Uploaded by PJ Tremblay

Contractor Ownership and Control

advertisement
Contractor Ownership and Control
Use this as a guide to provide additional information if 1a or 1b on the SF 328 are "yes."
Part 1. Identify each type and amount of stock, shares, capital units, or other representations of
ownership for your immediate organization. For organizations which issue multiple representations of
ownership, please ensure all are identified. If additional space is necessary, attach a separate sheet.
Interest Name
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Interest Name
Total Issued
Interest Type
Percentage
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Interest Name
Total Issued
Interest Type
Percentage
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Interest Name
Total Issued
Interest Type
Percentage
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Total Issued
Percentage
Part 1. (Continued) Identify each type and amount of stock, shares, capital units, or other
representations of ownership for your immediate organization. For organizations which issue multiple
representations of ownership, please ensure all are identified. If additional space is necessary, attach
a separate sheet.
Interest Name
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Interest Name
Total Issued
Interest Type
Percentage
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Interest Name
Total Issued
Interest Type
Percentage
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Interest Name
Total Issued
Interest Type
Percentage
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Total Authorized
Total Issued
Percentage
Part 1: Additional Information.
Part 2. Foreign Ownership in the Cleared or In-Process Entity You Represent. Identify all foreign
persons/entities with 5% or greater of ANY class ANYWHERE within ownership/controlling interest(s)
of the cleared or in-process entity you represent.
Name
Address
Citizenship
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Amount
Held
Total
Diluted
Amount
Held
Total
Diluted
Amount
Held
Total
Diluted
Yes
Name
Address
Citizenship
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Name
Address
Citizenship
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Part 2 (Continued). Foreign Ownership in the Cleared or In-Process Entity You Represent.
Identify all foreign persons/entities with 5% or greater of ANY class ANYWHERE within ownership/
controlling interest(s) of the cleared or in-process entity you represent.
Name
Address
Citizenship
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Amount
Held
Total
Diluted
Amount
Held
Total
Diluted
Amount
Held
Total
Diluted
Yes
Name
Address
Citizenship
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Name
Address
Citizenship
Interest Type
Voting?
Non-Voting
Stock
Convertible?
Yes
N/A
No
No
Yes
Part 2 (Continued). Foreign Ownership in the Cleared or In-Process Entity You Represent.
Identify all foreign persons/entities with 5% or greater of ANY class ANYWHERE within ownership/
controlling interest(s) of the cleared or in-process entity you represent.
Complete summary table for data contained in Part 2
Total Voting
Total Authorized
Total Voting
Total
Passive
Total
Combined
Part 2: Additional Information
%
Total Issued
%
Part 3. Foreign Ownership in Facility Organization Structure.
Are there any entities in your ownership chain that are owned five percent
(5%) or greater, directly/indirectly, by a foreign person?
Yes
No
If "Yes" to Part 3, complete Part 3a. If "No" to Part 3, do not complete Part 3a.
Part 3a. Fully identify the entity in the ownership chain where foreign ownership of five percent (5%)
or greater is evident.
Entity Name
CAGE Code (If
Applicable)
Address
Person / Entity
Name
Citizenship
Address
Interest Name
Interest
Type
Total Authorized
Total
Issued (to
All)
Total Issued (to
this Person or
Entity)
Total
%
Diluted
Voting?
Yes
No
Notes
Person / Entity
Name
Citizenship
Address
Interest Name
Interest
Type
Total Authorized
Total
Issued (to
All)
Total Issued (to
this Person or
Entity)
Total
%
Diluted
Voting?
Yes
No
Notes
Person / Entity
Name
Citizenship
Address
Interest Name
Interest
Type
Total Authorized
Total
Issued (to
All)
Total Issued (to
this Person or
Entity)
Total
%
Diluted
Voting?
Yes
No
Notes
Part 3: Additional Information
Download