SEC Form 4
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. 20549 |
OMB APPROVAL |
|
|
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |
||
|
OMB Number: |
3235-0287 |
|
|
Estimated average burden |
||
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 |
hours per response: |
0.5 |
|
or Section 30(h) of the Investment Company Act of 1940 |
|
1. Name and Address of Reporting Person* |
2. Issuer Name and Ticker or Trading Symbol |
5. Relationship of Reporting Person(s) to Issuer |
|||||||||||||||||||||||||||||||||||
|
(Check all applicable) |
|||||||||||||||||||||||||||||||||||||
|
X |
Director |
10% Owner |
|||||||||||||||||||||||||||||||||||
|
Officer (give title |
Other (specify |
||||||||||||||||||||||||||||||||||||
|
(Last) |
(First) |
(Middle) |
below) |
below) |
|||||||||||||||||||||||||||||||||
|
3. Date of Earliest Transaction (Month/Day/Year) |
|||||||||||||||||||||||||||||||||||||
|
11892 SOUTH BROOKGLEN DRIVE |
01/21/2021 |
||||||||||||||||||||||||||||||||||||
|
4. If Amendment, Date of Original Filed (Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable |
||||||||||||||||||||||||||||||||||||
|
(Street) |
Line) |
||||||||||||||||||||||||||||||||||||
|
SANDY |
UT |
84092 |
X Form filed by One Reporting Person |
||||||||||||||||||||||||||||||||||
|
Form filed by More than One Reporting |
|||||||||||||||||||||||||||||||||||||
|
(City) |
(State) |
(Zip) |
Person |
||||||||||||||||||||||||||||||||||
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|||||||||||||||||||||||||||||||||||||
|
1. Title of Security (Instr. 3) |
2. Transaction |
2A. Deemed |
3. |
4. Securities Acquired (A) or |
5. Amount of |
6. Ownership |
7. Nature of |
||||||||||||||||||||||||||||||
|
Date |
Execution Date, |
Transaction |
Disposed Of (D) (Instr. 3, 4 and 5) |
Securities |
Form: Direct |
Indirect |
|||||||||||||||||||||||||||||||
|
(Month/Day/Year) |
if any |
Code (Instr. |
Beneficially |
(D) or Indirect |
Beneficial |
||||||||||||||||||||||||||||||||
|
(Month/Day/Year) |
8) |
Owned Following |
(I) (Instr. 4) |
Ownership |
|||||||||||||||||||||||||||||||||
|
Reported |
(Instr. 4) |
||||||||||||||||||||||||||||||||||||
|
Code |
V |
Amount |
(A) or |
Price |
Transaction(s) |
||||||||||||||||||||||||||||||||
|
(D) |
(Instr. 3 and 4) |
||||||||||||||||||||||||||||||||||||
|
Class A Common Stock |
01/21/2021 |
S |
6,000 |
D |
$9 |
22,300 |
D |
||||||||||||||||||||||||||||||
|
Class A Common Stock |
01/22/2021 |
S |
6,000 |
D |
$9 |
16,300 |
D |
||||||||||||||||||||||||||||||
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|||||||||||||||||||||||||||||||||||||
|
(e.g., puts, calls, warrants, options, convertible securities) |
|||||||||||||||||||||||||||||||||||||
|
1. Title of |
2. |
3. Transaction |
3A. Deemed |
4. |
5. Number of |
6. Date Exercisable and |
7. Title and Amount |
8. Price of |
9. Number of |
10. |
11. Nature |
||||||||||||||||||||||||||
|
Derivative |
Conversion |
Date |
Execution Date, |
Transaction |
Derivative |
Expiration Date |
of Securities |
Derivative |
derivative |
Ownership |
of Indirect |
||||||||||||||||||||||||||
|
Security |
or Exercise |
(Month/Day/Year) |
if any |
Code (Instr. |
Securities |
(Month/Day/Year) |
Underlying |
Security |
Securities |
Form: |
Beneficial |
||||||||||||||||||||||||||
|
(Instr. 3) |
Price of |
(Month/Day/Year) |
8) |
Acquired (A) |
Derivative Security |
(Instr. 5) |
Beneficially |
Direct (D) |
Ownership |
||||||||||||||||||||||||||||
|
Derivative |
or Disposed |
(Instr. 3 and 4) |
Owned |
or Indirect |
(Instr. 4) |
||||||||||||||||||||||||||||||||
|
Security |
of (D) (Instr. |
Following |
(I) (Instr. 4) |
||||||||||||||||||||||||||||||||||
|
3, 4 and 5) |
Reported |
||||||||||||||||||||||||||||||||||||
|
Transaction(s) |
|||||||||||||||||||||||||||||||||||||
|
Amount |
(Instr. 4) |
||||||||||||||||||||||||||||||||||||
|
Date |
Expiration |
or |
|||||||||||||||||||||||||||||||||||
|
Code |
V |
(A) |
(D) |
Title |
Number |
||||||||||||||||||||||||||||||||
|
Exercisable |
Date |
of Shares |
|||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$0.8(1) |
7,951(1) |
Class A |
7,951(1) |
$0.8(1) |
7,951(1) |
|||||||||||||||||||||||||||||||
|
Option |
12/02/2011 |
A |
03/02/2012 |
12/02/2021 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$0.8(2) |
1,591(2) |
Class A |
1,591(2) |
$0.8(2) |
1,591(2) |
|||||||||||||||||||||||||||||||
|
Option |
12/07/2011 |
A |
03/07/2012 |
12/07/2021 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$1.01(3) |
7,573(3) |
Class A |
7,573(3) |
$1.01(3) |
7,573(3) |
|||||||||||||||||||||||||||||||
|
Option |
04/13/2012 |
A |
07/13/2012 |
04/13/2022 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$4.81(4) |
1,515(4) |
Class A |
1,515(4) |
$4.81(4) |
1,515(4) |
|||||||||||||||||||||||||||||||
|
Option |
12/07/2012 |
A |
03/07/2013 |
12/07/2022 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$3.3(5) |
6,982(5) |
Class A |
6,982(5) |
$3.3(5) |
6,982(5) |
|||||||||||||||||||||||||||||||
|
Option |
12/06/2013 |
A |
03/06/2014 |
12/06/2023 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$3.3(6) |
1,443(6) |
Class A |
1,443(6) |
$3.3(6) |
1,443(6) |
|||||||||||||||||||||||||||||||
|
Option |
12/07/2013 |
A |
03/07/2014 |
12/07/2023 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$3.61(7) |
6,869(7) |
Class A |
6,869(7) |
$3.61(7) |
6,869(7) |
|||||||||||||||||||||||||||||||
|
Option |
12/05/2014 |
A |
03/05/2015 |
12/05/2024 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$3.61(8) |
1,375(8) |
Class A |
1,375(8) |
$3.61(8) |
1,375(8) |
|||||||||||||||||||||||||||||||
|
Option |
12/07/2014 |
A |
03/07/2015 |
12/07/2024 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$5.07(9) |
6,541(9) |
Class A |
6,541(9) |
$5.07(9) |
6,541(9) |
|||||||||||||||||||||||||||||||
|
Option |
12/04/2015 |
A |
03/04/2016 |
12/04/2025 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
|||||||||||||||||||||||||||||||||||||
|
Director |
|||||||||||||||||||||||||||||||||||||
|
Stock |
$5.07(10) |
1,309(10) |
Class A |
1,309(10) |
$5.07(10) |
1,309(10) |
|||||||||||||||||||||||||||||||
|
Option |
12/07/2015 |
A |
03/07/2016 |
12/07/2025 |
Common |
D |
|||||||||||||||||||||||||||||||
|
(right to |
Stock |
||||||||||||||||||||||||||||||||||||
|
buy) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of |
2. |
3. Transaction |
3A. Deemed |
4. |
5. Number of |
6. Date Exercisable and |
7. Title and Amount |
8. Price of |
9. Number of |
10. |
11. Nature |
|||||||
|
Derivative |
Conversion |
Date |
Execution Date, |
Transaction |
Derivative |
Expiration Date |
of Securities |
Derivative |
derivative |
Ownership |
of Indirect |
|||||||
|
Security |
or Exercise |
(Month/Day/Year) |
if any |
Code (Instr. |
Securities |
(Month/Day/Year) |
Underlying |
Security |
Securities |
Form: |
Beneficial |
|||||||
|
(Instr. 3) |
Price of |
(Month/Day/Year) |
8) |
Acquired (A) |
Derivative Security |
(Instr. 5) |
Beneficially |
Direct (D) |
Ownership |
|||||||||
|
Derivative |
or Disposed |
(Instr. 3 and 4) |
Owned |
or Indirect |
(Instr. 4) |
|||||||||||||
|
Security |
of (D) (Instr. |
Following |
(I) (Instr. 4) |
|||||||||||||||
|
3, 4 and 5) |
Reported |
|||||||||||||||||
|
Transaction(s) |
||||||||||||||||||
|
Amount |
(Instr. 4) |
|||||||||||||||||
|
Date |
Expiration |
or |
||||||||||||||||
|
Code |
V |
(A) |
(D) |
Title |
Number |
|||||||||||||
|
Exercisable |
Date |
of Shares |
||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$5.59(11) |
6,230(11) |
Class A |
6,230(11) |
$5.59(11) |
6,230(11) |
||||||||||||
|
Option |
12/02/2016 |
A |
03/02/2017 |
12/02/2026 |
Common |
D |
||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$5.59(12) |
1,246(12) |
Class A |
1,246(12) |
$5.59(12) |
1,246(12) |
||||||||||||
|
Option |
12/07/2016 |
A |
03/07/2017 |
12/07/2026 |
Common |
D |
||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$4.22(13) |
1,187(13) |
Class A |
1,187(13) |
$4.22(13) |
1,187(13) |
||||||||||||
|
Option |
12/01/2017 |
A |
03/01/2018 |
12/01/2027 |
Common |
D |
||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$4.86(14) |
5,651(14) |
Class A |
5,651(14) |
$4.86(14) |
5,651(14) |
||||||||||||
|
Option |
11/30/2018 |
A |
02/28/2019 |
11/30/2028 |
Common |
D |
||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$4.86(15) |
1,131(15) |
Class A |
1,131(15) |
$4.86(15) |
1,131(15) |
||||||||||||
|
Option |
11/30/2018 |
A |
02/28/2019 |
11/30/2028 |
Common |
D |
||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$5.06(16) |
5,381(16) |
03/06/2020(16) |
Class A |
5,381(16) |
$5.06(16) |
5,381(16) |
|||||||||||
|
Option |
12/06/2019 |
A |
12/06/2029 |
Common |
D |
|||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$5.06(17) |
1,076(17) |
03/06/2020(17) |
Class A |
1,076(17) |
$5.06(17) |
1,076(17) |
|||||||||||
|
Option |
12/06/2019 |
A |
12/06/2029 |
Common |
D |
|||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$3.67(18) |
2,563(18) |
06/27/2020(18) |
Class A |
2,563(18) |
$3.67(18) |
2,563(18) |
|||||||||||
|
Option |
03/27/2020 |
A |
03/27/2030 |
Common |
D |
|||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
|
Director |
||||||||||||||||||
|
Stock |
$3.67(19) |
3,588(19) |
06/27/2020(19) |
Class A |
3,588(19) |
$3.67(19) |
3,588(19) |
|||||||||||
|
Option |
03/27/2020 |
A |
03/27/2030 |
Common |
D |
|||||||||||||
|
(right to |
Stock |
|||||||||||||||||
|
buy) |
||||||||||||||||||
Explanation of Responses:
- This option was granted on December 2, 2011 as an option for 5,000 shares of Class A Common Stock under the 2006 Director Stock Option Plan at an exercise price of $1.30 per share, but adjusted pursuant to the anti-dilution provisions of the 2006 Director Stock Option Plan to reflect 5% stock dividends paid on February 3, 2012, February 1, 2013, February 7, 2014, February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 7, 2011 as an option for 1,000 shares of Class A Common Stock under the 2006 Director Stock Option Plan at an exercise price of $1.24 per share, but adjusted pursuant to the anti-dilution provisions of the 2006 Director Stock Option Plan to reflect 5% stock dividends paid on February 3, 2012, February 1, 2013, February 7, 2014, February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on April 13, 2012 as an option for 5,000 shares of Class A Common Stock under the 2006 Director Stock Option Plan at an exercise price of $1.56 per share, but adjusted pursuant to the anti-dilution provisions of the 2006 Director Stock Option Plan to reflect 5% stock dividends paid on February 1, 2013, February 7, 2014, February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 7, 2012 as an option for 1,000 shares of Class A Common Stock under the 2006 Director Stock Option Plan at an exercise price of $7.42 per share, but adjusted pursuant to the anti-dilution provisions of the 2006 plan to reflect 5% stock dividends paid on February 1, 2013, February 7, 2014, February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 6, 2013 as an option for 4,842 shares of Class A Common Stock under the 2006 Director Stock Option Plan at an exercise price of $4.85 per share, but adjusted pursuant to the anti-dilution provisions of the 2006 Director Stock Option Plan to reflect 5% stock dividends paid on February 7, 2014, February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 7, 2013 as an option for 1,000 shares of Class A Common Stock under the 2006 Director Stock Option Plan at an exercise price of $4.85 per share, but adjusted pursuant to the anti-dilution provisions of the 2006 Director Stock Option Plan to reflect 5% stock dividends paid on February 7, 2014, February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 5, 2014 as an option for 5,000 shares of Class A Common Stock under the Amended and Restated 2014 Director Stock Option Plan (the "2014 Director Stock Option Plan") at an exercise price of $5.02 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 7, 2014 as an option for 1,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $4.85 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 6, 2015, February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 4, 2015 as an option for 5,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $6.72 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 7, 2015 as an option for 1,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $6.72 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 5, 2016, February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 2, 2016 as an option for 5,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $7.03 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 7, 2016 as an option for 1,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $7.36 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 1, 2017 as an option for 1,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $5.05 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 2, 2018, February 1, 2019, and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on November 30, 2018 as an option for 5,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $5.52 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 1, 2019 and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on November 30, 2018 as an option for 1,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $5.52 per share, but adjusted pursuant to the anti-dilution provisions of the 2014 Director Stock Option Plan to reflect 5% stock dividends paid on February 1, 2019 and February 7, 2020; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 6, 2019 as an option for 5,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $5.46 per share but adjusted pursuant to the anti-dilution provisions of the Director Stock Option Plan to reflect a 5% stock dividend paid on February 7, 2020. The option vests in four equal quarterly installments of Class A Common Stock, beginning on March
6, 2020, until such shares are fully vested; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on December 6, 2019 as an option for 1,000 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $5.46 per share but adjusted pursuant to the anti-dilution provisions of the Director Stock Option Plan to reflect a 5% stock dividend paid on February 7, 2020. The option vests in four equal quarterly installments of Class A Common Stock, beginning on March 6, 2020, until such shares are fully vested; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on March 27, 2020 as an option for 2,500 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $3.76 per share. The option vests in four equal quarterly installments of Class A Common Stock, beginning on June 27, 2020, until such shares are fully vested; and a 2.5% stock dividend paid on July 17, 2020.
- This option was granted on March 27, 2020 as an option for 3,500 shares of Class A Common Stock under the 2014 Director Stock Option Plan at an exercise price of $3.76 per share. The option vests in four equal quarterly installments of Class A Common Stock, beginning on June 27, 2020, until such shares are fully vested; and a 2.5% stock dividend paid on July 17, 2020.
|
/s/ H. Craig Moody |
01/26/2021 |
||
|
** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
-
Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.
This is an excerpt of the original content. To continue reading it, access the original document here.
Attachments
Disclaimer
SNFC - Security National Financial Corporation published this content on 27 January 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 27 January 2021 19:13:19 UTC
