Please note: Mississippi Market’s 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 refect 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. Dep ending 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 Quit Claim Request Form

Membership Type(Required)
Current Stockholder's Name(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)
Consent(Required)
New Stockholder's Name(Required)
New Stockholder's Mailing Address(Required)

I understand that by transferring my membership, I relinquish and give up all rights, title, and interest in all membership stock, patronage dividends (either paid or not yet paid), equity, or other ownership interest, including non-voting stock, in Mississippi Market Co-op as well as other rights and privileges of membership. I further understand that this change is subject to the approval of the Board of Directors and such change can only be granted to another individual in my household. Depending on the Board of Director's meeting schedule, this process can take up to 7 weeks.
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