Change of Ownership or

Transfer of Lease Request

Business to Business

Both parties should fill out this form and read all terms and
On completion this form
conditions before signing. Please ensure that all information should be scanned and emailed
supplied is correct. Incorrect information may cause delay in to change.ownership@team.
processing your application. telstra.com or faxed to
02 9218 5990 or returned to
Depending on the complexity of the application, processing your local Telstra store.
times will vary. When we have received your application
you will receive a confirmation email that will contain a
Telstra Reference Number.
If this Change of Ownership or Transfer of Lease request is for
mobile services only and the Incoming Customer has been a
Telstra customer for less than 6 months, this form must be
submitted to your local Telstra store for processing.

Part A Services to be transferred Services to be transferred can include

To be completed by the customer that currently owns or leases the services but not limited to:
(Outgoing Customer) Landline services
Mobile services (including leased
The list of services should be reviewed by both the Outgoing and Incoming Customers services)
before submitting the application form to ensure both parties are aware of and agree Internet (fixed and wireless)
to the details provided. A full list of your services and account numbers can be found on BigPond Mailboxes (provide email
your latest Telstra bill or you can contact Telstra Business on 13 2000. address)
Please attach additional services on a
You can list whole account numbers, individual services or both as below. Please note
separate sheet if required.
transferring services may affect your current pricing. Please ensure you have checked
your plan terms and conditions before proceeding. Services with another carrier will not be
transferred.
*Please note that a $44/service fee applies for the transfer of 1300, 1800 and 13 numbers,
which will be applied to the Incoming Customer account.
1. Do you want to transfer all services under your account to the Incoming Customer?
No Go to option 2
Yes List account numbers here. All services under these accounts will be transferred.

Page 1 of 11
Part A (continued)
2. Do you want to transfer individual services?
No Continue below
When services in a bundle are nominated

 es List service numbers here. Only these services/mailboxes will be transferred

Y to transfer (e.g. Digital Office Technology
(unless part of a bundle) (DOT), BizEssentials, Telstra Bundles etc), all
services within the bundle will move to the
0358251721 358253481 358253501 Incoming Customer. If you wish to move
individual services currently under a bundle,
please contact your Dealer, Account
358254958 358251700
Representative or Telstra Business on
13 2000 to discuss plan options first.
Early Termination Charges (ETC) may be
incurred for services still in contract.
Please provide details of all associated services/accounts to the Incoming Customer
before this transfer can take place.
If there is a Mobile Device contract associated with your service, including leased devices,
you will need to hand this device over to the Incoming customer at the time the contract
is transferred.
We suggest you provide a copy of the Critical Information Summary to the Incoming
Customer provided to you at the time of connection or you can obtain a copy from
telstra.com (search critical information summary).

TBS (Telstra Business System)/Phone System

Are you transferring a TBS/Phone System?

No You may skip to Transfer Date section on this page

Yes Continue below

Is this TBS/Phone System under a Finance Contract?

No Please provide the TBS service number here. No action will be taken on Finance Contracts
TBS/Phone Systems that have a Finance Contract. To confirm if there is a Finance Contract
in place, refer to your Telstra bill where the
reference will state Finance Repayment
to Capital.
Yes Please read below information on how to transfer.

If the TBS/Phone System is under a Finance Contract, you will need to contact Capital
You can find your 10 digit TBS service
Finance on 1300 133 873 to organise the transfer independently. All TBS agreements
number on your Telstra Bill under the Other
with Capital Finance repayment options are between the contract signatory and Capital Charges & Credits section. It will be
Finance directly. Telstra act on behalf of Capital Finance as a third party biller and are referenced as Other Services.
unable to make changes to the billing details of the finance contract without their
approval. Capital Finance may charge a transfer fee.
Until Capital Finance have agreed to the transfer, charges will continue to bill to the
Outgoing Customer.
Upon Capital Finance confirming approval of the transfer to the new legal entity,
Telstra will be notified directly of the new entity details and all TBS/Phone System
charges (including maintenance) will be transferred to the Incoming Customer.

Transfer date (for all services or accounts listed)

What date should the Transfer of Services take effect? You may nominate a date up to 30 days in
the future. Otherwise, we will attempt to
11/1/2018 DD/MM/YYYY transfer the services within 7 working days
from receipt of this form, however some
requests may take longer to complete.
The Transfer Date cannot be earlier than 7 working days from the date that this form is
submitted to Telstra including all required information. Telstra will attempt to transfer the
services on the date you have requested, providing you have given at least 7 days notice.

Page 2 of 11
Part B Outgoing Customer Details
To be completed by the customer that currently owns the services (Outgoing Customer)
Customer name
Your business information
Shepparton Newspapers Pty Ltd
This must be provided for validation
and confirmation of your details.
Business or trading name ACN/ABN/ARBN
85 004 406 946

I am currently listed as a Full Authority contact to act on behalf of the

Outgoing Customer
Authorised Representative
Title (Mr, Mrs, etc) Full name Please ensure you provide a number and
email address you can be contacted on.
Mr Glenn James

Date of birth Phone number
26/10/1972 DD/MM/YYYY ( ) 0418575212

Email address
glenn.james@mmg.com.au

We may need to send you a Final Bill at the end of this transaction. Would you like this Final Bill
issued to a different address than the one currently listed against your account? If you are transferring some of the services
on your account and retaining other

No Use account address

services, you will receive your bills as per
Yes Provide address below your normal billing cycle for the services you
are retaining.
If you are transferring all services on your
account, once the Change of Ownership or
Transfer of Lease has taken effect, we will
send you a Final Bill for your services.

Letter of Authorisation
In addition to this form, you must also provide a Letter of Authorisation on company
letterhead and signed by a Company Director or Authorised Representative. The Letter of
Authorisation must include your Business Name, ABN and a Statement of Authorisation
to approve the person signing this form to act on behalf of the business.
I have attached the required Letter of Authorisation to this form

Agreement Outgoing Customer to Sign

Terms and conditions
(This is the customer who currently owns the services) Please ensure you read all terms and
conditions before signing.
Important information
Where services cant be retained on the same plan because those plans are no longer
available or the Incoming Customer is not eligible, Early Termination Charges may be applied
to your account. To discuss possible ETC charges please contact Telstra on 13 2000.
MessageBank services for fixed and mobiles phones reset to the default settings
when a Change of Ownership or Transfer of Lease is processed. All messages and
settings will be permanently deleted.
White Pages listings cannot be transferred. You will need to contact Sensis directly to
cancel your subscription and associated charges.
Silent Line subscription and associated charges existing on fixed services will remain
when the service is transferred.
Priority Assistance existing on fixed services will be removed when the service is
transferred. Incoming Customer may contact Telstra to confirm eligibility after transfer.
BigPond Mailboxes and Telstra Mail services will retain existing and newly received
emails that will be available to the Incoming Customer.
If you have BigPond Mailboxes or Telstra Mail services that will remain on your account
without an active internet connection, you may be charged an ongoing subscription fee.
On behalf of the Outgoing Customer, I request that Telstra transfer the legal responsibility
of the services listed above to the Incoming Customer whose details are included in Part C
of this form.
I acknowledge that:
I will remain liable for all debts incurred on the services listed above prior to the Date
of Transfer including any applicable ETCs;
I have handed over all related Mobile devices associated with the contracts to
be transferred.
acceptance of this request by Telstra is subject to Telstras ordinary credit approval process;
I have read and understand all statements made in this application form;
the recipient of the email address(es) transferred will now be able to read emails
intended for me. I agree to take all necessary steps to ensure my contacts are notified
of my new contact details. Page 3 of 11
Part B Outgoing Customer Details (continued)
I agree that I will not seek to recover any loss I have suffered or may suffer (either directly
or indirectly) as a result of this transfer.
I confirm that I have provided a copy of the contract associated with all services/accounts
included in this transfer request to the Incoming Customer; and

I warrant that I am authorised to make this request on behalf of the Outgoing Customer.
Full name
Glenn James

Signature Date

12/12/2017 DD/MM/YYYY

Page 4 of 11
Part C Incoming Customer Details
To be completed by the customer that will be receiving the services (Incoming Customer)
Is the Incoming Customer an existing Telstra customer? (There are Telstra services already
billing in the name of the Incoming Customer.)
No Please proceed to Section 2 (Page 6)
Yes Complete Section 1 below

Section 1 Existing Customers

Existing Customer Account information
Customer Name (as per ASIC/ABN Register) If you are unsure of these details,
please refer to ASIC asic.gov.au or the Australian Business Register
abr.business.gov.au/Index.aspx

ACN ABN

Business or trading name (if applicable)

Do you want these services consolidated to an existing Telstra bill?

Single Bill
Yes Provide account number here If nominating an existing account for
consolidation, the provided account number
No A new billing account will be created for you must already be under the ownership of the
Incoming Customer.
If you would like a new billing account created for your services, provide billing Consolidation availability will depend on
address below. whether the services to be transferred are
compatible with the requested account. If
consolidation is not available, a new
account will be created for you.

I am currently listed as a Full Authority contact to act on behalf of the Incoming Customer

Title (Mr, Mrs, etc) Full name

This authorisation information is required
for credit assessment purposes.
Date of birth Phone number
DD/MM/YYYY ( )

Email address

Once Existing Customer section has been completed, go to Incoming Customer

Authorisation and Identification (page 9) for ID requirements.

Page 5 of 11
Part C Incoming Customer Details (continued)
Section 2 To be completed by customers new to Telstra
If you are not an existing Telstra customer, this application will be subject to a
Telstra Credit Assessment.
This form will not be processed until approval has been received.
Does the Incoming Customer have an ACN?
No Please proceed to Section 2b
Yes Please complete Section 2a only

Section 2a) Company Customer Section

To be completed only if you have an ACN. You can check the details of your ACN on the
ASIC website asic.gov.au
Company name (as per ASIC)

ACN ABN

Business or trading name (if applicable)

Will the company be acting on behalf of a Trust or Partnership?

You can check your ABN details on the ABN Register abr.business.gov.au/Index.aspx
No Please continue to Business Location
Yes Please provide ABN for Trust/Partnership here

Business Location (must be a fixed site address; cannot be a PO Box address, etc)
Level/Unit no. etc Street address

Suburb State Postcode

Is your billing address the same as your Business Location?

Yes As above
No Provide billing address below

How many employees does your company employ?

This information is required for credit assessment purposes.

I am currently listed as a Full Authority contact to act on behalf of the
Incoming Customer

Title (Mr, Mrs, etc) Full name

Date of birth Phone number
DD/MM/YYYY ( )

Email address

Once company section has been completed, go to Incoming Customer Authorisation

and Identification (page 9) for ID requirements.

Page 6 of 11
Part C Incoming Customer Details (continued)
Section 2b) Individual Customer Section
To be completed if youre a Sole Trader or an individual who is acting on behalf of a
A Trust isnt a legal entity in its own right
Trust or a Partnership and you are not already the owner of the services. You can check and cant be accepted as the sole name
your ABN details on the ABN Register http://www.abr.business.gov.au/Index.aspx of the customer to a Telstra service.
New account Information: A trust is an arrangement under which
property is handed to, or vested in, a person
Title (Mr, Mrs, etc) Full name (trustee) to use or dispose of for the benefit
of another. The trustees will be liable for all
debts incurred in respect of a service.
A Superannuation Fund is a type of trust,
ABN/ARBN Business or trading name (if applicable) and will have a trustee. The trustee may
either be an individual or a company.

Date of birth Phone number
A Partnership must be represented by either
DD/MM/YYYY ( ) an individual or a company. A Partnership
isnt a legal entity. Its an association of more
Email address than two people who own and control a
business in common with a view to profit.
Every partner is legally liable for any debts
both jointly and separately. Each partner has
Business location (must be a fixed site address; cannot be a PO Box address, etc) unlimited personal liability.

Level/Unit no. etc Street address

Suburb State Postcode

Is your billing address the same as your business location?

Yes As above
No Provide billing address below

We require some of your personal details in order to complete a credit assessment.

Your application cannot proceed if this information is not provided.
Current residential address (must be a fixed site; cannot be a PO Box address, etc)
Level/Unit no. etc Street address

Suburb State Postcode

Page 7 of 11
Part C Incoming Customer Details (continued)
Residential status
Rent Own Other

Duration at current address

Previous address (must be a fixed site; cannot be a PO Box address, etc)

Level/Unit no. etc Street address

Suburb State Postcode

Occupation

If you are self employed, you do not need to complete the employer information below.
Employer name

Employer address

Phone number Duration with current employer

( )

Once individual section has been completed, continue to Incoming Customer

Authorisation and Identification (page 9) for ID requirements.

Page 8 of 11
Incoming Customer Authorisation and Identification
Letter of Authorisation
In addition to this form, you must also provide a Letter of Authorisation on company
letterhead and signed by a Company Director or Authorised Representative.
The Letter of Authorisation must include your Business Name, ABN and a Statement of
Authorisation to approve the person signing this form to act on behalf of the business.

I have attached the required Letter of Authorisation to this form

Incoming Customer ID requirement

The person authorising this transaction must provide 100 points of ID, including
primary and secondary ID, as part of this application. This is a requirement and
must be provided for every change of ownership or transfer of lease request for
both new and existing customers.
You will need to provide us with a copy of your ID by attaching it to this form.
For information on what ID you can provide to Telstra, including a comprehensive list
of acceptable primary and secondary ID and their point values, please visit telstra.com
and search Acceptable Identification or call Telstra on 13 2000.

ID type and identification number

Primary ID type (must include photo and DOB) (eg. Australian Passport, Australian
Drivers Licence, NSW Birth Card, Tasmanian Personal Identity Card)
Type State of issue Number

I have attached a copy of this ID to this form

Secondary ID type (eg. Medicare card, Seniors card, proof of age card)
Type State of issue Number

I have attached a copy of this ID to this form

Type State of issue Number

I have attached a copy of this ID to this form

Authorised Representatives
If you require additional contacts to be added to the account, please contact Telstra on
13 2000 or visit a Telstra store with the relevant identification.

Page 9 of 11
Agreement Incoming Customer to Sign
Terms and conditions
Important information Please ensure you read all terms and
Before agreeing to take over the ownership or lease of the above services, you must conditions before signing.
review and agree to the conditions set out in the relevant Critical information Summary.
Where services cannot be retained on the same plan because those plans are no longer
available or you are not eligible for the plan, services will be transferred to standard
pricing with no fixed contract term. To discuss your pricing options after the transfer
has taken place please contact Telstra on 13 2000.
Where contract include a Mobile device, this device should be handed over to you, by the
outgoing customer, at the time the contract is transferred.
The services listed above will be transferred as is along with any additional products
attached to those services.
Silent Line subscription and associated charges existing on fixed services will remain
when the service is transferred.
Priority Assistance existing on fixed services will be removed when the service is
transferred. Contact Telstra to confirm eligibility after transfer.
If you have BigPond Mailboxes or Telstra Mail services transferred to your account without
an active internet connection, you may be charged an ongoing subscription fee.
On behalf of the Incoming Customer, I request Telstra transfer the legal responsibility of
the services listed above from the Outgoing Customer, whose details appear in Part B of
this form to me, the Incoming Customer.
I agree:
I will be taking over the services listed above including any and all applicable contracts
and that the nominated services will be transferred to my account with the same
structure and set up as they currently have, unless the plan is no longer available, in
which case I consent to Telstra transferring the service to a reasonably comparable plan
on standard pricing;
that acceptance of this request by Telstra is subject to Telstras ordinary credit
approval process;
to terms and conditions of Telstras Our Customer Terms located at
telstra.com.au/customerterms/index.htm for the services being transferred
to me and acknowledge either receiving, or having had the opportunity to review,
a copy of Our Customer Terms;
to fulfil all obligations imposed upon the current owner under the existing contract for
the services;
I will be liable for all debts incurred on the services listed above from the date of
transfer, except for BigPond services, where I will be liable for all outstanding charges
on the account;
I agree that I will not seek to recover loss I have suffered or may suffer (either directly
or indirectly) as a result of the transfer;
that Telstra may, subject to the Privacy Act 1988:
a) verify my identifying information (such as my drivers licence or passport) with the
document issuer or official record holder; and
b) disclose information about me and this application (including information contained
in any application for additional services and information about the conduct of my
account) to a credit reporting body to obtain credit reporting information about me
and to another credit provider or a debt collection agent to collect overdue payments
relating to credit owed by me and to notify defaults by me to a credit reporting body;
and
c) obtain and use information about my creditworthiness (including consumer credit
reporting information or a commercial credit report) from a credit reporting body or
other business that reports on creditworthiness or from a credit provider to assess
any application for services or to collect any overdue payments,
where applicable, I have read considered and understand the Telstra StayConnected
Critical Information Statement. I agree to the terms and conditions for StayConnected;
and
I have read and understand all statements made in this application form.

I warrant that I am authorised to make this request on behalf of the Incoming Customer
Name

Position

Signature Date

DD/MM/YYYY

Page 10 of 11
Office use only
If this Change of Ownership or Transfer of Lease form is being filled out by a Channel
Partner, please provide your Dealer Code and Contact Information.
Dealer code Contact name

Contact number Contact email
( )

Telstra Dealers
All mobile Change of Ownership or Transfer of Lease requests are to be completed in
store. Please refer to Retail Live or contact Retail Channel Support if further information
is required https://retaillive.com.au/45570.aspx

and are trade marks and registered trade marks of Telstra Corporation Limited, ABN 33 051 775 556.

C116 NOV16 Page 11 of 11