Management Change Notification Form

Management Change Notification Form

Recitals

WHEREAS, the organization identified below (Company Name: ) is required to notify business counterparties and regulatory recipients of changes in senior management and authority;

WHEREAS, the undersigned have authority to provide notice of such management changes on behalf of the Company and to document the transfer and limitation of managerial duties and signatory authority effective as of the Effective Date: ;

WHEREAS, the parties desire to record the scope of management responsibilities, any change in compensation or billing arrangements related to management services, and the terms governing such changes.

Notification Details

Details of Management Change

Effective Date of Change:

Outgoing Manager

Last Working Date:

Incoming Manager

Date Assumed Office:

Scope of Management Duties

Describe the principal duties, decision authority, and limits of authority to be undertaken by the incoming manager. Include any specific accounts, contracts, or delegated powers.

Payment Terms (if applicable)

If compensation or billing arrangements change as a result of this management change, specify the terms below. Amount payable for management services (if any):

Billing and invoicing will be rendered to the Contact provided above unless an alternate billing address is supplied in writing. Acceptance of an invoice constitutes certification that management services were performed in accordance with this notification and any underlying agreement.

Term and Termination

This notification and any related management services shall commence on: and, unless earlier terminated in accordance with the terms below, shall continue until: .

Either party may terminate services related to this management change for convenience upon written notice delivered at least days prior to the effective termination date. Termination for cause shall be effective immediately upon written notice if the notified party breaches a material obligation and fails to cure within any cure period specified in the underlying agreement.

Confidentiality

All non-public information disclosed in connection with this management change, including personnel records, financial terms, customer lists, account access credentials, and internal policies, shall be treated as Confidential Information. The recipient shall: (i) use Confidential Information solely for purposes of implementing and documenting the management change; (ii) restrict disclosure to employees or agents who have a legitimate need to know and are bound to confidentiality obligations no less protective than those herein; and (iii) maintain the confidentiality of such information for a period of three (3) years following disclosure, except as required by law or pursuant to a valid order of a court of competent jurisdiction.

Governing Law

This Notification shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles.

Entire Agreement

This Notification, together with any referenced board resolutions, delegation of authority instruments, and the underlying management agreement (if any), constitutes the entire understanding between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral, regarding the same. Any amendment or waiver must be in writing and signed by authorized representatives of both parties.

Certifications and Attachments

The undersigned certify that they are duly authorized to provide this notification on behalf of their respective organizations and that the information contained herein is true and complete to the best of their knowledge.

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