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Annual Statement for Directors and Officers and Members of a Committee with Board-Delegated Powers

Name:

Position:

Email:

Are you a voting Director?

Are you an Officer?

If you are an Officer, which position do you hold:

I affirm the following:

Disclosures:

Do you have a financial interest (current or potential), including a compensation arrangement, as defined in the Conflict-of-Interest policy with C.A.T.S.?
- If yes, please describe it:
- If yes, has the financial interest been disclosed, as provided in the Conflict-of-Interest policy?
In the past, have you had a financial interest, including a compensation arrangement, as defined in the Conflict-of-Interest policy with C.A.T.S.?
- If yes, please describe it, including when (approximately):
- If yes, has the financial interest been disclosed, as provided in the Conflict-of-Interest policy?
Are you an independent director as defined in the Conflict-of-Interest policy?
- If you are not independent, why?

Date:

Title:

Print Name:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

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August 6, 2024 2:41 am EDT

Annual Statement for Directors and Officers and Members of a Committee with Board-Delegated Powers Uploaded by CATS Administration - info@atdevicesforkids.org IP 98.166.151.97

August 6, 2024 2:50 am EDT

Timp Hecht - timp@atdevicesforkids.org added by CATS Administration - info@atdevicesforkids.org as a CC'd Recipient Ip: 98.166.151.97