Annual Business Report

ANNUAL BUSINESS REPORT & BUSINESS AGREEMENT

Company Name:   Entity Type: Corporation LLC Partnership Sole Proprietorship

State of Formation:   Tax ID / EIN:

Report Year:   Report Date:

WHEREAS

WHEREAS, the Company identified above is duly formed and in good standing under the laws of the State of Formation and is required to file an annual report documenting corporate status, principal offices, officers, and material business changes for the Report Year; and

WHEREAS, the Company desires to provide an accurate summary of its operations, financial position, and governance for internal recordkeeping and for submission to applicable regulatory or contractual counterparts; and

WHEREAS, the Preparer or Authorized Representative identified in this report shall prepare and certify the statements herein and, by signature, enter into the Business Agreement provisions set forth below regarding preparation, review, and any associated services.

BUSINESS INFORMATION

Registered Agent:   Phone:

OFFICERS, DIRECTORS, AND KEY PERSONNEL

Full-time:   Part-time:

FINANCIAL SUMMARY

Gross Receipts / Revenue: $   Net Income (Loss): $

Total Assets: $   Total Liabilities: $

SCOPE OF WORK (PREPARATION AND SERVICES)

The Preparer shall, subject to the terms of this Agreement, prepare, review, and deliver the Annual Business Report and any associated schedules, certifications, and attachments required by the Company. The Preparer's duties shall include collection and verification of information supplied by the Company, preparation of report documents, and delivery of final report in a format agreed by the parties.

PAYMENT TERMS

Fee for Services: $ . Payment is due according to the schedule below.

Late Fee: on any undisputed past-due amount. Company agrees to reimburse Preparer for reasonable collection costs.

TERM AND TERMINATION

Term Commencement Date: . Term Expiration Date: .

Either party may terminate this Agreement for convenience upon days' prior written notice to the other party. Termination for cause may occur where a material breach remains uncured for days after written notice.

CONFIDENTIALITY

The parties acknowledge that in the performance of services and preparation of the Annual Business Report, each party may disclose Confidential Information. "Confidential Information" means nonpublic business, financial, operational, or personnel information disclosed in oral, written, or electronic form that is identified as confidential or that reasonably should be understood to be confidential. Each party shall (a) use Confidential Information only for the purposes of performing obligations under this Agreement, (b) restrict disclosure to those employees, agents, or contractors who have a need to know and are bound by confidentiality obligations at least as protective as those herein, and (c) employ reasonable safeguards to protect Confidential Information from unauthorized disclosure. Confidential Information does not include information that (i) is or becomes publicly known through no breach by the receiving party, (ii) is rightfully received from a third party without restriction, or (iii) is independently developed without use of the disclosing party's Confidential Information.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement and the Annual Business Report shall be governed by and construed in accordance with the laws of the State of Formation without regard to conflict of laws principles. Any dispute arising under this Agreement shall be subject to the exclusive jurisdiction of the courts located in the State of Formation unless the parties mutually agree otherwise in writing.

This document, including all schedules and attachments expressly incorporated by reference, constitutes the entire agreement between the parties concerning the subject matter hereof and supersedes all prior and contemporaneous negotiations, understandings, and agreements, whether written or oral. No amendment or modification will be effective unless made in writing and signed by authorized representatives of both parties.

CERTIFICATION

I certify, under penalty of perjury, that I am an authorized officer or agent of the Company named above; that I have reviewed this Annual Business Report and any accompanying schedules; and that to the best of my knowledge and belief the information contained herein is true, correct, and complete as of the date signed below.

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