On-line Account Nomination

Please enter your details and the details of your accounts / policies below to enable iRefund to collect your cashback as soon as possible.

First Name: *
Last Name: *
Mobile Phone:*
Home Phone:*
Business Phone:*
Date of Birth:* / /
Member Number (if you are already a member):
Email Address: *

Details of Existing Products

Add products

Financial Institution Name * (e.g. 'Colonial First State')
Account Name * (e.g. Bill Smith)
Name of fund/policy * (22 characters maximum, e.g. 'Superannuation')
Client account/policy number * If unsure you can add the Client account/policy number later. (client code or investor code as advised by your financial institution; usually found on front page of statement)
Add To List

Product List

Your Signature

Clear Signature
Use your mouse/finger to sign in the space provided

I/We request that the fund manager named above amend their records to indicate that Investor Refund Pty Ltd is the appointed broker for the investments listed above. I/We understand that Investor Refund Pty Ltd will replace the existing broker & request that Investor Refund Pty Ltd receive the existing trailing commission / adviser service fee currently being generated by my/our investment amount.

I/We have read and agree to the Investor Refund Pty Ltd terms and conditions and Financial Services Guide and acknowledge that Investor Refund Pty Ltd has not provided me/us with advice regarding the above investment/insurance.

I have read and agree to the Terms & Conditions, Privacy Policy and Financial Services Guide *

Submit Form

Member Login