HTML Preview Company Ownership Transfer Letter page number 1.
To transfer the ownership of an Office Ally account, we require the current owner to submit a Transfer of Ownership Letter
(page 2) authorizing the transfer as well as pay all balances due on the account. In addition, the new owner must complete
a Transfer of Ownership Enrollment Form (page 3), Transfer of Ownership Authorization Sheet (page 4), and the required
agreement forms for any Add-On Service(s) they want to keep active on the account (if any).
When transferring ownership, usernames cannot be changed and claims/transactions cannot be transferred between
usernames. To be assigned a new username, the current account must be closed, and a new account opened by the new
owner. Please allow at least 48 hours for this request to be completed.
Note: In order to transfer ownership of an account, any past due balances must be paid in full.
WHAT IS REQUIRED?
Transfer of Ownership Letter (Current Account Owner)
The Transfer of Ownership Letter must be on company letterhead (of the current account owner). A standard template for
this letter is on page 2 of this document. If you choose not to use this template be sure that all the requested information is
included in your letter:
• Current Account Owner Information:
- Office Ally Username(s) to be transferred.
• Note: Sub-account usernames must be included or their ownership will not be transferred to
the New Account Owner. Child account usernames do not need to be listed.
• Security Administrator Accounts (username_sa) will automatically be transferred if any.
- Acknowledgement Statement:
“By signing below, I am acknowledging that I am responsible for all charges incurred prior to
account ownership being officially transferred and am authorizing Office Ally to
relinquish my Office Ally account to the company/individual listed.”
- Signature of Current Account Owner
- Printed Name & Title of Current Account Owner
- Current Account Owner’s Company Name
- Current Account Owner’s Contact Phone Number and/or Email (optional)
• New Account Owner Information:
- New Account Owner Name
- New Account Owner Company Name
- New Account Contact (if different than above)
- New Account Owner Contact Email and Phone Number
Transfer of Ownership Enrollment Form and Authorization Sheet (New Account Owner)
The new owner is required to complete the Transfer of Ownership Enrollment Form and Transfer of Ownership
Authorization Sheet provided on pages 3-4 of this document.
Required Add-On Service Agreements (New Account Owner)
The new owner is required to complete the agreements of any Add-On Services they wish to keep on the account (e.g.
Practice Mate, EHR 24/7, Reminder Mate, Eligibility Verification, etc…). These forms are available in the Resource Center on
the Office Ally website.
TRANSFER OF OWNERSHIP -
INSTRUCTIONS