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Pricing employee stock options with the click of a mouse

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Service Request Form

Please print and FAX only: 1(212) 500-0552 (Global)

(This form is used for requesting computing services only.  To purchase the software, click Order Form)

Customer Information:

Name:

Title:

Company:
Address:
City: State/Province:
Country: Zip/Postal Code:
Telephone: Facsimile:
Email(required):

Billing Information:

Name:
Address:
City: State/Province:
Country: Zip/Postal Code:
Home Telephone: Facsimile:
Email(required):

I want you to compute fair value, allocate expense, calculate diluted EPS and prepare disclosure report

Q'ty

Price

Amount
Annual set-up fee

$349.95

Diluted EPS calculations / disclosure information preparation (FAS123 and FAS148)

$249.95

Free to computing for the first 5 grant items

5

$0

Total number of grant items to be valued/expensed in addition to the first 5 grant items

$29.95

Shipping & Handling (Delivered On-Line only)  

$0

Total

I want you to compute values only

Q'ty

Price

Amount
Annual set-up fee

$349.95

Free for computing the first 5 grant items

5

$0

Total number of grant items to be valued/expensed in addition to the above 5 grant items

$29.95

Shipping & Handling (Delivered On-Line only)  

$0

 

Total

Payment Information:
Credit Card (check one): AMEX    Discover    MasterCard   Visa
Cardholder's Name:
Card Number:
CSC:
Expiration Date (mm/yy):

Please provide the following information:

Part I: Answer the following questions(Please only answer Item 1, 5, 6, 7 and 12 for non-public companies):
 

Your choice:

1. Which Option Pricing Model do you prefer to use?       
    (A). Binomial Option Pricing Model (Default)
    (B). Black-Scholes Option Pricing Model
    (C). Both

2. Select the stock price standard       
    (A). Closing (Default)
    (B). Opening
    (C). Highest
    (D). Lowest

3. Select a time-interval to calculate the volatility of your stock   
    (A). Monthly (Default)
    (B). Weekly
    (C). Daily

4. If "Daily" in Question 2, select days-in-a-year to calculate volatility?
    (A). Actual 252 Trading Days(Default)
    (B). Fixed 360 Days
    (C). Fixed 365 Days

5. Do you want us to allocate expenses monthly over the Vesting Period of Option?
    (A). Yes
    (B). No

6. What method of accounting for forfeitures is selected?
    (A). Actual
    (B). Estimated

7. What is your fiscal year ending date (mm/dd/yy)?

8. If an option provides tax benefits, what is the effective tax rate for the fiscal year?

9. Has you company adopted FAS123?
    (A). Yes. When (mm/dd/yy)?
    (B). No

10. What accounting/transition method elected in your company (FAS 148)?       
    (A). Continued APB 25 (only if FAS 123 has NOT been adopted)
    (B). Prospective Method
    (C). Modified Prospective Method
    (D). Retroactive Restatement Method.  Restating from when?

11. Your stock symbol:

12. Your industry(or SIC Code) - for volatility calculation using a proper industry index:

Part II: Please fill in the following data table or create it on an Excel spreadsheet(click for a Complete Data Table on Spreadsheet ):

Item No.
Grantee's Name or ID Date of Grant (mm/dd/yy)

Shares Granted

Vesting Date (mm/dd/yy)

Expiration Date (mm/dd/yy) Exercise (strike) Price Stock Price* (optional)

Expected Life of Options  (fill-in # of Years, e.g. 5.4321)

Annual Risk Free Rate(%) (optional) Annual Expected Dividend Yield Rate(%) Volatility (optional)**
1
2
3
4
5
6
7
8
9
10
*.  Stock price information is optional unless it is NOT publicly traded.           
**. Historical volatility will be calculated/used unless you want to use your own estimated volatility.

If you request us to compute diluted EPS and prepare disclosure, please provide full activities of cancellation/forfeiture and exercise for all periods.

Please print and FAX only: 1(212) 500-0552 (Global)


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Terms are subject to change without prior written notices.  Contact us via Email: service@option123.com

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