Form preview

Get the free - template

Get Form
FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign template

Edit
Edit your template form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your template form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit template online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the professional PDF editor, follow these steps:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit template. Text may be added and replaced, new objects can be included, pages can be rearranged, watermarks and page numbers can be added, and so on. When you're done editing, click Done and then go to the Documents tab to combine, divide, lock, or unlock the file.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.
Dealing with documents is simple using pdfFiller. Try it now!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

What is - Form?

The - is a fillable form in MS Word extension you can get completed and signed for specific purpose. Then, it is furnished to the actual addressee to provide specific information of any kinds. The completion and signing can be done in hard copy by hand or with a suitable tool e. g. PDFfiller. Such applications help to complete any PDF or Word file online. It also lets you customize it according to the needs you have and put an official legal e-signature. Upon finishing, the user ought to send the - to the recipient or several ones by email and also fax. PDFfiller includes a feature and options that make your document of MS Word extension printable. It has different options when printing out appearance. It doesn't matter how you file a form after filling it out - in hard copy or by email - it will always look well-designed and clear. To not to create a new file from the beginning every time, make the original form as a template. Later, you will have a rewritable sample.

Template - instructions

Before filling out - form, make sure that you prepared all the information required. That's a mandatory part, as long as some typos may bring unpleasant consequences from re-submission of the whole entire template and finishing with missing deadlines and you might be charged a penalty fee. You have to be careful enough filling out the digits. At first glance, this task seems to be dead simple thing. However, you can easily make a mistake. Some use such lifehack as keeping everything in another document or a record book and then put this information into document's template. Anyway, put your best with all efforts and provide true and genuine data in your - word form, and check it twice during the process of filling out all the fields. If you find a mistake, you can easily make some more corrections when you use PDFfiller editor and avoid missed deadlines.

How should you fill out the - template

The first thing you need to begin completing the form - is exactly template of it. If you're using PDFfiller for this purpose, there are these options how to get it:

  • Search for the - form from the Search box on the top of the main page.
  • In case you have the very template in Word or PDF format on your device, upload it to the editing tool.
  • Draw up the writable document from scratch via PDFfiller’s creation tool and add the required elements with the help of the editing tools.

Regardless of the option you prefer, you'll be able to edit the document and add various nice things in it. Except for, if you want a word template containing all fillable fields from the box, you can get it only from the filebase. The second and third options are short of this feature, so you'll need to place fields yourself. However, it is quite easy and fast to do as well. Once you finish it, you will have a convenient template to be submitted. These fillable fields are easy to put once you need them in the file and can be deleted in one click. Each purpose of the fields corresponds to a certain type: for text, for date, for checkmarks. If you want other individuals to sign it, there is a signature field too. E-sign tool makes it possible to put your own autograph. When everything is ready, hit Done. And now, you can share your .doc form.

Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.3
Satisfied
26 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

You may use pdfFiller's Gmail add-on to change, fill out, and eSign your template as well as other documents directly in your inbox by using the pdfFiller add-on for Gmail. pdfFiller for Gmail may be found on the Google Workspace Marketplace. Use the time you would have spent dealing with your papers and eSignatures for more vital tasks instead.
The best way to make changes to documents on a mobile device is to use pdfFiller's apps for iOS and Android. You may get them from the Apple Store and Google Play. Learn more about the apps here. To start editing template, you need to install and log in to the app.
You can. With the pdfFiller Android app, you can edit, sign, and distribute template from anywhere with an internet connection. Take use of the app's mobile capabilities.
Fill out your template online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.