Business: Change of Ownership and Financial Responsibility Request Business Change of Ownership and Financial Responsibility Business Name * Service Address * Service Address Service Address Service Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Tax Id: * Previous Owner: I understand that by signing below I approve of the Ownership Change of the above business. I agree to pay any outstanding fees or charges incurred prior to the transfer of ownership. I will no longer control any aspect of this account and closing/transfer of ownership). I will no longer control any aspect of this account and I will not be able to make changes going forward starting on the date of closing/transfer of ownership). I give NineStar Connect permission to transfer control of the above-named business. Date of closing/transfer of ownership * Signature of Previous Owner/Authorized Contact * signature keyboard Clear Date * New Owner: I understand that by signing below, I approve of the Ownership Change of the above-named business. I agree to take over any existing contract(s), to complete said contract(s) and taking over fiscal responsibility for the account starting on the date of closing/transfer of ownership. I ensure NineStar Connect that I am an authorized owner and have full authority to make this change in ownership. Email of New Business Owner * Signature of New Owner * signature keyboard Clear Date * Please list any authorized contacts including phone numbers and emails below: Authorized Contact Authorized Contact Authorized Contact New Business Name (if applicable) Tax Id: * Address Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal If you are human, leave this field blank. Submit
