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). ? Check this box to indicate that a transaction was made pursuant to a
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 our professional PDF editor, follow these steps:
1
Log in to account. Start Free Trial and sign up a profile if you don't have one.
2
Upload a document. Select Add New on your Dashboard and transfer a file into the system in one of the following ways: by uploading it from your device or importing from the cloud, web, or internal mail. Then, click Start editing.
3
Edit template. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.
4
Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
With pdfFiller, it's always easy to work with documents.

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 you can get filled-out and signed for specific purpose. Next, it is furnished to the actual addressee to provide specific info of any kinds. The completion and signing can be done in hard copy by hand or using a trusted tool like PDFfiller. These tools help to complete any PDF or Word file online. It also allows you to edit it according to your needs and put legit e-signature. Once you're good, the user sends the - to the recipient or several ones by mail and even fax. PDFfiller offers a feature and options that make your blank printable. It provides 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 neat and organized. To not to create a new editable template from scratch again and again, turn the original Word file as a template. Later, you will have a customizable sample.

Instructions for the - form

Before starting filling out - Word template, make sure that you prepared all the necessary information. This is a mandatory part, because errors may cause unpleasant consequences from re-submission of the full blank and completing with missing deadlines and even penalties. You need to be observative when writing down figures. At first glance, you might think of it as to be not challenging thing. Nevertheless, it is easy to make a mistake. Some use some sort of a lifehack storing all data in another file or a record book and then add it into documents' temlates. Nevertheless, come up with all efforts and present actual and solid data with your - word form, and check it twice while filling out all required fields. If you find a mistake, you can easily make corrections when using PDFfiller editor and avoid blowing deadlines.

Frequently asked questions about - template

1. Is this legal to fill out documents digitally?

According to ESIGN Act 2000, forms submitted and authorized with an electronic signature are considered as legally binding, equally to their hard analogs. This means you can rightfully complete and submit - form to the establishment needed using electronic signature solution that suits all requirements based on particular terms, like PDFfiller.

2. Is it secure to fill in personal documents on the web?

Sure, it is totally risk-free as long as you use trusted product for your workflow for those purposes. As an example, PDFfiller offers the benefits like:

  • All data is stored in the cloud supplied with multi-layer encryption. Every single document is protected from rewriting or copying its content this way. It's only you the one who controls to whom and how this document can be shown.
  • Each writable document signed has its own unique ID, so it can’t be falsified.
  • You can set extra protection settings such as authentication of signers via picture or security password. There's also an option to protect entire folder with encryption. Place your - fillable form and set your password.

3. Is it possible to transfer available data to the form from another file?

Yes, but you need a specific feature to do that. In PDFfiller, we call it Fill in Bulk. By using this one, you can export data from the Excel worksheet and insert it into your file.

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
4.6
Satisfied
47 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.

Yes. By adding the solution to your Chrome browser, you can use pdfFiller to eSign documents and enjoy all of the features of the PDF editor in one place. Use the extension to create a legally-binding eSignature by drawing it, typing it, or uploading a picture of your handwritten signature. Whatever you choose, you will be able to eSign your template in seconds.
Install the pdfFiller iOS app. Log in or create an account to access the solution's editing features. Open your template by uploading it from your device or online storage. After filling in all relevant fields and eSigning if required, you may save or distribute the document.
You can make any changes to PDF files, such as template, with the help of the pdfFiller mobile app for Android. Edit, sign, and send documents right from your mobile device. Install the app and streamline your document management wherever you are.
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.