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COMPANY INFORMATION

Company Name

Ticker

FYE (Fiscal Year End) Month

Billing Address (No PO Boxes)

City

State

Zip

CONTACT INFORMATION

Name (required)

Title (required)

Email Address (required)

Phone (required)

INDEX SELECTION

Please Select Major Market Index (Required), Industry Index(es) and/or Peer Group (Required)

Major Market Index:

Published Industry Index:

Additional Indexes (if desired)

Click HERE to view a list of indexes

Self-Constructed Peer Group (list all competitors):

Comments or special instructions:

DELIVERY OPTION - Please Select (Required):

GRAPH FORMAT - Please Select (Required)

Standard Format - (Black & White Chart, Plot Point Table and Company Back-up Data in Excel Format)

Enhanced Format - (Includes Standard Format with SEC Compliant Text and Full-Color Chart in both Excel and Word Format)

Complete Annual Report /10-K Compliance Format - (Includes Enhanced Format, Quarterly Hi-Low Prices and monthly or quarterly updates tracking your company, Major Market, Industry and Peer Group performance as you move through your Shareholder and Board meeting cycles)

This Section Is For Companies Trading Less Than Five Years:

As a recent IPO, please recognize our closing stock price of $ per share on our IPO Date of (mm/dd/yyyy) . (Please include the applicable "split-adjusted" price.)

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