Spotless MIDRGM details

To start the form, please enter your Master ID, which can be found either in the email that directed you here, or your Notice of Estimated Distribution.

Master ID*

Account details

Please advise whether your nominated bank account is*

Financial institution account located in Australia Financial institution account located outside Australia

Please indicate which of the following applies to you*

I am an Australian resident for tax purposes I am a non-Australian resident for tax purposes

For security reasons, please do not send Slater + Gordon your bank account details other than via this secure web-form. If you need to make alternative arrangements for payment, please contact Slater + Gordon directly by email at SpotlessClassAction@slatergordon.com.au or call us on 1800 071 827.

Australian Bank Account Details

Name of Beneficiary Bank, Building Society or Credit Union*

BSB (Branch number)*

eg. 016999. Please do not hyphenate your BSB

Account Number*

Account Name*

Foreign Bank Account Details

Do you require the services of an intermediary bank?

No Yes

Intermediary Bank Name*

Intermediary Bank Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Intermediary Account Name

Intermediary SWIFT Code*

Intermediary Bank Account Number/IBAN*

Note: we cannot accept PO Box addresses

Intermediary Beneficiary Address

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Beneficiary Bank*

Beneficiary Bank Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Beneficiary Account Name*

Beneficiary SWIFT Code*

Beneficiary Account number/IBAN

ABA Routing (USA Banks)

CNAPS Routing (China Banks)

Note: we cannot accept PO Box addresses

Beneficiary Street Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Lodgement Reference (If required)

For Further Credit (If required)

areaOfLaw

campaign

GAclientID

GAsessionID