Confidentiality and Verification Notice

Company Performance Information

Cougar 100 applicants will be ranked by percentage of compound annual growth in sales or revenues (net of returns) for the period from 2013 to 2015.

Please enter the company's sales or revenues (net of returns) in U.S. dollars for each of the following years:

2013 ______2014 ______2015______

To verify sales or revenues (net of returns), copies of either (1) audited, reviewed or compiled financial statements or (2) copies of page 1 of the company’s tax return, or letter from external accountant attesting to financial data submitted be enclosed with THIS DOCUMENT.

Confidentiality and Verification Notice

If your company is named to the Cougar 100, the following information will be published in the Houston Business Journal and in other articles and media releases: Cougar 100 ranking, company name, year founded, city, state, product/service, and name(s)/class year(s) of Cougar 1eader(s).

For Cougar 100 companies, all other information will be kept confidential. For applicants not selected as a Cougar 100 company, all information submitted will be kept confidential. Applications and supporting information will not be returned to the applicant.

The University of Houston Alumni Association reserves the right to verify that nominees meet the criteria and reserves the right, in its sole discretion, to reject any nominee for any reason. UHAA has retained the services of PKF Texas, P.C. and may retain the services of other organizations to assist with the management and operation of the Cougar 100 program.

Sign this printed application and send with supporting documentation to PKF Texas. See below for further instructions.

I attest that the information reported above and supplied in the supporting information is true and correct and that I understand the Confidentiality and Verification notice:

NAME: ______TITLE:______

COMPANY NAME:______

SUBMITTED BY: ______Date: ______

SEND COMPLETED PERFORMANCE DOCUMENT AND SUPPORTING FINANCIAL INFORMATION TO:

By Mail: Cougar 100 Committee

C/O PKF Texas, P.C.

5847 San Felipe, Suite 2600

Houston, Texas 77057

Or By Fax to: (832)-325-6428

Or by email to:

For more information email

Or call (713) 743-9558

REMEMBER TO INCLUDE:

This form and 2013, 2014, and 2015 financial statements, tax return information or letter from external accountant attesting to financial data submitted to support revenue/sales figures.