Attestation of Ownership Form - Myrexis Inc 2026

1. Click ‘Get Form’ to open the Attestation of Ownership Form in our platform's editor.
2. Begin by entering your name in the designated field, certifying your ownership of Myrexis, Inc. shares.
3. Fill in the number of shares you owned as of each specified date: December 31, March 31, June 30, and September. Ensure accuracy for compliance.
4. Provide details about the registered or beneficial owner in the next section, including any corporate or institutional relationships if applicable.
5. If your shares are held in street name, indicate the brokerage institution where they are kept.
6. Complete your full address and contact information, including phone number and email address for report delivery.
7. Finally, sign and date the form to attest to the accuracy of your responses before submitting it via fax as instructed.

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