Change of representative form

For NCSI Certified Organisations

Please complete and submit this form if you wish to notify NCSI of a change to your Authorised Representative.


Details of Organisation
Organisation Name:

Certification Number(s):

I hereby advise that the following person has ceased to be the Authorised Representative of this organisation for the above certification(s).

(insert full name)
Nomination of Authorised Representative

I hereby nominate the following person to represent this organisation in all matters affecting the certification of this organisation by NCS International and declare that the nominated person has the authority to commit the organisation to compliance with all certification requirements.


Name: (insert full name)

Position:

Postal Address:

City/Town:

State:

Post/Zip Code:

Country:

Telephone:

Fax:

Email:

Nominated by:

Position:
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