One off cash withdrawal

PURPOSE OF THIS FORM

For authorised officers of the below named client to request the collection of a once off cash float from the nominated CBA branch as detailed in this form.

INSTRUCTIONS FOR COMPLETION

All fields are mandatory and must be completed by two account signatories on the debit account before returning the form to the CDF.
Digital signatures are not accepted. Form to be authorised with wet ink signatures.

* Please allow 5 business days for the preparation of the cash float request.

SECTION 1 – DETAILS OF CDF ACCOUNT TO BE DEBITED

Name of Account*

Address*

Member No*

Sub "S" Account*

Amount ($)*

SECTION 2 – DETAILS OF CASH FLOAT

Collecting Officer – please bring photo identification (ie. drivers licence) to CBA branch when collecting cash.

Full Name as displayed on photo ID*

Date of Birth*

Email*

Mobile Number*

Collection Branch*

Collection Date*

BSB/ACC No: 062902 0090 3419

Time of collection*

:

Denomination

Quantity

Total Value

$50

Quantity – $50*

Total Value – $50

$20

Quantity – $20*

Total Value – $20

$10

Quantity – $10*

Total Value – $10

$5

Quantity – $5*

Total Value – $5

$2

Quantity – $2*

Total Value – $2

$1

Quantity – $1*

Total Value – $1

0.50c

Quantity – 0.50c*

Total Value – 0.50c

0.20c

Quantity – 0.20c*

Total Value – 0.20c

Total Amount: $

Total Amount

Signature of collecting officer*

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

Upload a scan or photo of the wet ink signature (JPG, PNG or PDF). Digital signatures are not accepted.

SECTION 3 – AUTHORITY BY CDF CUSTOMER

We hereby authorised signatories to the member account as mentioned in Section 1 approve the CDF to debit funds and prepare cash float as indicated.

Wet Ink Signature of Authorised Person 1*

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

Upload a scan or photo of the wet ink signature (JPG, PNG or PDF). Digital signatures are not accepted.

Wet Ink Signature of Authorised Person 2*

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

Upload a scan or photo of the wet ink signature (JPG, PNG or PDF). Digital signatures are not accepted.

Name of authorised person 1*

Name of authorised person 2*

Date (Authorised Person 1)*

Date (Authorised Person 2)*

Please return the completed form to CDF via email at cdf@cg.org.au for processing.

Disclosure Statement | Privacy Collection Statement

CASHFLOAT REQUEST 2026/09

Once Off Cash Withdrawal Authority

PURPOSE OF THIS FORM

INSTRUCTIONS FOR COMPLETION

SECTION 1 – DETAILS OF CDF ACCOUNT TO BE DEBITED

SECTION 2 – DETAILS OF CASH FLOAT

SECTION 3 – AUTHORITY BY CDF CUSTOMER