I authorize OTC PR WIRE, LLC and OTC PR WIRE Press Partners that may include
GlobeNewsWire, NewsFile and or Accesswire to issue a company wire press release on our
behalf and using our public ticker symbol. I have authority to legally bind the company and to provide this authorization*. This form may be digitally signed via Adobe Sign or signed by hand & emailed to email@example.com *
Authorization form MUST be signed by a C-level of below public company and MUST include a valid company email, title and contact details from the company domain prior to OTC PR WIRE providing Wire Press Releases. NO Yahoo, Hotmail, Gmail or personal email will be accepted; nor will ADMIN@ IR@, INFO@ or PR@ via company email.
I further authorize the individuals listed below to request and approve content on behalf of the above public company:
* Permission hereby continually authorizes OTC PR WIRE, LLC & Wire Press Partners to utilize company’s ticker symbol and disseminate press releases once approved by company until permission granted from this form as of its efective date is removed via written correspondence via email firstname.lastname@example.org
I hereby affirm that I am the owner of the below referenced credit card and that my name is listed on the front of the credit card.
hereby authorize OTC PR WIRE, LLC to charge my credit card (listed below) for services ordered by an authorized representative of
I/We hereby declare that the particulars given herein above are true, correct and complete to the best of my/our knowledge and belief, the documents submitted in support of this Form KYC are genuine and obtained legally from the respective issuing authority. In case of any change in any of the aforementioned particulars, I/we undertake to notify you immediately in writing failing which the above particulars may be relied. I/we hereby authorize you to submit the above particulars to the customs and other regulatory authorities on my/our behalf as may be required.
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