Change of Details Form

Change of Details Form
Sandhurst Protected Global Opportunities Fund
Please complete all sections in BLOCK letters.
Investor name:
Investor ID/Portfolio
Do you have an investment loan for this product?
If yes, please provide your Investment Loan number and we will forward your change of details to
Leveraged Equities
Investment Loan number:
1. Change of nominated account details
Name of financial institution:
BSB number:
Account number:
Investor full name
NB. if nominating a Credit Union or Building Society, the accounts must be help in exactly the same name
2. Change of Holder Indentification Number (HIN)
3. Change of Address
Old Residential Address
Phone number:
New Residential Address
Phone number:
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4. Change of individual name/s
Provide a certified copy of marriage certificate or registration of change of name. We will not accept photocopies or electronic
transmissions of a certification. Please mail certified documents to the address noted in our contact details.
Old name(s)
New names(s)
Old Signature
New Signature
5. Change of entity name
For a change of name to a company, partnership or super fund trust, please contact our customer service centre to discuss the
required supporting documentation.
6. Customer acknowledgement
I acknowledge and agree to the maximum extent permitted by law to release discharge and indemnify the responsible entity from
and against all actions, proceedings, accounts, costs, expenses, charges, liabilities, claims and demands arising directly or
indirectly as a result of the instructions given in this form.
I/we acknowledge that this change of details form is subject to the terms and conditions set out in the current Product
Disclosure Statement available at
Please sign this form where indicated below. This form must be signed as per the current signing instructions we have on record.
If no amendments have been made, the current signatories for the account are the individuals who signed the initial investment
application form.
If signed under a power of attorney, a certified copy of the power of attorney must be provided (unless already provided to
Investor 1
Signature Date
Investor 2
Investor ID/Portfolio number:
Scan number:
Signture of checking office:
Contact Sandhurst
You can return this form by:
Fax: 1800 835 800 | Email: [email protected] | Post: Funds administration Level 5, 120 Harbour Esplanade Docklands VIC 3008
For all queries please contact our Customer Service Centre, from Monday to Friday 8.30am to 5.00pm Victorian time. Phone 1800 634 969
In respect of electronic instructions (email or fax), it is important to be aware that Sandhurst:
will not accept electronic instructions unless it is accompanied by the scanned or faxed signature/s and/or company seal of the Investor/s
is not responsible for any loss or delay that results from a transmission not being received by Sandhurst;
will only process your electronic instructions if it is received in full and has been signed by authorised signatories;
will not accept a receipt confirmation from the sender’s facsimile machine or computer as evidence of receipt of the instructions;
will not compensate you for any losses relating to electronic instructions, unless required by law;
does not take responsibility for any fraudulent or incorrectly completed electronic instructions; and
will not process a change in name, until original certified documents are received (refer steps 4,5 & 6).
In the event of fraud you agree to release us from, and indemnify us against, all losses and liabilities whatsoever arising from our acting in
accordance with any instructions received by electronic instructions bearing your Investor ID/Portfolio number and a signature purportedly yours
or that of an authorised representative.
Sandhurst Trustees Limited (Sandhurst) ABN 16 004 030 737 AFSL 237 906 is the responsible entity and the issuer of the Sandhurst
Protected Global Opportunities Fund.
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S34815 (05/11)