BLSP Realized and Unrealized Loss Survey

Welcome
In order to determine losses accrued in purchasing securities of BLSP, we've put together a quick and convenient form for you.

Instructions and examples will be available on the data submission page at the end.

Name*

First NameLast Name
Email*
john_smith@example.com
Phone Number (optional)

Country CodePhone Number

Unrealized & Realized Losses

Please follow these formats: | MM/DD/YY | ###,### | ###.## |*

	Date Purchased	Number of Shares	Total Cost
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Additional entries

To be used if you have more than 20 transactions:*

	Date Purchased	Number of Shares	Total Cost
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Example & Instructions
1. Date Purchased: Please enter the date of your purchase in mm/dd/yy or m/d/yy format.
  (Example: January 8th, 2021 would be entered as 01/08/21, or 1/8/21)
2. Number of Shares: Enter the number of shares purchased, ideally without commas.
  (Example: 500000)
3. Total Cost: Enter the final cost, including brokerage fees, if applicable.

Click or tap the 'Submit' button at the bottom right of the page, and you are done!
Should be Empty: