Stella Ops Compliance Self-Attestation Form

Form Version: 1.0.0 Attestation Period: [YEAR]


Instructions

  1. Complete all sections marked with [ ] or ___
  2. Replace placeholder text [...] with your information
  3. Have an authorized representative sign
  4. Submit to: compliance@stella-ops.org
  5. Retain a copy for your records

Section 1: Operator Information

FieldValue
Organization Legal Name[Full legal name of organization]
Primary Contact Name[Name of compliance contact]
Primary Contact Email[Email address]
Primary Contact Phone[Phone number - optional]
Mailing Address[Business address]
Installation ID[From /admin/compliance dashboard, or “Not Available”]
Attestation Date[YYYY-MM-DD]

Section 2: Usage Declaration

2.1 Environment Count

Current number of active Environments in this installation:

If more than 3 Environments, commercial license reference: _______________

2.2 Scan Volume

Peak daily scan volume (new hash scans) in the past 12 months:

If over 999 scans/day, commercial license reference: _______________

2.3 Usage Metrics Source

How were the above metrics determined?


Section 3: Distribution Declaration

3.1 Redistribution Status

3.2 Stella Ops Redistribution (if applicable)

Distribution channels: _______________

3.3 Plugin Redistribution (if applicable)

Plugin name(s): _______________


Section 4: SaaS / MSP Declaration

4.1 Deployment Model

Select ONE:

4.2 MSP Details (if applicable)

Number of customer instances hosted: _______________

License coverage:

Instance isolation:


Section 5: Certification

I certify that:

  1. [ ] The information in this attestation is accurate and complete to the best of my knowledge

  2. [ ] Our organization’s use of Stella Ops complies with the Business Source License 1.1 and the Community Plugin Grant Addendum

  3. [ ] I am authorized to make this attestation on behalf of the organization named above

  4. [ ] I understand that knowingly providing false information may result in termination of license rights

  5. [ ] I will notify stella-ops.org within 30 days of any material changes to the information provided


Section 6: Signature

FieldValue
Printed Name___________________________
Title/Role___________________________
Signature___________________________
Date___________________________

Section 7: Internal Use Only (stella-ops.org)

FieldValue
Received Date
Reviewed By
Review Date
Status[ ] Accepted [ ] Clarification Needed [ ] Referred to Sales
Confirmation Sent
Notes

Submission

Email completed form to: compliance@stella-ops.org

Subject line: Compliance Attestation - [Organization Name] - [Year]

Attachments (optional but recommended):


Form version 1.0.0 | Effective 2026-01-25 Questions? Contact legal@stella-ops.org