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Proudly Serving Clients Since 1983 PacificStockTransfer. Statement OF AFFILIATION RESTRICTIVE LEGEND REMOVAL REQUEST PURSUANT TO RULE 144 (b) (1) FOR REPORTING ISSUERS ONLYAFTER SIX-MONTH HOLDING
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To fill out a statement of non-affiliation restrictive, follow these steps:
02
Begin by writing your full name and contact information at the top of the document.
03
Include the name of the organization or entity that you are stating non-affiliation with.
04
Clearly state that you are not affiliated with the organization in any way.
05
Provide a brief explanation of why you are stating non-affiliation.
06
Sign and date the statement at the bottom.
07
Keep a copy of the completed statement for your records.

Who needs statement of non-affiliation restrictive?

01
Statement of non-affiliation restrictive is needed by individuals or organizations who want to declare their lack of affiliation or association with a specific organization or entity.
02
This could include individuals refusing any connection to an organization, or companies clarifying that they are not affiliated with any particular brand.
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A statement of non-affiliation restrictive is a legal document used to declare that an entity or individual is not affiliated with certain organizations or individuals, often relevant in contexts like licensing or regulatory compliance.
Typically, organizations or individuals applying for licenses, permits, or certifications that require confirmation of non-affiliation with certain entities are required to file a statement of non-affiliation restrictive.
To fill out a statement of non-affiliation restrictive, one should provide personal or organizational details, clearly state the non-affiliation, and sign the document, ensuring all information is accurate and comprehensive.
The purpose of the statement is to ensure transparency and integrity by confirming that the filer does not have conflicting affiliations that could influence their eligibility or actions regarding licenses, permits, or other regulatory matters.
The statement must include full names, addresses, the nature of the non-affiliation, and any relevant identification numbers that may pertain to the licensing or regulatory body.
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