GC - Change of Ownership - Galactic Solutions

Galactic Communications Change of Ownership

Change of Ownership

Current Company Information

Company Name

First and Last name

Invoice Number - Most Recent Invoice

ABN:

Phone/Mobile

Service Address

Address Line 1

City

State

Post Code

Authorised List Services / Phone Numbers to be transferred

IMPORTANT INFORMATION
• Where services cannot be retained on the same plan, early termination charges may be payable by the Current Account Owner.
• Current Account Owner will remain liable for any outstanding balance on the nominated account as it stands on the transfer date.
• New Account Owner will be liable for all fees and charged incurred on the account after the transfer date.
• It is the responsibility of the Current Account Owner to give/send all equipment associated with the nominated account, at their own cost, to the New Account Owner.
• Billing, Payment and Usage history will be visible to the New Account Owner.
• Existing and newly received account emails will be available to the New Account Owner.

TRANSFER DATE
• We will attempt to transfer the services within the account on the date you have requested, however some requests may take longer to complete.
• Ownership of all services within the nominated account will be transferred.

Date of account Ownership to take effect

AGREEMENT

Must be read & signed by the Current Account Owner.

• I warrant that I am the current owner of the nominated account or am an authorised representative and can make this request on behalf of the current account owner.

• I have obtained authorisation from the new account owner for Galactic Communications contact to arrange transfer the legal responsibility of the services of the nominated account to the New Account Owner Listed Below.

I agree that:

• I will remain liable for all debts incurred on the nominated account prior to the date of transfer including any applicable early termination charges;

• I will give/send equipment associated with the nominated account to the New Account Owner at my own cost;

• I agree that I will not seek to recover any loss I have suffered or may suffer (either directly or indirectly) as a result of this transfer;

• I have read and understand all the information provided in this form.

New Account Owner Details

Company Name

Phone Number

First and Last Name

ABN:

Change of Ownership

Current Company Information

Services

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