Acis | Company Name Change Order Form

Name

Phone

Firm

E-mail

Address

Company Details

Current Company Name

ACN

Proposed New Name

Is this name a registered business name owned by the company?

YesNo

If Yes, ABN/BN

Company Officer

IMPORTANT: Full, verifiable names are required.

Please provide the name of the Company Officer who will act as signatory on the ASIC Form.

Name

Positions Held

DirectorSecretary

Names of ALL Voting Members

Name

(include ACN if Company)

Name

(include ACN if Company)

Name

(include ACN if Company)

Name

(include ACN if Company)

Name

(include ACN if Company)

Special Resolution Details

The member/s Special Resolution to change the company name will be passed via a circular resolution pursuant to the Corporations Act (whereby the voting members of the company will sign a document containing a statement that they are in favour of the necessary resolution).

OR please select one of the following:

CONVENE AN EXTRAORDINARY GENERAL MEETING OF THE COMPANY WHERE EITHER

1. MEMBERS ARE GIVEN WRITTEN NOTICE:

Due notice (at least 21 days) is given and the Special Resolution is passed at the ensuing meeting;

2. NOTICE OF MEETING IS WAIVED:

Notice of the meeting is waived pursuant to the Corporations Act, as members present to pass the Special Resolution represent at least 95% of the total exercisable voting rights.

If 1 or 2 applies, please provide -

Date of Notice

(if applicable)

Date and Time of Meeting

Meeting Address