Instructions Print Clear
Close Account Request
Complete the form using blue or black pen and print in clear CAPITAL LETTERS
Local 1300 765 150
Mail the completed form to: GPO Box 5302, SYDNEY NSW 2001 OR Fax to:
International +612 9762 9339
ACCOUNT DETAILS
Account name Account type
Entity Single Joint Give details for
Customer 1 & 2
CUSTOMER 1 CUSTOMER 2
Title First name Middle name(s) Title First name Middle name(s)
Surname Surname
CLOSURE OF HSBC ACCOUNTS
Select account type(s)
Day To Day HSBC Everyday Savings HSBC Premier Cash Management
Term Deposit Offset Savings HSBC Bonus Savings
Everyday Global Which accounts are to be closed?
Close all accounts including Specify the account(s) to be closed by
OR
the control currency account currency (except control currency account)
Other Specify
Account(s) to be closed
BSB Account number BSB Account number
Reason for account closure
Interest rate Product features No longer required Customer service
Other Specify
Destroy all debit cards and cheque books attached to closed accounts
ACCOUNT WITHDRAWAL DETAILS – Complete if you are withdrawing funds
How are funds to be withdrawn?
Receive by cheque/draft*
Pay by cash (Branch only) BSB Account number
Credit HSBC Bank account
Credit to other Local Bank account (AUD)* Specify account details below
Account name BSB Account number
Note: To credit a local bank account (foreign currency) or an overseas bank account, complete a separate Transfer of Funds form*
* Fees and charges apply. Refer to the Personal Banking Booklet.
CUSTOMER SIGNATURE(S)
Signature of Customer 1 Date Signature of Customer 2 Date
On completion of this form, DD MM YY On completion of this form, DD MM YY
please print and sign by hand please print and sign by hand
Name Name
Office Use Only
SV Checking officer name Signature Date
Issued by HSBC Bank Australia Limited ABN 48 006 434 162 AFSL 232595 HUB009 11/21