Get the free l501 sss form

OD ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? SSS Form B - 5 (07-94) Tel. No. ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? SSS Form K - 7 (07-94) Tel. No. ? ? ? SSS Form C - 9 (07-94) Tel. No. ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? The above form is for use in connection with the establishment and operation of the Service. The name of the Company to which this Notice of Appointment relates shall not be used in connection with the Service, unless the application for appointment specifically requests publication at the Company's address designated in the Notice for the purpose of serving a Notice of Appointment. No other name shall be used unless otherwise authorized by the Company's Board of Directors or in connection with the Service for which it will be responsible. All persons shall be deemed to have consented to be contacted by the Company in connection with the Service, when a written request is submitted by such person requesting the Company to do so. Dated: November 12, 2011 By: /s/ John S. Thompson Chairman of the Board Name Phone/Fax Name of Company Address City State Country S-1. Certification. [Reserved] S-2. Appointments, Appointment. [Reserved] S-3. Resignation/Removal From Board. [Reserved] S-4. Annual Reports. [Reserved] S-5. Committee Chairs. [Reserved] S-6. Committee Vice-Chairmen. [Reserved] S-7. Committee Members. [Reserved] S-8. Committee Designated Officers. [Reserved] S-9. Annual Report to Shareowners. [Reserved] S-10. Annual Reports on Activities of Committees. [Reserved] S-11. Committee Meetings and Committees. [Reserved] S-12. Disclosure to the Shareholders. [Reserved] S-13

I. This form SSS Form L-501 should be accomplished in two 2 copies by the responsible officials authorized by the employer to certify and/or sign documents on the Social Security System SSS.