Notice of Change of Address Date To From (Authorized Signer): Company Name Merchant ID # Telephone: Fax Fax Please change our address as indicated below:Previous Physical Address: Previous Mailing Address (if applicable): Previous Web Site Address: http://www. Previous e-mail Address(s): Previous Phone Number: Previous Bank Fax Number: ToNew Physical Address: New Mailing Address (if applicable): New Web Site Address: http://www. New e-mail Address(s): New Bank Phone Number: New Bank Fax Number:
