Basic Checklist To Assist In Submitting Changes Or Updates To A Current Amc Registration printable pdf download

Basic Checklist To Assist In Submitting Changes Or Updates To A Current Amc Registration

AMC USE FOR UPDATES TO CURRENT REGISTRATION

Basic Checklist to Assist in Submitting Changes or Updates to a Current AMC Registration

Note: Changes or updates may be subject to approval

Currently Registered AMC NAME:

CURRENT Expiration Date:

Registration: #

√ All Boxes that apply to changes or updates

Submit applicable documents for each checked item.

Yes No CHANGE AMC NAME TO:

Current AMC Name _____________________________________________________________________________________

New AMC Name _______ _______________________________________________________________________________

Yes No CHANGES TO CONTACT INFORMATION:

Mailing Address

Physical Address

Business Phone#

Business Fax#

Business Email

Yes No CHANGES TO OWNERS/OFFICERS/DIRECTOR(s):

Yes No CHANGES TO INDIVIDUAL/ENTITY (INCLUDING STOCKHOLDERS) WHO OWNS 10% OR MORE:

 Use page #2 from application to list changes

 Original notarized certification(s)

 Documents for any YES answers(s)

Yes No CHANGE OF CONTROLLING PERSON:

Remove____________________________________

Add _____________________________________

Use page #2 and #3 from application to list change

Original notarized certification

Documents for YES answers(s)

The AMC Certification form must be completed and signed by new controlling person

AMC Certification -Original notarized certification

AMC Certification -Documents for YES answers(s)

Yes No CHANGES TO SERVICE OF PROCESS:

 Verified with AZ Corp. Commission

Yes No CHANGE TO AZ CORP. COMM/SEC OF STATE REGISTRATION:

 Arizona Corporation Commission -Letter of Good Standing

 Arizona Secretary of State -Letter of Good Standing

Yes No CHANGES TO BOND:

 SURETY BOND -Original

 SURETY BOND NUMBER ____________________

√ The following must be submitted if there is a CHANGE OF AMC NAME:

 Bond Under Former Name -One year from effective date of name change

 Bond Under New Name

Changes to the AMC registration are completed and submitted by:

___________________________________

____________________________________

Print Name

Title

_____________________________________

____________________________________

Signature

Date

Basic Checklist To Assist In Submitting Changes Or Updates To A Current Amc Registration

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