Discharge Authority Form

Discharge Authority

IMPORTANT NOTES:

1. SECTIONS 1 TO 5 MUST BE COMPLETED IN ORDER FOR THIS FORM TO BE ACCEPTED.

2. ALL BORROWERS MUST SIGN THIS DISCHARGE FORM.

3. COMPLETED DISCHARGE AUTHORITIES WILL BE ACTIONED WITHIN 15 BUSINESS DAYS.

4. THIS DISCHARGE AUTHORITY IS VALID FOR 90 DAYS FROM THE DATE ALL BORROWERS SIGN.

Full Discharge -

Please email completed authority to .auor fax to 08 8375 7878

Partial Discharge -

Please email completed authority to .auor fax to 08 8375 7878

Borrower Name(s):

Loan ID or Loan Number:

SECTION 1: Discharge Reason

Refinance - Reasons:

Interest Rate

Customer Service

Other –please

specify________________Incoming Mortgagee ________________________________

Property Sale

Anticipated Settlement date as per Contract of Sale ____/____/_____

Please attach a copy of the Contract of Sale

Other

Please specify reason ______________________________________________________________________

SECTION 2: Security Property to be Discharged

If Partial Discharge, Security Property to be

Retained

1.

________________________________

1.

______________________________________

2.

________________________________

2.

______________________________________

3.

________________________________

3.

______________________________________

SECTION 3: Borrower Representative Contact Details for Discharge Settlement

Solicitor/Conveyancer

Incoming Mortgagee

Acting for self

Please complete details below

Please complete details below

Company _______________________________________________________________________

Contact Name ____________________________________________________________________

Telephone Number (

)_________________ Facsimile Number (

)____________________________

SECTION 4: Borrower Contact Details Post Discharge (for applicable refunds)

Mailing Address _______________________________________________________________________

Telephone Number (

)________________________ Facsimile Number (

)_____________________

Email_________________________________

Banking Details (for any applicable refunds)

Please deposit in my Account you have on file

Please deposit any refunds in the following Account:

Name of Account __________________________________

BSB________________________

Account Number _____________________________

SECTION 5: Borrower’s Authority

I/we acknowledge that fees and charges including any Additional Valuation Fees may apply which are payable at the time a security is discharged. Where a discharge of security does not proceed, I/we acknowledge that

Australian First Mortgage Pty Ltd may debit my/our loan with the Additional Valuation Fee if a valuation was arranged due to my/our initial request to discharge the security. Where the matter is for a partial discharge of security,

a Security Variation Fee is payable upon the completion of the partial discharge, which I/we authorise to be: i) debited to my/our loan; or ii) debited to my/our nominated account; at Australian First Mortgage Pty Ltd discretion.

Surname ____________________________ Given Name/s_____________________ Signature_____________________ Date_________

Surname ____________________________ Given Name/s_____________________ Signature_____________________ Date_________

Surname ____________________________ Given Name/s_____________________ Signature_____________________ Date_________

Surname ____________________________ Given Name/s_____________________ Signature_____________________ Date_________

Last updated: March2011