MILLENNIUM AUTHORITY TO ACCESS INFORMATION ‘To whom it may concern This letter gives you authority to release any relevant information or documentation on my investments, insurances, superannuation or other financial information to the planner or staff of the practice listed below. Please accept a photocopy or scanned copy of this letter as my authority. The original will stay on my file at Millennium Wealth Advisory. Name of Adviser/s: Holley Lucey, Shane Lucey Practice Name: Millennium Wealth Advisory Pty Ltd ABN: 58 243 237 296 Corporate Authorised Representative of Hillross Financial Services Li ited AFSL 232705, Staff: Montana Ledgar, Bren Manatad, Tehlani Speers Address: PO Box 373 Mermaid Beach QLD 4218 Phone: Email (07) 3526 0474 hello@milwelth com.au This authority remains in force until withdrawn in writing By me. Full Name: Date of Birth: Mibsel Faybeirn 268 Previous Name: Address: A&E baler street paeybeld txt Ir, 2%, Previous Address: Super Fund Name/st Member Number/s: SAT Sop 02> SL §, Signature: 7 ‘Today's Date: f= G2 a2 At signatory, obtain a clear, legible copy of Drivers Licence (front & back) for certification