Order Form: Auditing Services

Order Form for Auditing Services
This form is for use by corporate clients requesting an audit of the "proof of stock ownership" documentation submited by a shareholder with a shareholder proposal.
1.0. Corporate Client Information
Company Name
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Designated Company Contact for this Order:
Phone Number for Designated Contact:
Please enter a valid phone number.Format: (000) 000-0000.
Email Address for Designated Contact:
example@example.com
2.0. Document Auditing Order Information
The number of "proof of stock ownership" document audits being ordered today is:
Audit #1: Name of shareholder

First NameLast Name
Audit #1: The shareholder identified their stock ownership as:
Audit #2: Name of shareholder

First NameLast Name
Audit #2: The shareholder identified their stock ownership as:
Audit #3: Name of shareholder

First NameLast Name
Audit #3: The shareholder identified their stock ownership as:
Audit #4: Name of shareholder

First NameLast Name
Audit #4: The shareholder identified their stock ownership as:
Audit #5: Name of shareholder

First NameLast Name
Audit #5: The shareholder identified their stock ownership as:
Audit #6: Name of shareholder

First NameLast Name
Audit #6: The shareholder identified their stock ownership as:
Audit #7: Name of shareholder

First NameLast Name
Audit #7: The shareholder identified their stock ownership as:
3.0. Order Information: Document Auditing Services
We are requesting document auditing services be performed as follows:

We request all "proof of stock ownership" audits be performed at the three-year holding period rate of service. (We will perform a documentation audit on the shareholder's stock holding AND we will perform any secondary reviews that may be needed after a regulatory Notice of Deficiency has been provided to the shareholder and any "proof of correction" documentation has been submitted by them. A declaration concerning the auditing assessment is included for the first and any secondary review that may be required.)
4.0. Calculating Payment Amount
Document Auditing Costs for Assessing "Proof of Stock Ownership"
ADDITIONAL INFORMATION:

Clients that may desire secondary audits without additional charges for any "proof of correction" that may be submitted by a shareholder after providing the required regulatory "notice of deficiency" should select the 3-year holding period for all orders as a condition of fee-free secondary auditing.

Each audit is limted to one account number. Should holdings need to be assessed across different accounts, each account reviewed counts as a separate audit.
5.0 Document Upload
Please state the number of files that are being uploaded so that we can ensure that all of them were transferred and received.
FILE NAMING INSTUCTIONS

Please help us stay organized in processing your order by including your company's name within the file name. For example, if Nike Corporation were submitting brokerage account statements for a shareholder proposal submitted by Mr. Johnson, the preferred file naming convention would be:

Nike-Johnson.pdf
Document transfer and upload window.

Cancelof
6.0 Payment and Authorization
Payment Acknowledgement
Printed Name of the person placing the order:
I am authorized to submit this order on behalf of the company and to use the financial account provided for payment of services. I request that my typed name substitute for my signature and that it be given the same effect as if this order had been signed.
Date

MonthDayYear
Date
The cost of today's ordered services in ($) USD is:
(Total Cost for the Services Ordered)
WE THANK YOU FOR YOUR ORDER!

AFTER CLICKING THE SUBMIT BUTTON, YOU WILL BE AUTOMATICALLY DIRECTED TO OUR PAYMENT PROCESSING PAGE. FOR THOSE THAT MAY NOT INTEND TO COMPLETE PAYMENT IMMEDIATELY, OUR PAYMENTS PAGE CAN BE ACCESSED THROUGH THE ABOVE LINK OR BY WRITING DOWN THE URL FOR FUTURE USE.

https://pci.jotform.com/260948247026158
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Order Form for Auditing Services

1.0. Corporate Client Information

2.0. Document Auditing Order Information

3.0. Order Information: Document Auditing Services

4.0. Calculating Payment Amount

5.0 Document Upload

6.0 Payment and Authorization