ASIC Lodgement - Change of Address Form

Company Name

ACN

Australian Company Number

Corporate Key

(not required if CorpSec Services is the company's ASIC agent)

Name of Director or Secretary who will sign ASIC form

Indicate which address(es) are being updated:

New Registered Office address

Office, unit, level, suite,

Street Number and Street name

Suburb / CityState / Territory

Post Code

Will the Company 'occupy' the premises listed above?

If you answered NO above, indicate name of occupier:

Name of occupier

If you answered NO above, tick the box below to make the declaration.

New Business Address

Office, unit, level, suite,

Street Number and Street name

Suburb / CityState / Territory

Post Code

Name(s) of current director, secretary, member or public officer who has changed their address?

Please indicate name(s) of director, secretary or member

New Residential Address of Officeholder or Member

Unit, Suite or Apartment

Street Number and Street Name

Suburb / City

Postcode / Zip Code Country

Effective date of change of address

Please add date

Does the same change of address apply to another company?

Company Name 2

ACN

Australian Company Number

Corporate Key

(not required if CorpSec Services is the company's ASIC agent)

Does the same change of address apply to another company?

Company Name 3

ACN

Australian Company Number

Corporate Key

(not required if CorpSec Services is the company's ASIC agent)

Does the same change of address apply to another company?

Company Name 4

ACN

Australian Company Number

Corporate Key

(not required if CorpSec Services is the company's ASIC agent)

Does the same change of address apply to another company?

Company Name 5

ACN

Australian Company Number

Corporate Key

(not required if CorpSec Services is the company's ASIC agent)

Do you consent to CorpSec Services being appointed as ASIC agent for the company/ies?

Additional Notes

Provide any additional instructions or information

Method of Payment

Direct Bank Transfer - Total of $165 (incl GST) is payable per company/form.

Account Name: CorpSec Services Pty Ltd

BSB: 083 004

Account No: 98 301 7259

Please include your company name as reference.

For 6 or more companies contact us for our discount rates.

Credit Card Payment

ASIC Lodgement - Change of Address $150.00 AUD

Quantity

Subtotal Tax Shipping Total $0.00 AUD

Debit or Credit Card
Name on card
Credit Card Number	Security Code
Expiration Month	Expiration Year

I hereby declare that:

Your name

First NameLast Name

Email

Company / Firm name

Capacity

Role with company/firm

Phone Number

Area CodePhone Number

Thank you for submitting the change of address form. The information provided will be used to prepare the prescribed ASIC form and applicable supporting documents (if requested) and will be forwarded to you for your review and signature prior to lodgement with ASIC.

In accordance with ASIC's Electronic Lodgement Protocol, we are not permitted to proceed with ASIC lodgement without the prior signature of a director or secretary of the company. Forms are lodged on the same day returned signed.

If an ASIC late fee is payable in connection with this notification, we will advise you prior to lodgement.

Disclaimer – CorpSec Services Pty Ltd does not provide legal, accounting or financial advice and therefore takes no responsibility for your taxation, legal or other liabilities which may arise from the work we perform on your instructions.

Complete Form

Payment

Credit Card Payment

Declaration