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
Use the instructions below to start using our professional PDF editor:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit template. Add and replace text, insert new objects, rearrange pages, add watermarks and page numbers, and more. Click Done when you are finished editing and go to the Documents tab to merge, split, lock or unlock the file.
4
Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.
With pdfFiller, dealing with documents is always straightforward.

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 document needed to be submitted to the required address in order to provide certain information. It has to be filled-out and signed, which can be done manually, or with a particular solution such as PDFfiller. It lets you complete any PDF or Word document directly from your browser (no software requred), customize it depending on your purposes and put a legally-binding electronic signature. Right after completion, you can send the - to the relevant individual, or multiple recipients via email or fax. The blank is printable too because of PDFfiller feature and options offered for printing out adjustment. In both electronic and in hard copy, your form will have got organized and professional look. It's also possible to turn it into a template for further use, there's no need to create a new document from scratch. All you need to do is to customize the ready template.

- template instructions

Once you are ready to begin filling out the - word template, it is important to make certain all required info is well prepared. This very part is highly important, so far as mistakes can result in unpleasant consequences. It's always irritating and time-consuming to resubmit forcedly the entire word template, not to mention penalties resulted from missed due dates. Work with figures requires more concentration. At first sight, there’s nothing complicated about this. Yet, there's no anything challenging to make an error. Experts suggest to save all required information and get it separately in a different file. When you have a template, you can easily export it from the file. In any case, you need to be as observative as you can to provide actual and solid data. Check the information in your - form carefully when completing all required fields. You also use the editing tool in order to correct all mistakes if there remains any.

How to fill - word template

In order to start submitting the form -, you'll need a blank. When using PDFfiller for filling out and submitting, you can get it in a few ways:

  • Find the - form in PDFfiller’s filebase.
  • You can also upload the template via your device in Word or PDF format.
  • Create the document to meet your specific needs in PDF creator tool adding all required objects via editor.

Regardless of what choice you prefer, you will have all the editing tools at your disposal. The difference is, the form from the library contains the necessary fillable fields, you ought to create them on your own in the rest 2 options. Nonetheless, it is dead simple thing and makes your sample really convenient to fill out. The fillable fields can be placed on the pages, you can delete them too. There are different types of those fields based on their functions, whether you are typing in text, date, or place checkmarks. There is also a signature field if you need the word file to be signed by other people. You can put your own e-sign via signing feature. When you're good, all you've left to do is press the Done button and proceed to the distribution of the 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
4.1
Satisfied
42 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.

Add pdfFiller Google Chrome Extension to your web browser to start editing template and other documents directly from a Google search page. The service allows you to make changes in your documents when viewing them in Chrome. Create fillable documents and edit existing PDFs from any internet-connected device with pdfFiller.
The pdfFiller mobile applications for iOS and Android are the easiest way to edit documents on the go. You may get them from the Apple Store and Google Play. More info about the applications here. Install and log in to edit template.
Use the pdfFiller mobile app to complete and sign template on your mobile device. Visit our web page (https://edit-pdf-ios-android.pdffiller.com/) to learn more about our mobile applications, the capabilities you’ll have access to, and the steps to take to get up and running.
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.