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I:
Company & Position:
hereby consent to being appointed as a Director of the Australian Finance Industry Association Limited [ABN 13 000 493 907] and provide my details below for notification to ASIC:
Digital signature:
Date:
PERSONAL DETAILS
Full Name:
Former name(s):
Residential Address:
Date of Birth:
Place of Birth:
DISCLOSURE OF INTERESTS
Matters in which I have, or may have, a relevant or material personal interest in relation to the Australian Finance Industry Association Limited (including details of other directorships, securities holding or interests in contracts to which AFIA is a party):