Your name (required)

Your email (required)

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Company name (required)

Stock symbol (required)

Number of shares you are looking to sell (required)

Dollar amount you are looking to sell the position for (required)

How did you obtain the position? (required)

Is there full supporting documentation and Legacy of the stock? (required)
YesNo

Was the stock issued under a registration statement or an exemption? (required)
StatementExemption

If by exemption what rule number. Do you have a legal opinion when you purchased the stock? (required)

Did you buy the stock directly from the company or from the company investor? (required)
Direct From CompanyThird Party

any supporting documentation (required) YesNo

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