ACOA Direct - Change of Authorized Client Administrator



ACOA DIRECT CHANGE OF AUTHORIZED CLIENT ADMINISTRATORSECTION 1 – BUSINESS DETAILSLegal Business Name:Operating as:SECTION 2 – FORMER AUTHORIZED CLIENT ADMINISTRATOR First Name:Last Name:Title:SECTION 3 – NEW AUTHORIZED CLIENT ADMINISTRATORFirst Name:Last Name:Title:Telephone No.:Email Address:Reason for Authorized Client Administrator Replacement:SECTION 4 – AUTHORIZING AUTHORITYFirst Name:Last Name:Title:Telephone No.:Email Address:PLEASE CHECK OFF THE BOX THAT BEST DESCRIBES YOUR SITUATIONSENIOR REPRESENTATIVE with signing authority(Must be a person with a higher level of authority than the Authorized Client Administrator)OWNER, CO-OWNER OR MAJORITY SHAREHOLDER(This person can also act as the Authorized Client Administrator)NON-PROFIT ORGANIZATION / ASSOCIATION(Must be either the president or the chair of the board of the non-profit organization/association)OTHER (please specify) _______________________________________ I, the Authorizing Authority named in section 4, assign the person identified in section 3 to act as the Authorized Client Administrator for the purpose of ACOA Direct and authorize this person to accept, on my behalf, any subsequent amendment(s) to the ACOA Direct Online Agreement once this change of Authorized Client Administrator request has been approved by ACOA. The ACOA Direct Online Agreement remains in full force and effect.I hereby confirm that the former Authorized Client Administrator is no longer acting as Authorized Client Administrator and request that his/her enrolment be revoked.SIGNATURE:DATE: ................
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