Authority To Discharge
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1Authority to Discharge
Borrower name:
Loan number:
On the above mortgage loan account, I/we wish to arrange:
a partial discharge
a full discharge
I/We request that you arrange discharge of the following property(ies):
$
In exchange for
being paid of the loan account.
The remaining security(ies) will be:
Postcode:
My/Our address (including postcode) for notices after settlement will be:
Postcode:
My/Our settlement agent/solicitor acting on my/our behalf is:
Company and address:
Postcode:
Contact name:
Phone number:
Fax number:
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Anticipated settlement date:
My/Our reason for discharging the loan is:
All borrowers must sign:
Surname and initials:
Date:
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ONCE COMPLETED PLEASE RETURN TO ADELAIDE BANK, LOAN SERVICING DEPT,
GPO BOX 1048, ADELAIDE SA 5001 or FACSIMILE NO. (08) 8300 6854
06/12/2013
Adelaide Bank a Division of Bendigo and Adelaide Bank Limited ABN 11 068 049 178, GPO Box 1048, Adelaide SA 5001.
3349
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Parent category: Financial