RG10 Class Action Participation Form
CBA or Bankwest (*)

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Personal name



First Name

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Surname

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Guarantor details

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What year did you borrow the funds? (*)

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What year did the bank first issue letter of demand? (*)

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What was the event of default the bank relied upon? (*)

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Have you already instigated legal proceedings or defending legal proceedings? (*)

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Have you made a complaint with the Ombudsman? (*)

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Estimated losses

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Was the borrower a Company? (*)

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Company Details (if applicable)



ACN

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How many employees?

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Business activity

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Company Accountant Name

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Company Accountant Contact Number

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Current solicitor details if any

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Is the Company externally administered ( I.e , Voluntary Adminsitrator / Receivers & Managers or Liquidation )? If yes provide contact details.

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External Administration (if applicable)



Administration A details

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Administration B details

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Administration C details

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Full contact details



Phone number

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Email address (*)

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Fax number

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Postal address

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Suburb

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Postcode

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