Notification By Officeholder Of Resignation Or Retirement Asic

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Australian Securities &
Investments Commission
Form 370
Notification by officeholder of resignation
Corporations Act 2001
205A
or retirement
This form must be accompanied by a copy of the letter of resignation, as provided to the company.
Company details
Company name
ACN
Lodgement details
Who should ASIC contact if there is a query about this form?
ASIC registered agent number (if applicable)
An image of this form will be available as
part of the public register.
Firm/organisation
Contact name/position description
Telephone number (during business hours)
(
)
Email address (optional)
Postal address
Suburb/City
State/Territory
Postcode
1 Resignation or retirement details
All roles and date of cessation must
Office held (tick all roles from which the officeholder is ceasing)
be in accordance with the letter of
Director
Secretary
Alternate director
resignation to the company.
Family name
Given names
Place of birth (town/city)
(state/country)
Date of cessation
Date of birth
/
/
/
/
[D
D]
[M
M]
[Y
Y]
[D
D]
[M
M]
[Y
Y]
Signature
I certify that the information in this form is true and complete and that the attached document marked (
) is a true
copy of the original letter of resignation or retirement given to the company.
This form must be signed by the resigning
or retiring officeholder.
Name
Signature
Date signed
Copy of resignation or retirement letter endorsed as an annexure
/
/
to this form.
[D
D]
[M
M]
[Y
Y]
Lodgement
Send completed and signed forms to:
For help or more information
Australian Securities and Investments Commission,
Web
PO Box 4000, Gippsland Mail Centre VIC 3841.
Need help? /question
Telephone
1300 300 630
ASIC Form 370
24 October 2011
Page 1 of 1

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