# Voluntary benefit adoption pledge
Benefit Atlas · version 1 · October 11, 2026

Company legal name: ___________________________
Incorporation jurisdiction / entity form: ___________________________
Target board-review date: ___________________________

On behalf of the company identified above, I support pursuing statutory benefit status through lawful corporate governance. By the target date, we intend to present a documented feasibility and approval plan to the appropriate governing body, addressing the incorporation jurisdiction, entity form, public-benefit purpose, board duties, reporting, owner votes, class and contractual rights, and applicable regulation. If the required corporate approvals are obtained, we intend to seek an effective filing and establish a benefit-reporting process. We intend to communicate the board’s decision and any resulting legal status accurately.

This is a voluntary, nonbinding statement of intent. It does not bind the board or shareholders, amend a charter, provide their votes, constitute a state filing, certify benefit status, waive any law, or create a paid membership obligation. A company may decline or withdraw this proposed path. No public endorsement or listing is authorized by this private form.

Representative full name: ___________________________
Role / title: ___________________________
Signature: ___________________________ Date: ___________

By signing, the representative states that they are authorized to make this nonbinding statement on behalf of the named entity. Authority is self-attested until independently checked. This form does not authenticate the signer or obtain corporate approval.

Delivery: Private signer copy. No central receipt or public listing occurs through this form. Retain a copy and obtain appropriate governance/legal review.