HSBC/0193/AU/00271/002

ACCOUNT TRANSFER FORM

(Account Transfer for Residential Individuals and Companies)

For any amount to be transferred, every customers are to abide by the banking Policies of
HSBC as directed by the HSBC Board of Directors.

Personal Details

Surname:

Other Names:

D.O.B: Place of Birth:

Gender: M F State:

Nationality:
HSBC 17492***64736**771

Bank Details
Account Holder Name:

Name of Bank:
Account Number:
Swift Code:

Bank Branch:

Type Of Account: Current Account Savings Account

Account Holder Email:

Mobile Number:
Next of Kin:

Relation to Next of Kin:

Information on other products and Services

From time to time, the HSBC releases special products, services and promotional offers which are beneficial to our customers.
Our products and services can be advertised to our customers you their email or through their mobile phones depending on
the decision of the customer.
Please help us to serve you better by offering you our day to day services and products. Every customers shall be dully informed
regarding existing products, services and offers to our customers.

HSBC.
© Copy Right 2021. All Rights Reserved vol1253/HSBC/000183.
 Debit Card Details:

Please Tick on block letters

Choose the type of card of choice
Debit Card Required: Yes No
Platinum Master Card Visa Card Gold Card
Name of Account Holder on Debit Card

I hereby declare that the information I have given are true and authentic. I do declare to the Manager of the Bank that
the details received are in accordance to decree 56 section 23b of the Australian financial laws of 1976 dated on
the ........ of ........... 2021 are true.

I do declare that all transactions operated by the HSBC shall be made through my bank account under my authorization.
Any transaction without my concert e.g use of credit card etc are rendered nun and void. Which shall be declared illegal under
the above law.

Date: Signature of Account Holder:__________________________

HSBC17492***64736**771

I have understood the Terms and Conditions (a copy of which I am in possession with) of Account Transfer Form with the
HSBC and those related services which excludes the services in ATMs / Debit Cards / Mobile Banking / Net Banking
/ Bill Pay Facility do agree ad accept to be bound by the said Terms and Conditions including those excluding limiting the
bank’s liability.

I understand that the Bank may at its absolute discretion, discontinue any services completely or partially without the
notice to me. I agree that the payment for Account Transfer shall be made by me.

Apart from this, the current schedule of change shall be received by me and I also agree to the same.

I do agree to maintain AQB of $AUD200.00 in my account

I agree to abide by the fees liable to be leveled in my debit card and also taxes chargeable for an image Debit Card.
I am also aware of the fact that the image Debit Card will not be a Photo Card.

Signature of Primary Account Holder

____________________________

Enclose details (This information to be filled by the branch manager

before sending AOF for automatic processing). For HSBC OFFICIALS ONLY
Number of Add on Forms enclosed:

Number of pages of KYC enclosed: Signature:_______________________

Camp. Reference Number For Branch Head

Signature:_______________________
4th line embossing required for:
For Regional Manager

S.S Number:_________________

HSBC.
© Copy Right 2021. All Rights Reserved vol1253/HSBC/000183.