Membership Quit Claim Request

Please note: Rivers Co-op Markets bylaws specifically prohibit transferring a membership to another household. This form is used for changing the name on a membership from the original stockholder’s name to another household name, such as to reflect the primary household grocery shopper or in the case of divorce or separation. If requesting a stockholder change in the event of a member-owner’s death, the executor of the estate or beneficiary may complete the form. This request will be presented at the next Board of Directors Meeting for approval. Depending on their meeting schedule, it can take up to 7 weeks for approval. If you need an equity refund, please use the Membership Equity Refund Request Form.

Membership Type(Required)

Rivers Co-op Markets Member-Owner

Rivers Co-op Markets LIME Member-Owner

Current Stockholder's Name(Required)

First Last

Member-Owner Number(Required)

If you do not have your member-owner number, please call us at 651-310-9499 and we can look it up for you.

Current Stockholder's Mailing Address(Required)

Make sure you enter the correct address for 6-8 weeks from now if you are moving.

Street Address Address Line 2 City State ZIP Code

Current Stockholder's Email(Required)

Current Stockholder's Phone(Required)

New Stockholder's Name(Required)

First Last

New Stockholder's Address(Required)

Street Address Address Line 2 City State ZIP Code

New Stockholder's Email(Required)

New Stockholder's Phone(Required)

Reason for Change(Required)

Signature(Required)

Date(Required)

Membership Quit Claim Request

EAST 7TH STREET, ST. PAUL

WEST 7TH STREET, ST. PAUL

SELBY AVENUE, ST. PAUL

MAIN STREET, STILLWATER