1. The company and other persons or employers are released from all liability brought forth by any investigation
resulting from my submission of this electronic application and the data contained here in.
2. The information in this application is true and complete to the best of my knowledge. Any falsification,
misrepresentation, or omission on this application can be cause for denial or termination of being registered as
a shareholder descendant.
3. In order to complete this descendant registration, I will need to mail or fax in a Certificate of Indian Blood (CIB) and
a Birth Certificate for each applicant.
4. I have read and reviewed the information provided in this application and the above statements. By signing
this application for registration of a shareholder descendant I certify that I understand all parts of it and have
answered all questions completely and fully.
5. I understand that my Social Security Number (SSN) and my descendants SSN number will not be submitted
electronically through this application for safety and identity theft prevention measures. Please do not email this
information to our office.
6. I understand that by typing my name in the signature box below and submitting this application electronically,
this becomes a legal and binding contract of registration.