Change of Member or Trustee

Current existing Trustee*

Individual Trustee
Corporate Trustee

Number of Trustees*

Trustee 1 Name

First Middle Last

Trustee 1 Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Trustee 1 is:

Resigning as Trustee
Continuing as Trustee

Is the Trustee resigning due to death?*

Yes
No

Trustee 2 Name*

First Middle Last

Is Trustee 2 Address the same as Trustee 2*

Yes
No

Trustee 2 Address

Street Address City State / Province / Region ZIP / Postal Code Country

Trustee 2 is:

Resigning as Trustee
Continuing as Trustee

Is the Trustee resigning due to death?*

Yes
No

Trustee 3 Name

First Middle Last

Is Trustee 3 address the same as Trustee 1?

Yes
No

Trustee 3 Address

Street Address City State / Province / Region ZIP / Postal Code Country

Is Trustee 3:

Resigning as Trustee
Continuing as Trustee

Is the Trustee resigning due to death?*

Yes
No

Trustee 4 Name

First Middle Last

Is Trustee 4 address the same as Trustee 1?

Yes
No

Trustee 4 Address

Street Address City State / Province / Region ZIP / Postal Code Country

Is Trustee 4:

Resigning as Trustee
Continuing as Trustee

Is the Trustee resigning due to death?*

Yes
No

Company Name*

Company ACN*

Company Registered Address*

Street Address City State / Province / Region ZIP / Postal Code Country

How many Directors?*

Director 1 Name*

First Middle Last

Is Director 1:

Resigning as Director
Continuing as Director

Is Director 1 resigning due to death?*

Yes
No

Director 2 Name*

First Middle Last

Is Director 2:

Resigning as Director
Continuing as Director

Is Director 2 resigning due to death?*

Yes
No

Director 3 Name*

First Middle Last

Is Director 3:

Resigning as Director
Continuing as Director

Is Director 3 resigning due to death?*

Yes
No

Director 4 Name*

First Middle Last

Is Director 4:

Resigning as Director
Continuing as Director

Is Director 4 resigning due to death?*

Yes
No

Change of Member or Trustee

Change of Member or Trustee (Individual Trustee Fund).

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