Questionnaire for Standard & Poor's Register of Corporations, Directors and Executives

Please copy this page to a word-processing program or text editor, answer the questions and send the completed form to:

Standard & Poor's Register of Corporations, Directors and Executives
P.O. Box 1628
Charlottesville VA 22902-1628
U.S.A.
Telephone (434) 977-1450
Fax (434) 979-3514 or (434) 977-8172

The symbol [] is a box that you can check if appropriate. On a computer, add an X between the square brackets to check the box, like this: [X]

Questions:

Company Name: ___
Street Address: ___
City, State, Zip Code, Country: ___
Year Business Started: ___
Telephone Number: ___
Fax: ___
Toll Free: ___
Web Site: ___
E-mail: ___
The firm is a subsidiary []
or division []
Name of Parent Company:

Company is in following industries:
Mining and Oil []
Construction []
Manufacturing []
Wholesale []
Retail []
Services []
Import []
Export []
Agriculture, Forestry and Fisheries []
Transportation, Communications, Electricity, Gas, Sanitary Services []
Banks, Finance, Insurance & Real Estate []
Other: ________________

Company products or services are sold in:
New England []
Middle Atlantic []
East North Central []
West North Central []
South Atlantic []
East South Central []
West South Central []
Mountain []
Pacific []

National (U.S.) []
International []

Company is Publicly []
or Privately [] owned.
If Public, what exchange is stock traded on: ___
Ticker symbol: ___

Sales _______
for year ending [date]
Number of employees ____
Accounting firm: (name, city, state) ______
Primary bank (name, city, state) ____
Law firm (name, city, state) ____
Standard Industrial Classification (SIC) Codes:
Primary:
Secondary:

Business Description: ___

Executives (give title and name)

Chairman:
President:
Executive VP:
VP:
VP:
VP:
Treasurer:
Secretary:
Comptroller:
Please provide the names and titles of any other executives who should be listed.

Board of Directors (please list all members of the board)


Form completed by (name, title, telephone): _______

Notes:


Whenever your company appoints a new senior executive or member of the board of directors, please send a copy of the announcement to the address shown above.

Similarly, if a senior executive or member of the board of directors should die, please send a note to Standard & Poor's Register of Corporations, Directors and Executives so that the listing for that person can be deleted.