/our old account (as described above).

I/we understand and acknowledge that:

• The regular payments list includes my/our personal information;

• I’m/we’re authorised to operate the account above; and

• The account is a personal account held in my/our name(s).

I/we acknowledge that when this form is provided (together with the details of my instructions) to each debit user or credit user, this will change the account details set out in my/our direct debit arrangements and direct credit arrangements with them. The other terms of my/our original direct debit request and direct credit arrangements aren’t affected.

I/we instruct each debit /credit user to use the new Challenger account details provided above for my/our direct debts/credits with immediate effect. I/we acknowledge that all information provided on this form may be shared with our old financial institution and each debit/credit user, through its sponsor or user financial Institution as the case may be, for the purpose of switching my/our account.

Signature of primary account holder

Date

Signature of secondary account holder

Date