Forms and Instructions

Click on and download the applicable form below:

Business Survey Authorization Form 68-A

Here are instructions on how to complete Form 68-A and, provided your business qualifies for the survey service, how to initiate a survey of your business.

Here are steps you and I must take to initiate a business survey for your business:

1. You: Print and complete the Business Survey Authorization Form 68-A:

• Write the name, address and contact information for your business at the top of the form.


• Write the date, on a Monday or a Thursday, and time you want to meet with the Executive Analyst, where it says "to make a preliminary study of our company beginning_______________".


• Sign the form, on the line above "Authorized By", and complete the business details section below it including the number of W-2 employees full and part time and the approximate gross dollar sales in the past 12 months.

2. You: Fax the completed form to my (Mark Bruemmer's) attention at 270-738-4587. Or you could scan the completed form and email it to me at GMAYUSASE@gmail.com as an attachment.

3. Me: I'll review the form and contact you if I have any questions. I'll contact GSMIC Corporate Office and provide them the information you've given me.

4. GSMIC: A Representative in Survey Service contacts you to confirm details of your business and the date, time and place you agree to meet with the Executive Analyst.

5. You: Prepare for the business survey by writing down any business problems and goals you have for your company.  The more information the Executive Analyst has regarding your business challenges and your plans for the future, the greater the value and benefit you'll receive in return.

Version 1.02 Updated 05/14/10