A form of Section 16 Questionnaire to be used to collect and verify information relating to the ownership of a public company's securities by its directors and officers. This questionnaire can be used in the preparation of an initial Form 3 filing, to determine the necessity of filing a Form 5, or in preparation of the company's Form 10-Q, Form 10-K, annual report to stockholders and proxy statement. This Standard Document has integrated notes with important explanations and drafting tips.