Can the form be signed electronically?

Yes. Under the federal ESIGN Act (15 U.S.C. ch. 96) and state UETA statutes, electronic signatures are generally legally equivalent to handwritten ones, provided intent, consent, attribution, and retention requirements are met. Confirm any statutory exceptions for the specific transaction.

Do I need a notary or witnesses?

Not always. Many conversions require a notary acknowledgement or witness depending on document type and state law. Remote online notarization may be accepted where permitted; verify state requirements and whether audio-video recording or journal retention is mandated.

What supporting documents are needed?

Typical attachments include articles of conversion, amended certificates, board resolutions, prior registrations, and identification documents. Ensure attachments are legible and reference the conversion form's identifier. Missing or inconsistent attachments are a common reason for rejection or processing delays.

How does eSignature authentication work?

Authentication can be email link, SMS code, knowledge-based answers, or stronger methods such as multi-factor or certificate-based signatures. Choose the level required by the transaction and industry; record timestamps, IP addresses, and audit trails to support attribution and non-repudiation.

What if names or TINs don't match?

Mismatched legal names or taxpayer identification numbers can trigger backup withholding, rejection, or processing delays. Correct the form, provide supporting proof of identity or amended tax documents, and ensure the payer receives an updated W-9 or equivalent to avoid withholding penalties.

How do I correct or revoke a submitted form?

Submit a corrected form with a clear 'corrected' indicator and the effective date. If revocation is required, provide written notice signed by authorized parties and retain proof of delivery. For tax-related items, notify payers and the IRS per applicable reporting rules.

Electronic Signature
Templates
Miscellaneous
Conversion Information Form

Conversion Information Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

CONVERSION INFORMATION FORM

Parties and Contact Information

Converting Entity (Party A): Address:

Primary Contact Name:

Phone:

Email:

Receiving/Assisting Party (Party B): Address:

Primary Contact Name:

Phone:

Email:

Recitals

WHEREAS, Converting Entity represents that it intends to effect a conversion, restructuring, transfer of assets, or reclassification of business operations as described herein (the Conversion), and requires detailed information and mutual covenants governing the Conversion; and

WHEREAS, Receiving/Assisting Party has the technical, legal, or administrative capacity to assist with or implement aspects of the Conversion and the parties wish to memorialize responsibilities, payment terms, confidentiality obligations, and timelines in connection with the Conversion; and

WHEREAS, the parties intend this Conversion Information Form to govern the provision of services, information exchange, and actions required to effect the Conversion, subject to the terms and conditions set forth below.

Conversion Specific Details

Conversion Type: Statutory conversion Merger Asset transfer Other Describe other:

Proposed Effective Date: Conversion Method / Plan Reference ID:

Assets, Liabilities or Operations to be Converted or Transferred:

Approvals Required: Approvals Obtained: Yes If yes, Date of Approval:

Responsible Parties for Filings and Notices:

Scope of Work

Scope Description:

Services to be provided include, without limitation: preparation of conversion documentation, coordination of required corporate actions, completion of regulatory filings, transfer of specified assets and liabilities, confirmation of creditor or stakeholder notices where required, and reasonable post-conversion support as set forth in the Scope of Work above.

Payment Terms

Total Fee (if fixed): $ OR Hourly Rate: $

Payment Schedule / Milestones:

Deposit Required: $ Payment Due Days After Invoice:

Late Payment: Any undisputed amount not paid when due shall accrue interest at or the maximum rate permitted by applicable law, whichever is less. Costs of collection, including reasonable attorneys' fees, shall be payable by the delinquent party.

Term and Termination

Term Commencement Date: Anticipated Completion / End Date:

Either party may terminate this agreement for convenience upon written notice of days to the other party. Termination for material breach shall be effective upon written notice if the breaching party fails to cure the breach within days after receipt of notice specifying the breach.

Termination obligations: Upon termination, the parties shall promptly account for and settle all fees, expenses, and deliverables due for services performed through the effective date of termination and shall take commercially reasonable actions to minimize disruption of operations and preserve confidential information.

Confidentiality

Each party (Recipient) shall maintain in confidence all non-public information and materials disclosed by the other party (Discloser) that are marked confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure ("Confidential Information"). Recipient shall not use Confidential Information except to perform its obligations under this Conversion Information Form and shall not disclose Confidential Information to any third party except as permitted herein. Recipient may disclose Confidential Information to its employees, advisors, agents, or contractors who have a need to know and are bound by confidentiality obligations no less protective than those herein.

Exceptions: Confidential Information does not include information that (a) is or becomes generally available to the public other than by a breach of this obligation; (b) was rightfully in Recipient's possession prior to disclosure; (c) is received from a third party not under an obligation of confidentiality; or (d) is independently developed by Recipient without use of Discloser's Confidential Information. Recipient may disclose Confidential Information to the extent compelled by law, provided Recipient gives Discloser prompt notice and cooperates in any available protective measures.

Representations; Compliance

Each party represents and warrants that it has the full corporate power and authority to enter into and perform this Conversion Information Form and that the execution, delivery, and performance of this Conversion Information Form has been duly authorized by all necessary corporate or other action. Each party agrees to comply with all applicable laws, rules and regulations in performing its obligations hereunder.

Governing Law; Entire Agreement

Governing Law: This Conversion Information Form shall be governed by and construed in accordance with the laws of the State of without regard to principles of conflicts of law.

Entire Agreement: This document, together with any attachments and referenced exhibits executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written. Any amendment or modification must be in writing signed by authorized representatives of both parties.

Attachments and Deliverables

List of Attachments (plans, schedules, exhibits, lists of assets, creditor notices):

Certification: Each signatory below certifies that the information provided in this Conversion Information Form is true, accurate and complete to the best of their knowledge and that they are authorized to bind the party on whose behalf they sign.

Party A (Converting Entity) - Print Name:

By:

Date:

Party B (Receiving/Assisting Party) - Print Name:

By:

Date:

What the Conversion Information Form Is and When It’s Used

A Conversion Information Form is a standardized document used to record the facts and authorizations required when an asset, account, legal entity, or record is changed from one status to another. It captures identifying details, prior and new classifications, effective dates, and signatures from authorized parties. Organizations use this form for entity conversions, account migrations, beneficiary updates, and process transitions to create an auditable record. When completed electronically, the form should comply with U.S. legal frameworks such as ESIGN and UETA and meet any industry-specific authentication or retention requirements.

Why a Clear Conversion Information Form Matters

A clear Conversion Information Form creates an auditable record that reduces legal ambiguity, ensures correct tax and ownership treatment, and documents authorization. It supports compliance with ESIGN (15 U.S.C. ch. 96) and UETA where electronic execution is used.

Who Typically Completes and Reviews This Form

The Conversion Information Form is commonly completed by administrators, legal counsel, compliance officers, and account managers responsible for record changes.

Legal counsel who draft and approve conversion documents and certify corporate authority.
Compliance officers ensuring regulatory, tax, and retention rules are met for conversions.
Operations and account managers who update systems, records, and notify affected parties.

Coordination among legal, compliance, and operations reduces errors and speeds acceptance of conversion requests across internal and external registries.

Core Elements of a Professional Conversion Information Form

A professional Conversion Information Form is structured to capture identity, prior and new status, authorization details, supporting documents, and a clear audit trail for compliance and recordkeeping.

Identifiers

Include full legal names, registration numbers, taxpayer identification numbers, and account IDs. Consistent identifiers enable matching across registries and reduce the risk of misfiled conversions or incorrect tax reporting.

Conversion Details

Describe the type of conversion, former and new classifications, effective date, and any transitional provisions. Be specific about terms that affect rights, liabilities, or tax treatment to avoid interpretive disputes.

Authorization

Document who authorized the conversion, including board resolutions, shareholder approvals, or written consents. Identify titles, dates, and the scope of authority to support legal validity.

Supporting Documents

Attach articles of conversion, amended certificates, resolutions, transfer agreements, and identification. Verify document seals and signatures; missing exhibits commonly delay acceptance.

Signatures

Include signature blocks with printed name, title, date, and contact details. Note whether electronic signatures are used and record authentication method and audit trail.

Audit Trail

Maintain timestamps, IP addresses, signer authentication logs, and version history. A robust audit trail supports enforceability and simplifies regulatory reviews or future audits.

Step-by-Step: Complete and Submit the Form

Follow these sequential steps to complete and submit the Conversion Information Form, verify identities, attach evidence, and record the executed document for retention.

01

Prepare: Gather prior records, certificates, and supporting resolutions.
02

Complete Fields: Enter all required fields using MM/DD/YYYY dates.
03

Authorize: Obtain signatures from authorized officers or representatives.
04

File & Retain: Submit to registry and keep copies per retention rules.

Configure an Online Workflow for Accurate Processing

Configure the digital workflow to collect fields, attachments, identity checks, and signatures in the correct order before finalizing submission.

Field	Requirement \| Configuration
Identifiers	Required \| Exact match enforced
Dates	Required \| MM/DD/YYYY format
Attachments	Conditional \| PDFs preferred, 300 dpi
Authentication	Configurable \| Email, SMS, or MFA
Submission	Final step \| Lock and archive record

Where to Send the Completed Conversion Form

This section explains routing options for the completed form: internal registries, state agencies, and third-party payers or custodians.

Internal Filing: Save to corporate records and update systems.
State Filing: Submit to secretary of state or recorder.
Payer Notification: Send corrected forms to payers and vendors.
Third-Party Custody: Provide copies to banks or custodians.

Digital Submission and Platform Compatibility Considerations

For eSubmission, ensure platform supports required file formats, signer authentication, audit trails, and secure storage.

File Types: PDF, DOCX, XLSX supported
Integrations: Salesforce, NetSuite, Google Workspace, Microsoft 365
Security: TLS 1.2/1.3 in transit, AES-256 at rest

eSignature Pricing and Capability Comparison

Compare common vendor pricing and feature criteria for eSignature solutions; signNow is listed first per comparison conventions.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Essential Data Elements to Include on the Form

Full Legal Name: Exact name on ID or formation

Taxpayer ID: TIN or EIN as applicable

Effective Date: Enter date as MM/DD/YYYY format

Prior Status: Previous legal classification or name

Supporting Docs: Attach signed, dated, legible copies

Signature Method: Specify eSign or wet signature

Common Preparation Mistakes to Avoid

Incomplete identifiers lead to mismatches between registries and delayed processing; always include TINs, registration numbers, and consistent corporate names across documents.
Missing or illegible attachments are frequently cited reasons for rejection; scan at 300 dpi, include cover page references, and verify signatures are present.
Using inconsistent dates or not indicating effective dates creates ambiguity in tax and liability timing; specify MM/DD/YYYY and confirm transitional provisions.
Failing to confirm signer authority or failing to attach board resolutions invites legal challenges; document authority clearly and retain supporting minutes.

Primary Risks and Penalties from Incorrect Forms

Tax Penalties: Backup withholding 24% rate

Late Filing: 1099 late: $60 / $130 / $330

Incorrect TIN: Triggers 24% withholding

Notarization Failure: Possible rejection by recorder

Authority Challenge: Signatures may be invalidated

Data Breach Risk: Protect PHI under HIPAA

Key Deadlines and Processing Expectations

Key deadlines and expectations when completing conversion forms, including response times, reporting triggers, and agency filing dates.

Provide form upon payor request:

W-9 style information is supplied when requested to avoid backup withholding.

Notify payers and withholding agents promptly:

Update payer records immediately after conversion to prevent incorrect reporting.

Inform tax reporting parties of payee changes:

Incorrect payee data can trigger 1099 reissue or corrections.

Confirm notarization acceptance windows and recording rules:

Some registries require original notarized documents within specified timeframes.

Set internal SLAs for review and filing:

Common SLAs are 3–10 business days depending on complexity.

Practical Tips to Improve Accuracy and Speed

Adopt clear procedures, validate identity, and use standardized templates to reduce errors and speed processing for conversion events.

Centralize document templates and version control

Maintain a single master template for Conversion Information Forms in a secure repository. Control versioning and restrict editing to authorized personnel. This reduces inconsistent language, ensures required fields are present, and simplifies audit and compliance reviews.

Validate signer authority before submission

Confirm signers' authority through board minutes, power of attorney, or corporate resolutions before accepting signatures. Require verifier names and contact information and retain documentation to defend against future authority disputes or title challenges.

Use consistent identifier formats across systems

Standardize formats for names, TINs, registration numbers, and account IDs. Avoid abbreviations or inconsistent punctuation. Consistency prevents failed matches, duplicate records, and reporting errors to regulators or payers.

Record and retain a complete audit trail

Capture timestamps, IP addresses, authentication method, and document versions. Store signed PDFs and metadata in encrypted storage to support legal admissibility and streamline regulatory audits.

How Organizations Use Conversion Forms in Practice

Real-world examples show how organizations complete conversions and preserve audit evidence while using electronic workflows and secure signing.

Martin Properties

Martin Properties moved lease-to-purchase records online, consolidating prior and new ownership details and storing executed conversion forms alongside supporting exhibits for each transaction.

The team captured signatures and timestamps centrally.
This reduced manual filing errors, simplified title searches, and provided a single audit trail for each conversion event. Auditors could verify chain of custody without requesting paper files, shortening review time and reducing administrative overhead.

Fertility Centers of Illinois

Fertility Centers of Illinois standardized patient conversion documentation to track changes in patient status, consent, and billing details across multiple clinics and EMR systems.

Signatures were captured on mobile devices.
Standardized forms ensured consistent retention and simplified HIPAA-compliant access controls. The organization retained form versions and audit trails to support clinical governance and regulatory requests without relying on fragmented local paper records.

How the Conversion Information Form Differs from an Amendment Form

Key differences between a Conversion Information Form and a standard Amendment Form to help choose the correct document type.

Document	Conversion Form	Amendment Form
Purpose	change status or classification	modify specific contract terms
Attachments	articles, resolutions, certificates	redlined agreement, signature page
Signatures	authorized officers or counsel	contracting parties only
Filing	may require registry/sos filing	typically not filed with registry
Effect on Tax	may change tax classification	generally no tax classification change

Frequently Asked Questions and Troubleshooting

Answers to common questions about completing, signing, and preserving the Conversion Information Form, including eSignature, notarization, and state-specific concerns.

Need help? Contact support

Can the form be signed electronically?
Yes. Under the federal ESIGN Act (15 U.S.C. ch. 96) and state UETA statutes, electronic signatures are generally legally equivalent to handwritten ones, provided intent, consent, attribution, and retention requirements are met. Confirm any statutory exceptions for the specific transaction.
Do I need a notary or witnesses?
Not always. Many conversions require a notary acknowledgement or witness depending on document type and state law. Remote online notarization may be accepted where permitted; verify state requirements and whether audio-video recording or journal retention is mandated.
What supporting documents are needed?
Typical attachments include articles of conversion, amended certificates, board resolutions, prior registrations, and identification documents. Ensure attachments are legible and reference the conversion form's identifier. Missing or inconsistent attachments are a common reason for rejection or processing delays.
How does eSignature authentication work?
Authentication can be email link, SMS code, knowledge-based answers, or stronger methods such as multi-factor or certificate-based signatures. Choose the level required by the transaction and industry; record timestamps, IP addresses, and audit trails to support attribution and non-repudiation.
What if names or TINs don't match?
Mismatched legal names or taxpayer identification numbers can trigger backup withholding, rejection, or processing delays. Correct the form, provide supporting proof of identity or amended tax documents, and ensure the payer receives an updated W-9 or equivalent to avoid withholding penalties.
How do I correct or revoke a submitted form?
Submit a corrected form with a clear 'corrected' indicator and the effective date. If revocation is required, provide written notice signed by authorized parties and retain proof of delivery. For tax-related items, notify payers and the IRS per applicable reporting rules.

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