Address Verification Proof

ADDRESS VERIFICATION PROOF

Parties

Individual Corporation LLC Partnership Other

WHEREAS

WHEREAS, Client engages Verifier to perform address verification services with respect to the individual or entity identified below (the "Subject"), and Verifier has represented that it possesses the necessary expertise, authority and processes to perform such services in accordance with applicable standards and the terms of this document.

WHEREAS, Verifier will collect, examine and retain evidence reasonably necessary to substantiate the Subject's claimed address and will provide a signed certification of the outcome to Client; Verifier's certification will describe the verification method(s), documents relied upon, and the date(s) the verification activity occurred.

WHEREAS, the parties desire to set forth their respective duties, payment terms and other material terms governing the provision of the address verification services, and to record the results of verification as an enforceable certification by Verifier.

Verification Details

Subject Date of Birth:

Period of Residence (if applicable): From to

Utility bill in subject's name
Government-issued ID showing address
Lease or rental agreement
Bank statement
Mail returned / return receipt
Other (describe below)

In-person inspection
Electronic database / records search
Mail verification / return receipt
Third-party verification service

Scope of Work

Verifier shall perform the verification activities specifically described below. Verifier will exercise reasonable care and industry-standard procedures in collecting and documenting evidence, and will maintain records sufficient to support the certification made to Client.

Payment Terms

Client shall pay Verifier the fees set forth below in exchange for the verification services. All fees are exclusive of applicable taxes unless otherwise stated. Verifier shall invoice Client in accordance with the schedule below, and Client shall pay undisputed invoices in cleared funds within the agreed payment window.

Term and Termination

This Agreement commences on the Start Date below and continues until the completion of the services or the End Date below, unless earlier terminated as provided herein. Either party may terminate for material breach if such breach is not cured within the notice period specified below.

Start Date:    End Date:

Confidentiality

Each party shall maintain in confidence all non-public information disclosed by the other party that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information. Verifier may disclose confidential information to its employees, subcontractors or agents on a need-to-know basis provided such persons are bound by confidentiality obligations no less protective than those herein. Confidential information does not include information that is or becomes publicly available through no fault of the receiving party, is lawfully obtained from a third party without restriction, or is independently developed by the receiving party without use of the disclosing party's confidential information.

Governing Law; Remedies

This Agreement shall be governed by and construed in accordance with the laws of the state identified below without regard to conflict-of-law principles. The parties agree that monetary damages may be inadequate to remedy certain breaches of confidentiality and that equitable relief may be awarded in addition to other remedies at law.

Entire Agreement

This document, including any attachments or schedules 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, representations, and understandings, whether written or oral. No amendment or waiver shall be effective unless in writing and signed by an authorized representative of each party.

Certification by Verifier

The undersigned Verifier certifies, under penalty of liability for willful misrepresentation and to the best of Verifier's knowledge after reasonable inquiry, that the information and evidence referenced herein were reviewed and that the verification described above was conducted in accordance with the Scope of Work. Verifier further certifies the date(s) of verification activity and that all retained documents described above are true copies of those reviewed.

Certification Date:

Acknowledgement and Signatures

The parties below represent and warrant that they are duly authorized to execute this Address Verification Proof and that the statements and certifications set forth herein are accurate and complete to the best of their knowledge.

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