BA5
Form 501

Lodged By:
Name:
Address:
E-mail: 
Telephone (BH):

CESSATION OF BUSINESS NAME

		 PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH)) OVERLEAF 

NOTE:  THIS FORM IS USED TO NOTIFY THE REGISTRAR-GENERAL THAT THE PROPRIETORS OF THE BUSINESS NAME NO LONGER TRADE UNDER THAT BUSINESS NAME.  WHERE THE BUSINESS IS UNDERGOING A CHANGE OF NAME, THE NEW BUSINESS NAME SHOULD BE REGISTERED BEFORE CEASING THE PREVIOUS BUSINESS NAME.  

THIS FORM MUST BE SIGNED BY ALL CURRENT PROPRIETORS.  IN THE CASE OF CORPORATE PROPRIETORS, ONE AUTHORISED SIGNATORY MUST SIGN FOR EACH CORPORATE PROPRIETOR.

1. BUSINESS NAME 

2. REGISTERED BUSINESS NUMBER
F		

3. DATE OF CESSATION 

4. SIGNATURE/S    (If the proprietors are individuals, complete first section. Otherwise, complete second section)  If insufficient space, attach annexure with remaining particulars and signatures.
					
	(full name in block letters)		(signature )		
					
	(full name in block letters)		(signature )		
					
	(full name in block letters)		(signature )		

					
	(full name in block letters)		(signature )		
					
	(capacity to sign for company ie Director, Company Secretary)		(name of company )		
					
	(full name in block letters)		(signature )		
					
	(capacity to sign for company ie Director, Company Secretary)		(name of company )		

PRIVACY STATEMENT

The Act authorises the Registrar-General to collect the information required by this form for the purpose of establishing and maintaining the public register of business names registered under the Act.  The public register is available for search pursuant to Section 22 and 23 of the Act, and is also made available to government agencies for statistical and administrative purposes, and to non-government persons and organisations.  A fee may apply to any or all of the above.

IMPORTANT INFORMATION

The proprietors are held accountable for the operation of the business trading under the registered business name, and for ensuring that the business operates in compliance with applicable laws, including the Business Names Act 1963 (the Act) and the Business Names Regulation 1963  (the Regulation).  Where a person or corporation is acting in this capacity as a trustee, the trustee, not the trust, will be deemed to be the proprietor for the purposes of the Act.

LOCATION
255 Canberra Avenue
Fyshwick   ACT   2609

OFFICE HOURS
9.00am to 4.30pm Monday to Friday
(excluding public holidays)

CONTACT NUMBERS
Phone	(02) 62070435 or 
	(02) 62070474  
Fax 	(02) 62070487

POSTAL ADDRESS
PO Box 225
CIVIC SQUARE   ACT   2608