Change of Ownership Request: Former Owner

Please complete and submit the form below if you are the selling party/former owner of an entity that is being sold to another party that would like to retain existing Pivotal Group accounts and member benefits.

If you have any questions about the required form fields below, please contact support@trypivotal.com for assistance.

Selling Party's Name*
First Last
Former Entity Name*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
New Ownership: Main Contact Name*
First Last
New Ownership: Entity/LLC/Corporation Name*
Effective Date*
MM slash DD slash YYYY
Change of Ownership Consent*
I agree to the Change of Ownership Confirmation.
The individual completing this form is no longer the owner of the business listed above at the address provided above.

I hereby acknowledge that ownership is being transferred to the new ownership listed above.

I acknowledge and approve this change of ownership and will assist in transitioning accounts to this new entity when applicable. I am ultimately responsible for payment of any invoices or account balances until such ownership has been fully transitioned.