Appendix 1 Bank Confirmation Audit Request General
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Bank (Name & Address)
Customer/Entity (Name & Address)
“Entity” includes companies, companies in a parent-subsidiary relationship, joint ventures, partnerships, trusts, and unincorporated associations.
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Auditor (Name & Address)
Contact Name:
Telephone Number:
Fax Number:
Email Address:
Confirmation Date (DD/MM/YYYY)
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Account Name
BSB Number
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Account Name
BSB Number
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Maker/Acceptor
Due Date
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Nature of Liability
Terms of Liability
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Provide details here
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Leased Item
Restrictions / Special Arrangements
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Account Name
BSB Number
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Types of Facility
Facility Limit
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Provide details here
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Auditor/customer to complete known details in shaded area
Bank to provide other information not identified by customer
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AUTHORISED BY:
Other authorisation details (where applicable)