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Get the free Name and Address of Reporting Person* Bertelsen Mark (Last) OMB APPROVAL OMB Number:...

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UNITED STATES SECURITIES AND EXCHANGE COMMISSION FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b) STATEMENT OF CHANGES IN BENEFICIAL
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Name and address refer to the legal name and physical address of an individual or organization.
Certain individuals or organizations, depending on the applicable regulations, may be required to file name and address information.
To fill out name and address information, you typically need to provide the full legal name and the physical address of the individual or organization as per the specified format or guidelines.
The purpose of collecting name and address information is to accurately identify and locate individuals or organizations for various legal, administrative, or regulatory purposes.
The information required to be reported on name and address may include the full legal name, mailing address, contact details, and any other relevant information specified by the applicable regulations or requirements.
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