Stroma Membership - 2012 EPBR (Change of details)

Please use this form to notify Stroma Certification of any changes to your certified Organisation.

Change of Personal/Company details

Please note this form applies to EPBR & Code only

Please provide your Stroma membership number and account holders name:
STRO
Account Holders Name
SECTION 1

Changes to personal details
Please Note:

Only complete the fields that you require to be changed against the given membership no.
Change of Name
If personal name is to be changed we require one of the following items of evidence to be provided:
Please indicate which one you will be providing

Please indicate which one you will be providing Passport Driving Licence Deed Poll Certificate
Upload Evidence
Change of Personal Address Change of Personal Address
Street Address Address Line 2 City County Postcode Country
If personal address is to be changed we require one of the following items of evidence to be provided:
Please indicate which one you will be providing

Please indicate which one you will be providing Driving Licence Utility Bill
Upload Evidence
Change of Telephone Number
Change of Fax Number
Change of Email Address
SECTION 2

Changes to company details
Company Information (The "Assessment Organisation") To be Invoiced

If Energy Performance Certificates (EPCs) and /or Display Energy Certificates (DECs) and/or Code for Sustainable Home (CSH) Certificates are to be produced on behalf of a third party (e.g. employer)
Please indicate where the changes are to be made:

Please indicate where the changes are to be made: For invoicing purposes Appearence on Landmark Register
Change of Company / Trading Name
Change of Company Registration Number
Change of Company Address Change of Company Address
Street Address Address Line 2 City County Postcode Country
Change of Telephone Number
Change of Fax Number
Change of Email Address
Change of Website Address
Please Note:

If company information is to be changed we require a copy of the certificate of incorporation on change of name provided by companies house:
Upload Evidence
Members Declaration *

Members Declaration I declare that the all information provided within this document is true to the best of my knowledge. I confirm I am duly authorised to act on behalf of the business to be invoiced, and I understand that I will be held personally liable in the event that I am not authorised to act on behalf of this entity. I am aware that if any lodgements have been made during the month this change takes effect that I will be responsible for the payment of this monies as well as any new lodgements made with my new company.
Employer’s Declaration *

Employer’s Declaration I confirm acceptance of all terms and conditions relating to the certification scheme and I am an authorised person of the above company detailed above. All relevant staff shall, at all times, comply fully with the requirements of the Assessor Code of Conduct.

Stroma Membership - 2012 EPBR (Change of details)

Stroma Membership - 2012 EPBR (Change of details)

Change of Personal/Company details

SECTION 1

Please Note:

SECTION 2

Company Information (The "Assessment Organisation") To be Invoiced

Please Note: