Ray White Landlord change of details form

CHANGE OF CONTACT OR BANK ACCOUNT DETAILS
Where a principal of the trust account requests a change of contact or bank account details the change of details must be confirmed via an alternate contact method to the way in which the request originated.

Any change of contact or bank account details must be verified with all parties to the
CHANGE OF CONTACT OR BANK ACCOUNT DETAILS
Name of Principal requesting the change

First NameLast Name
DATE CHANGE IS TO TAKE EFFECT
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
REQUEST TO CHANGE (CIRCLE WHICH IS APPLICABLE)
Type a question
CONFIRM ORIGINAL CONTACT DETAILS
Confirm ORIGINAL contact details
Original Email
example@example.com
Original Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Confirm ORIGINAL ADDRESS DETAILS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Original Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CONFIRM NEW CONTACT DETAILS
Confirm NEW contact details
NEW Email Address
example@example.com
NEW Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
NEW Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NEW Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Confirm ORIGINAL Account details:
Original BSB:
Original Account Number
Confirm NEW bank account details:
New BSB:
New Account Number
NAME & SIGNATURE PRINCIPAL REQUESTING CHANGE
Signature
Name - Principal 1

First NameLast Name
DATE OF REQUEST
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
NAME AND SIGNATURE OF PRINCIPAL 2
Signature
Name Principal 2

First NameLast Name
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
NAME AND SIGNATURE OF PRINCIPAL 3
Signature
Name

First NameLast Name
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
NAME AND SIGNATURE OF PRINCIPAL 4
Signature
Name

First NameLast Name
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
AGENCY TO COMPLETE
DATE REQUEST RECEIVED
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
NAME OF AGENT PROCESSING REQUEST
Name

First NameLast Name
ORIGINAL CONTACT/BANK ACCOUNT DETAILS VERIFIED
Original contact/ bank account details verified
AUTHORITY CONFIRMED BY ALTERNATE MEANS
Method

Other
AUTHORITY CONFIRMED BY ALL PRINCIPALS
Method

Other
NEW CONTACT / BANK ACCOUNT DETAILS ENTERED INTO TRUST ACCOUNT SYSTEM
DATE ENTERED
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Should be Empty:

CHANGE OF CONTACT OR BANK ACCOUNT DETAILS

CHANGE OF CONTACT OR BANK ACCOUNT DETAILS

DATE CHANGE IS TO TAKE EFFECT

REQUEST TO CHANGE (CIRCLE WHICH IS APPLICABLE)

CONFIRM ORIGINAL CONTACT DETAILS

CONFIRM NEW CONTACT DETAILS

Confirm ORIGINAL Account details:

Confirm NEW bank account details:

NAME & SIGNATURE PRINCIPAL REQUESTING CHANGE

DATE OF REQUEST

NAME AND SIGNATURE OF PRINCIPAL 2

NAME AND SIGNATURE OF PRINCIPAL 3

NAME AND SIGNATURE OF PRINCIPAL 4

AGENCY TO COMPLETE

DATE REQUEST RECEIVED

NAME OF AGENT PROCESSING REQUEST

ORIGINAL CONTACT/BANK ACCOUNT DETAILS VERIFIED

AUTHORITY CONFIRMED BY ALTERNATE MEANS

AUTHORITY CONFIRMED BY ALL PRINCIPALS

NEW CONTACT / BANK ACCOUNT DETAILS ENTERED INTO TRUST ACCOUNT SYSTEM

DATE ENTERED