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Change of primary contact request
Change of primary contact request
Please complete and submit this form to replace the current
primary contact
of a company registered with Éco Entreprises Québec.
New primary contact
Designation
*
Mr.
Ms.
Mx.
Name
*
*
First Name
Last Name
Title
*
Relationship to the company
*
Owner
Manager
Employee
External Consultant
Other
Email
*
*
*
Business phone
*
*
Mobile phone
*
Company
Company name
*
*
Account Number
*
Corporate website
*
Clarifications
*
Correspondence language
*
French
English
Reason for change of primary contact
*
The current primary contact has changed responsibilities within the company
The current primary contact is on long-term or indefinite leave
The current primary contact is no longer employed by the company
Other
I certify that I am duly authorized by the company to administer its file and submit material reports in its name to Éco Entreprises Québec.
*
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