Large Co Operative Banks by tgw21361

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									Australian Government Guarantee Scheme for Large Deposits and Wholesale Funding




                              ANNEXURE TO THE GUARANTEED LARGE DEPOSITS - FEE REPORTING FORM
Please use this form to notify the Scheme Administrator of the value of at-call and term deposits as at the last day of the month.
Please provide this information in both excel format and a signed copy in PDF format.
This information is to be sent to administrator@guaranteescheme.gov.au within 7 business days of the end of the month.

Queries relating to the completion of this form can be directed to the Scheme Administrator on 1800 013 806.

                  Reporting Eligible ADI                                                 <Name>                                                            Date

                               Legal Entity                                              <Name>                                                 For the month of   <month>


                                                                                                       Value on
                                                                                                  last day of month
                                                                                                  (in AUD millions)
                                                              At-Call                                  <amount>
                                                              Term                                     <amount>
                                                              Total Deposits                               0




                                                Signature
                                                              (Signature of eligible signatory as outlined in Schedule 5 of the Scheme Rules)




26277405-35bd-4cac-970a-21dd612938de.xls                                                                                                                               Page 1 of 1

								
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