Business Owner Details

BUSINESS OWNER DETAILS

This General Business Agreement for collection and verification of Business Owner Details (the Agreement) is entered into as of Effective Date: by and between Company Name: and Business Owner Name: .

WHEREAS

WHEREAS, Company requires accurate and current ownership and identification information for regulatory, contractual and recordkeeping purposes; and

WHEREAS, Business Owner will provide the requested personal and business details, and warrants that such information is true, complete and provided under penalty of contract; and

WHEREAS, the parties desire to set forth the scope of information, processing, confidentiality obligations and the terms under which such information is collected and maintained.

OWNER IDENTIFICATION & CONTACT DETAILS

Sole Proprietorship LLC Corporation Partnership Other:

The Business Owner certifies that they are authorized to execute this Agreement on behalf of the business entity indicated above: I certify I am authorized to bind the business.

SCOPE OF WORK

Business Owner shall provide the information and cooperate with Company as required to enable Company to fulfill contractual, regulatory and recordkeeping obligations. The specific data, documentation and deliverables to be provided are described below.

PAYMENT TERMS

In consideration for services or administrative processing rendered by Company, the Business Owner shall pay the fees set forth below.

All amounts are due in the currency specified in the invoice. Late payments shall accrue interest at the rate stated above and Owner shall be responsible for reasonable collection costs, including attorneys' fees, if incurred.

TERM AND TERMINATION

This Agreement commences on Start Date: and shall continue until End Date: unless earlier terminated in accordance with this Section.

Either party may terminate this Agreement for convenience upon written notice delivered at least days prior to the effective termination date. Either party may terminate this Agreement immediately for material breach that remains uncured for a period of 14 days after written notice.

CONFIDENTIALITY

"Confidential Information" means non-public information disclosed by one party (Disclosing Party) to the other (Receiving Party) in any form, including business, technical, financial or personal data. Receiving Party shall: (a) hold Confidential Information in strict confidence; (b) use Confidential Information solely to perform its obligations under this Agreement; and (c) not disclose Confidential Information to any third party except to its employees, agents or professional advisors on a need-to-know basis and subject to confidentiality obligations no less protective than those herein.

Confidential Information does not include information that: (i) is or becomes public through no fault of Receiving Party; (ii) was known to Receiving Party prior to disclosure as evidenced by written records; or (iii) is independently developed by Receiving Party without use of Disclosing Party's Confidential Information. Upon termination or upon written request, Receiving Party shall promptly return or destroy Confidential Information and certify such destruction if requested.

A breach of this Section would cause irreparable harm for which monetary damages may be inadequate; accordingly, the Disclosing Party is entitled to injunctive relief in addition to any other remedies.

REPRESENTATIONS, WARRANTIES & INDEMNIFICATION

Business Owner represents and warrants that the information provided is true, accurate and complete to the best of Owner's knowledge; Owner has authority to provide such information and to enter into this Agreement; and the provision of such information and performance hereunder will not violate any agreement or law.

Business Owner shall indemnify, defend and hold Company harmless from and against any claims, losses or liabilities arising from Owner's breach of the foregoing representations and warranties, except to the extent caused by Company's gross negligence or willful misconduct.

NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses below. Notices are effective upon personal delivery, reputable overnight courier, or three business days after deposit in the mail.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflicts of law principles. The parties consent to exclusive jurisdiction and venue in the state and federal courts located within that State.

ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous agreements, understandings and communications, whether written or oral. No amendment, modification or waiver shall be effective unless in writing and signed by both parties.

If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

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