Company or Trust in which investment is held
All Correspondence to:
BlackWall Limited
PO Box 612
Neutral Bay NSW 2089
Full Name(s) of
Tel: 1800 789 141 (within Aust)
Registered Holding
Tel: + 61 2 9033 8611 (outside Aust)
Fax: + 61 2 9033 8600
.au
Securityholder Reference Number (SRN)
Existing holders - required to insert this number
New holders – leave blank
Change of Address Notification
Use a black pen. Print in CAPITAL letters inside the boxes.
A. Change of Address
Current registered (old) address
Unit
Street Number
Street Name
OR Post Office Box or other mail details (if applicable)
City/Suburb/Town
State
Post Code
New Address Details
Unit
Street Number
Street Name
OR Post Office Box or other mail details (if applicable)
City/Suburb/Town
State
Post Code
___________________________________________________________________
Contact Name:
_________________________________________________________________
Contact Number: _
____________________________________________________________________
Email Address:
B.
Sign Here – This section must be signed for your instructions to be executed
I/We request you to amend the registered address in your records to the above address.
I/We acknowledge that these instructions supersede and have priority over all previous instructions in respect to my/our securities.
Individual or Securityholder 1
Securityholder 2
Securityholder 3
Sole Director and Sole Company
Director
Director/Company Secretary
Secretary
Day/Month/Year
/ /
Individual:
This form is to be signed by the securityholder.
Joint Holding:
Where the holding is in more than one name, all the securityholders must sign.
Power of
To sign as Power of Attorney, you must have already lodged it with the registry. Alternatively, attach a
Attorney:
certified photocopy of the Power of Attorney to this form.
Two Directors, Director & Company Secretary or Sole Director and Sole Company Secretary can sign.
Companies:
Please indicate the office held by signing in the appropriate space.
Privacy Statement:
BlackWall Property Funds Limited (‘BlackWall”) collects the personal information in this form as registrar or issuer of the securities you hold. BlackWall’s
privacy policy can be viewed at Your personal information is required for administration of the register of securityholdings. Should some or all of the
requested information not be provided correct administration of your securityholding may not be possible. Your personal information may be disclosed to our related bodies
corporate, external service companies such as print or mail service providers, IT service providers or otherwise as permitted by law. You may be sent marketing material in relation
current offers in addition to general corporate communications. You may elect not to receive marketing material or opt out of electronic corporate communications by contacting
BlackWall. You can obtain access to your personal information and (if required) advise of any incorrect, inaccurate or out of date information by contacting BlackWall on 1800 789
.
141 or at .au