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Business Agent Statement

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BUSINESS AGENT STATEMENT

WHEREAS

WHEREAS, Business Name: (the "Principal") is engaged in certain commercial activities and desires to engage an agent to perform limited services on its behalf; and

WHEREAS, Agent Name: (the "Agent") has represented that it has the experience, personnel and capacity to perform the services described in this Statement; and

WHEREAS, the parties desire to set forth the Agent's authority, the scope of the engagement, payment terms, confidentiality obligations and other material terms in this Business Agent Statement, effective as of Month: Day: Year: .

PARTIES AND CONTACT INFORMATION

Corporation    LLC    Partnership    Sole Proprietor    Other:

SCOPE OF WORK

The Agent is authorized to perform the following services on behalf of the Principal as limited agent. The Agent shall perform such services in accordance with the Standard of Care set forth herein and in all applicable laws.

Specific powers granted to the Agent include (select all that apply and describe limitations where applicable):

Negotiate contracts and terms    Execute agreements on behalf of the Principal (subject to limits)    Collect payments and remit to Principal    Market and solicit customers    Other:

PAYMENT TERMS

As compensation for services rendered under this Statement, the Principal shall pay the Agent as follows:

Late fee: — applied to overdue balances after days from invoice date.

TERM AND TERMINATION

This Statement shall commence on Start Date: Month Day Year and shall continue until End Date: Month Day Year unless earlier terminated in accordance with this Section.

Either party may terminate this Statement without cause upon written notice to the other party delivered not fewer than days prior to the effective date of termination. Termination for cause may be immediate upon written notice if the other party materially breaches any obligation and fails to cure within 15 days after receipt of written notice of the breach.

CONFIDENTIALITY

The Agent shall keep confidential all non-public information disclosed by the Principal or obtained by the Agent in the course of performance (collectively, "Confidential Information"). Confidential Information does not include information which is (i) already known to the recipient at the time of disclosure; (ii) or becomes publicly known through no fault of the recipient; (iii) lawfully obtained from a third party without restriction; or (iv) independently developed without reference to the Principal's Confidential Information.

The Agent shall use Confidential Information solely for the purposes of performing services under this Statement and shall not disclose such information to any third party except to the extent reasonably necessary to perform the services and subject to similar confidentiality obligations. The obligations in this Section shall survive termination of this Statement for a period of three (3) years.

Acknowledged and agree to confidentiality: .

REPRESENTATIONS, WARRANTIES AND INDEMNITY

Each party represents and warrants that it has full power and authority to enter into this Statement and to perform its obligations hereunder. The Agent represents that it will act in good faith and exercise reasonable care in performing services. The Agent shall indemnify, defend and hold harmless the Principal from and against any losses, liabilities, claims, damages and expenses arising out of the Agent's gross negligence, willful misconduct or material breach of this Statement.

GOVERNING LAW

This Statement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflict of laws principles.

ENTIRE AGREEMENT

This Statement, together with any exhibits or schedules expressly incorporated by reference, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written. No amendment or modification shall be effective unless in writing and signed by authorized representatives of both parties.

MISCELLANEOUS

Neither party may assign or delegate its rights or obligations under this Statement without the prior written consent of the other party, except that the Principal may assign to an affiliate or in connection with a sale of substantially all of its assets. If any provision of this Statement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Notices required or permitted hereunder shall be in writing and delivered to the contact information set forth above or such other address as a party may designate by written notice.

Business (Principal) - Printed Name:

By:

Date:

Agent - Printed Name:

By:

Date:

Enter text✕

What the Business Agent Statement Is and when it’s used

A Business Agent Statement is a signed declaration by an authorized representative confirming that the named individual or agent is empowered to act on behalf of a business entity for specific transactions. Common uses include vendor onboarding, banking authorizations, licensing filings, and third-party contract execution. The statement identifies the principal business, the agent, the scope and duration of authority, and any limitations. Electronic versions are increasingly accepted when they meet the legal requirements for intent, consent, attribution, and record retention under U.S. e‑signature law.

Why organizations rely on a Business Agent Statement

A clear agent statement prevents disputes over authority, speeds third-party approvals, and documents delegated powers for auditors and regulators. When properly executed it supports compliance and reduces onboarding delays while providing an auditable record of who may bind the business.

Why organizations rely on a Business Agent Statement

Which roles commonly complete or request this statement

Typical requesters and completers of Business Agent Statements vary by transaction type and organizational structure.

  • Business owners and executives responsible for delegating authority to third parties or agents for contracts and banking.
  • Corporate legal or compliance teams that verify delegated powers and attach supporting corporate records for third parties.
  • Banks, vendors, and licensing authorities that require written confirmation of an agent's power to sign, act, or receive information.

Use the list below to identify who should prepare, approve, or review the statement before signing.

Quick step-by-step: complete a Business Agent Statement

Follow these four core steps to prepare an accurate, enforceable statement.

  • 01
    Prepare: Gather corporate resolution, EIN, and ID for the proposed agent.
  • 02
    Identify agent: Enter full legal name, title, and scope of authority.
  • 03
    Complete form: Fill required fields, include effective and expiration dates.
  • 04
    Sign and verify: Sign, date, notarize if required, then distribute certified copies.

Digital workflow settings to use when completing online

Configure your e-sign workflow to guarantee identity, retention, and conditional behavior for agent statements.

Field Configuration
Authentication method Email link plus optional SMS code
Field validation Set required fields and formats
Conditional fields Show scope fields only for specified roles
Retention setting Store PDF plus audit trail copy

Typical routing from draft to accepted record

A clear routing plan reduces signer friction and preserves evidentiary records.

  • Create template: Draft the statement and mark signature/date fields.
  • Assign signer: Add agent email and authentication method.
  • Execute: Signer reviews, signs, and provides consent for electronic record.
  • Deliver copies: Provide signed PDF and audit trail to all parties.

Technical requirements for eSubmission and distribution

Confirm platform support for secure signing, audit trails, and necessary integrations before sending.

  • Authentication options: Email, SMS code, knowledge-based checks
  • Integrations: Salesforce, NetSuite, Microsoft 365 supported
  • File formats: PDF and Word DOCX supported

Timing considerations and common deadlines

Some recipients require immediate delivery or notarization; others accept statements on request. Confirm timing in advance.

On-request delivery:

Provide statement promptly when a vendor or bank requests it

Banking authorizations:

Often needed before account changes or signatory updates

Vendor onboarding:

Expect 7–30 day verification depending on checks

RON evidence retention:

Audio-video records commonly retained 5–10 years

eSignature consent record:

Keep proof of consent per ESIGN requirements

Key milestones from preparation through acceptance

Track these milestones to ensure a complete, auditable process for agent delegation.

01

Draft completed

Form and supporting resolution assembled and reviewed

02

Agent signs

Agent executes statement with required authentication

03

Verification

Third party or internal compliance confirms authority

04

Record retention

Signed copy plus audit trail stored securely

Common mistakes that delay acceptance

  • Entering abbreviated or informal names that do not match government or corporate records, causing rejection by banks or regulators.
  • Failing to specify the scope or duration of authority, which can lead to disputes about what the agent may legally do.
  • Skipping notarization when a recipient or state law effectively requires it, producing a non-acceptable document for certain transactions.
  • Using inconsistent dates or unsigned attachments, which undermines the document's integrity and auditability during reviews.

Security, compliance, and audit details to verify

Encryption in transit: TLS 1.2/1.3
Encryption at rest: AES-256
Audit trail: Timestamps, IP, action log
Regulatory standards: ESIGN, UETA, 21 CFR Part 11
HIPAA handling: BAA required for PHI
Certifications: SOC 2 Type II, ISO 27001

Consequences of an incorrect or unauthorized statement

Contract disputes: Unauthorized acts may be voided
Financial exposure: Losses or unfunded obligations possible
Regulatory fines: Noncompliance can trigger penalties
Bank rejection: Account actions may be refused
Operational delays: Vendor onboarding can stall
Reputational harm: Trust with partners can erode

Real-world examples of use and organizational context

Two illustrative customer stories highlight common scenarios where a Business Agent Statement clarifies authority and speeds processing.

Optica Ventures LLC — Brian Fitzgibbons, COO

Optica used a signed agent statement when delegating contract execution to regional managers to streamline closings.

  • The clear delegation reduced approval cycles.
  • The team noted that having a written, signed statement plus supporting corporate resolution simplified vendor onboarding and avoided repeated identity checks.

Fertility Centers of Illinois — John Butler, Founder

A health provider executed agent statements to authorize staff to manage patient administrative accounts.

  • Statements included HIPAA addenda.
  • Retaining the signed statements and an audit trail ensured compliance with privacy rules and made internal audits faster and more reliable.

Vendor pricing and feature snapshot for eSign platforms

Compare starting prices and a few feature criteria relevant when preparing Business Agent Statements; signNow is listed first per vendor comparison conventions.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes Varies
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Frequently asked questions about Business Agent Statements

Answers to common questions about enforceability, notarization, revocation, and storage for Business Agent Statements.


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