residential loan variation request

Section
L
Loan Variation Fees/Valuation Fee Authority to Debit
Option 1 - Payment by Credit Card
Received from Mr Mrs Miss Ms Other (please specify)
Surname First name Middle name
Please debit my Visa Mastercard Bankcard for the amount of $
Card number Expiry date /
Cardholder’s signature
Option 2 - Payment by Direct Debit
Please act on the existing Direct Debit Request and debit the Loan Variation Fees/Valuation Fee to my/our nominated account.
I acknowledge that you will debit my/our account when the Loan Offer is dispatched.
Signature 1 Signature 2
$
Note: I also acknowledge that the nominated account on the Direct Debit Request Form is the same account to which my regular loan instalments will be
debited.
Option 3 - Payment by Cheque
Cheques should be made payable to “ING DIRECT”.
Payment by you will only be credited when actually received by ING DIRECT. ING DIRECT is not liable for any cheque given to the Introducer or any money
to be deposited until it is actually received and cleared by ING DIRECT.
ING DIRECT will hold the cheque until the Loan Offer is dispatched.
Attached is a cheque for the sum of $
Option 4 - Payment from ING DIRECT redraw/line of credit
Account number
Borrower’s Name
Amount
$
Borrower’s Signature
Section M
Loan Variation Authority
All parties to the loan must sign
Borrower’s title and full name Signature Date (DD/MM/YY)
Mailing address
/ /
Borrower’s title and full name Signature Date (DD/MM/YY)
Mailing address
/ /
If you have any queries please contact your mortgage broker, financial adviser or ING DIRECT.
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ING DIRECT is a division of ING Bank (Australia) Limited | ABN 24 000 893 292 | INGD IM118 06/09