Client Information Update Form

CLIENT INFORMATION UPDATE FORM

Recitals

WHEREAS, Client Name: (the "Client") and Service Provider Name: (the "Provider") are parties to one or more existing agreements governing the provision of services; and

WHEREAS, the parties wish to record updated Client contact, billing and administrative information and, where applicable, to amend certain administrative terms of their agreement to reflect the updated information as set forth in this Client Information Update Form (the "Update Form").

NOW, THEREFORE, in consideration of the mutual promises contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree that the information and amendments set forth in this Update Form shall govern as provided below.

Client Contact Information

Billing and Tax Information

Scope of Work / Amendment

If this update constitutes an amendment to existing scope, describe the specific changes to services, deliverables, or responsibilities below. If no change to scope is intended, enter "No change to scope."

Payment Terms

The parties hereby confirm the payment arrangements applicable to invoices issued after the Effective Date of Update. Enter the agreed standard payment amount, schedule, and late fee provisions. These terms modify only administrative billing mechanics and do not alter substantive obligations unless expressly stated in Scope of Work above.

Term and Termination (Administrative)

Unless otherwise specified in a separate agreement, the administrative updates recorded herein shall become effective on the Effective Date of Update below and shall continue until superseded in writing. Either party may terminate the application of these administrative updates on written notice to the other party in accordance with the Notice Period below.

Confidentiality

Each party acknowledges that certain information disclosed in connection with the parties' relationship may be confidential. The parties agree that any non-public business, financial, technical, or customer information disclosed in connection with this Update Form will be held in confidence and will not be disclosed to third parties except as required by law or with the disclosing party's prior written consent. Confidential information does not include information that is or becomes generally available to the public through no breach of this obligation or that was known to the receiving party prior to disclosure.

Governing Law

This Update Form and any disputes arising out of or relating to it shall be governed by and construed in accordance with the laws of the state of , without regard to its conflicts of law principles.

Entire Agreement; Amendment

This Update Form, together with the underlying agreement(s) between the parties, constitutes the entire agreement with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings and agreements, whether written or oral, relating to the same subject matter. Any amendment to this Update Form must be in writing and signed by authorized representatives of both parties.

Acknowledgment and Certification

The undersigned certify that the information provided in this Client Information Update Form is true and accurate to the best of their knowledge and that they are authorized to submit this update on behalf of the party they represent. Submission of this Update Form constitutes a representation that authorized representatives of the parties have the authority to make the amendments and confirmations set forth herein.

By checking the box below, the signatory certifies that any prior contact or billing information on file is superseded by the information herein for the purposes of billing, notices, and contract administration as of the Effective Date of Update.

I certify that this submission supersedes prior contact and billing information.

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