Notification of Change of Ownership or Legal Entity

Notification of Change of Ownership or Legal Entity

For any assistance completing this form contact our Customer Support team on 1300 852 388 (Option 2) or email licence@apra.com.au
APRA AMCOS Client Number
8 digits
Trading Name of Business
Date the business was sold or change to legal entity

DayMonthYear
Select one from the following
Additional Information for a Change of Ownership
Please provide details of the new owner(s) including name, contact details, new legal entity etc
ABN of New Legal Entity
ACN of New Legal Entity (if applicable)
Name of Legal Entity
Must match the ABN or ACN
Trading Name (if different from above)
I confirm the information provided is true and correct.
Completed & Signed by

TitleFirst NameLast Name
Position of Person Signing
Director, Owner, Treasurer etc
E-mail
Contact Number
Should be Empty: