.AU REGISTRANT NAME CHANGE FORM A registrant

.AU REGISTRANT NAME CHANGE FORM
A registrant name change form is used to transfer the owner of a domain from one legal entity to
another paying by cheque. This form is a legal document and must be completed correctly. If it is
not completed correctly, we will not be able to process your application. Registrant Name Changes
are performed in accordance with AUDA’s Transfers (Change of Registrant) Policy 2004-03.
Please send all completed forms and supporting documents to the Cyanweb Domains Team:
EMAIL:
FAX:
POST:
d[email protected]
n/a
29 Challenger Ave, Morley WA 6062 (ATTN: Domains Team)
If you are unsure or require help in completing this form, please contact us at
[email protected] or phone 0431 757 449 and we will be happy to provide assistance.
TRANSFER OF REGISTRANT
Domain Name(s)
NEW REGISTRANT DETAILS
Company / Organisation Name: _____________________________________________________
New Registrant ABN / ACN / Business Number: _________________________________________
Contact Name: ___________________________________________________________________
Address: _______________________________________________________________________
Suburb: ______________________________ State: ______________ Postcode: ____________
Country: _____________________________ Email: ____________________________________
Phone: ______________________________ Mobile: ___________________________________
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Please create a new registration-account for the new registrant and move the domain
.AU REGISTRANT NAME CHANGE FORM
PAYMENT DETAILS
A Transfer of Registrant results in a new 2 year domain name license for the new registrant.
Transfers are charged at $110 (inc. GST) per domain name. Upon successful verification of
this application, Cyanweb will issue a tax invoice to the billing details below.
Billing Email Address: __________________________________________________
Invoice To: __________________________________________________________
DECLARATION BY CURRENT REGISTRANT OF DOMAIN NAME (TRANSFEROR)
Domain Name: ___________________________________________________________________
Current Domain Registrant: _________________________________________________________
Confirm Authcode: ________________________________________________________________
I/We declare and warrant to the Registrar and to .au Domain Administration Ltd that:
•
•
•
I am authorised to submit this form for or on behalf of the current registrant of the domain
name; and,
The current registrant of the domain name is entitled to transfer the domain name license to
the proposed new registrant; and,
All information contained in this transfer form are true, complete and correct, and not
misleading.
The current registrant hereby transfers the domain name license to the proposed new registrant,
subject to the terms and conditions on which the current registrant held the domain name license at
the time of transfer.
Please note, photo ID of the current Registrant may be requested for further confirmation.
_______________________________________
Signature
______________________
Date
_______________________________________
Name
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I agree that the above information is correct and agree to TPP Wholesale’s terms and
conditions, as visible at: http://www.tppwholesale.com.au/terms-conditions.php