Cashback request form 

Variation Types

Customer Details

Borrower Details

Borrowers and Guarantors must be the same across all loans being varied on the one form.

Borrower 1

(Note - Either ABN or ACN is required.)

Borrower Name

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Borrower 2

(Note - Either ABN or ACN is required.)

Borrower Name

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Borrower 3

(Note - Either ABN or ACN is required.)

Borrower Name

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Borrower 4

(Note - Either ABN or ACN is required.)

Borrower Name

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Borrower 5

(Note - Either ABN or ACN is required.)

Borrower Name

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Primary Contact details

By providing my email address on this form I consent to Suncorp Bank sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank's records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me.

Guarantor Details

Borrowers and Guarantors must be the same across all loans being varied on the one form.

Guarantor  1

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

Trustee Details

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Guarantor  2

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

Trustee Details

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Guarantor  3

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

Trustee Details

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Guarantor  4

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

Trustee Details

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Guarantor  5

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

Trustee Details

(Note - Either ABN or ACN is required.)

Director Details

Director 1

Director 2

Director 3

Director 4

Director 5

By providing my email address on this form I consent to Suncorp Bank or its electronic signature service provider, DocuSign, sending this form and potentially other notices and documents in relation to my variation request by email. I acknowledge that as a result of providing this consent I may no longer be given paper documents in relation to this variation request and will need to check my email regularly for variation documents. I understand that I can change this consent at any time by notice to Suncorp Bank. I acknowledge that, notwithstanding this consent, notices and documents, including in relation to this variation request, may continue to be posted to the mailing address held on Suncorp Bank’s records. I accept that by agreeing to delivery by electronic means there is a risk that my personal information may come into the possession of another person not entitled to receive it and acknowledge that while Suncorp Bank will take all reasonable steps to protect my privacy it accepts no liability for breach of confidentiality or damages for loss I might suffer provided Suncorp Bank can show it communicated to me at the electronic address provided by me. 

Loan Details

Borrowers and Guarantors must be the same across all loans being varied on the one form.

Loan

Cashback

Withdrawal Information

Please allow 2-3 business days processing time for the Cashback Withdrawal Request once received. If the cashback request is urgent and for an amount less than $10,000 with the remaining loan term less than 5 years, you may request for immediate processing (subject to approval) by returning the completed form to your local store.

Example:- For amount $123.45, please enter "one hundred and twenty-three dollars, and forty-five cents".

Disbursement Information

Please ensure the BSB and account number are correct

Declaration

Kindly read the declarations carefully before proceeding further.

Signed Authority

We require signature from the following Borrower/s:

We require signature from the following Guarantor/s:

 

Note: This form is required to have a wet ink signature, or a scanned copy of the wet ink signed form.