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Consent to Act as Secretary

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Please enter the name of the company of which the person is becoming a secretary. If any suffixes such as "Pty Ltd" apply, include those suffixes here. Do not include the Australian Company Number (ACN), as this will be included at the next step.

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CONSENT TO ACT AS COMPANY SECRETARY
________ (ACN ................................................)


I hereby consent to being appointed to the position of Secretary of ________. For the purposes of this role as Secretary, I hereby provide the following information:

Full name: ________

Date of birth: ________

Town/City of birth: ________

State/Country of birth: ________

Address for service of notices:

________


SIGNED BY ________ on this ........................ day of..............................................20...........


..................................................
________

In the presence of:


................................................
Witness Signature

................................................
Witness Name

................................................
Witness Occupation

................................................

................................................
Witness Address

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CONSENT TO ACT AS COMPANY SECRETARY
________ (ACN ................................................)


I hereby consent to being appointed to the position of Secretary of ________. For the purposes of this role as Secretary, I hereby provide the following information:

Full name: ________

Date of birth: ________

Town/City of birth: ________

State/Country of birth: ________

Address for service of notices:

________


SIGNED BY ________ on this ........................ day of..............................................20...........


..................................................
________

In the presence of:


................................................
Witness Signature

................................................
Witness Name

................................................
Witness Occupation

................................................

................................................
Witness Address