Get the free OMB Number: 3235-0104

Title of Security Instr. 4 2. Amount of Securities Beneficially Owned 3. Ownership 4. Nature of Indirect Beneficial Ownership Form Direct D or Indirect I Instr. 5 Common Stock 19 000 D I By Family Trust 1 Reminder Report on a separate line for each class of securities beneficially owned directly or indirectly. 25 SAWYER PASSWAY 4. Relationship of Reporting Person s to Issuer Check all applicable X Street FITCHBURG MA 01420 City Director Officer give title below 10 Owner Other specify below...

How to fill out omb number 3235-0104

How to fill out omb number 3235-0104

1. Start by downloading the OMB Number 3235-0104 form from the official website or obtain a physical copy from the relevant authority.
2. Read the instructions provided with the form carefully to understand the purpose and requirements of the form.
3. Gather all the necessary information and documents required to complete the form. This may include personal information, financial details, and supporting documents depending on the nature of the form.
4. Begin filling out the form by entering your personal details such as name, address, social security number, etc. Make sure to follow the specified format and provide accurate information.
5. Proceed to the main sections of the form and fill in the requested information as per the instructions provided. Use additional sheets if necessary and label them appropriately.
6. Double-check your entries to ensure accuracy and completeness. Any errors or missing information can lead to delays or rejection of the form.
7. Once you have completed filling out the form, review it thoroughly to ensure everything is filled correctly and all required sections are completed.
8. Sign and date the form as per the instructions provided. If applicable, make sure to get any necessary signatures from other parties involved.
9. Attach any supporting documents as required. Ensure that all attachments are properly labeled and organized.
10. Make a copy of the completed form and all attachments for your records.
11. Submit the filled-out form and any accompanying documents as per the specified submission method. This may include mailing it to the designated address, submitting it online through a portal, or hand-delivering it to the relevant authority.
12. Keep track of the submission date and any reference numbers provided for future reference or follow-up if needed.

Who needs omb number 3235-0104?

1. OMB Number 3235-0104 may be required by individuals or organizations that are involved in specific activities regulated by the relevant authority.
2. Some examples of who may need this OMB number include:
3. - Financial institutions or entities engaged in certain activities that require reporting or compliance with federal regulations.
4. - Individuals applying for specific permits, licenses, or certifications that fall under the jurisdiction of the authority associated with OMB Number 3235-0104.
5. - Entities involved in government contracts or grants that require information or certification provided through this OMB number.
6. It is important to refer to the specific instructions or guidelines related to the form or activity in question to determine if OMB Number 3235-0104 is mandatory or recommended for your situation.

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