HomeMy Public PortalAboutTown of Gulf Stream -- WestlawCustomer Name Change Form
This will result in a permanent name change to the fallowing accounts:
Account Number(s)
Subscriber Name: (Old)
Full Legal Name/Business Entity
Atin/Department
Street Addrless
City 6Jl� cltr�M
Chaneeto: (New)
Full Legal NamelBusiness Entity
Doing Business As (DBA)
Arm/Department
ul'e SFrfAnrn
Slate �Ff- County PA[pM (W4(& Zip
Street Address 100 S cr
City 6U)M State County rAIM c t" Zip 3y I
BANK REFERENCE TRADE REFERENCE
Name Name
Address Address
Phone Number
Contact
Account Number
Fax Number
Phone
Contact
Fax Number
WESTe
A Thomson Reuters business
Suite/Floor
Country US Pr
Suite/Floor
Country (1M
AUTHORIZATION
The undersigned hereby consents to and authorizes West, a Thomson business, to contact any source listed above, request a current
financial statement and/or obtain a consumer credit report to determine creditworthiness.
Owner Printed Name Date
Home Address
Owner Signature
Owner Printed Name
Home Address
Owner Signature
Date
Should credit be granted by West, all decisions with respect to the extension or continuation shall be at the sole discretion of West. West does not
discriminate against credit appliconts on the basis of race, color, religion, national origin, sex, marital status, or age provided the applicant has the capacity to
enter into a binding contract West may terminate any credit availability within its sole discretion.
THIS SECTION MUST BE SIGNED BY CUSTOMER IF SUBSCRIBER NAME HAS CHAN D
Assignment and Assumption Agreement
Whereat, Assignor, entered into West Agreemem(s) for goods and/or services which may not be assigned without West's pnor written consent.
Now, therefore, the parties agree at (allows
Assignor transfers and assigns; =to Assignee all of Assignor's rights, obligations, interests and liabilities under any and all Agmemcnu Assignee assumes all
Assignors rights, obligations, interests and liabilities under the Agreement(s) end agrees to perform and fulfill all team and conditions of the Agreements as
if it had originally been a parry. West is not required to pursue remedies against Assignor before enforcing assumption against Assignee This Agreement is
governed and comwed by Minnes/off jJaw. Receipt and process by West comtitmes West's
are:
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