Authority-to-Alter-Settlement-Account-form

PURPOSE OF THIS FORM

For authorised officers of the below named client to request the redirection of merchant settlements and loan repayments (if necessary).

INSTRUCTIONS FOR COMPLETION

All fields in Section 1 and 3 are mandatory and must be completed before forwarding the form to the CDF.
Please provide your electronic signature where indicated below.
If there are any other account actions that require alteration that are not listed below, please provide these on a separate document authorised by two account signatories.

IMPORTANT INFORMATION

If you require the change of account details for external vendors either debiting or crediting your account, you will need to provide them with the new account number, CDF will not be able to facilitate this for you.
If you require formal bank confirmation to provide to the vendor, please contact the cdf@cg.org.au

SECTION 1 – CDF ACCOUNT DETAILS

Name of Account*

Address*

Member No*

SECTION 2 – NEW ACCOUNT TO DEBIT / CREDIT

(MERCHANT & BPAY FACILITIES – SETTLEMENTS AND FEES)

Qkr Facility

Qkr Facility – Merchant Facility No.

Qkr Facility – Alter from Acc

Qkr Facility – To Acc

BPoint Facility

BPoint Facility – Merchant Facility No.

BPoint Facility – Alter from Acc

BPoint Facility – To Acc

Eftpos Facility 1.

Eftpos Facility 1 – Merchant Facility No.

Eftpos Facility 1 – Alter from Acc

Eftpos Facility 1 – To Acc

Eftpos Facility 2.

Eftpos Facility 2 – Merchant Facility No.

Eftpos Facility 2 – Alter from Acc

Eftpos Facility 2 – To Acc

Eftpos Facility 3.

Eftpos Facility 3 – Merchant Facility No.

Eftpos Facility 3 – Alter from Acc

Eftpos Facility 3 – To Acc

*Please attach separate listing for more Merchant Facilities

BPay Facility

BPay Facility – Biller Code:

BPay Facility – Alter from Acc

BPay Facility – To Acc

Loan Repayments

All loans – interest payments and principal & interest repayments

Loan Repayments – Alter from Acc

Loan Repayments – To Acc

Deposit Books

Deposit Books – Agent No. (1)

Deposit Books – Agent No. (2)

Deposit Books – Agent No. (3)

Deposit Books – Alter from Acc

Deposit Books – To Acc

SECTION 3 – AUTHORITY

I/We as authorised signatories to the CDF Accounts, hereby authorise the CDF to alter the settlement account(s) as indicated above.

Name of Authorised Person 1*

Name of Authorised Person 2*

Signature of Authorised Person 1*

Please sign above using your mouse, touchscreen, or stylus.

Signature of Authorised Person 2*

Please sign above using your mouse, touchscreen, or stylus.

Date (Authorised Person 1)*

Date (Authorised Person 2)*

Disclosure Statement | Privacy Collection Statement

ALTER SETTLEMENT 2026/09