Client Receiver Information

CLIENT RECEIVER INFORMATION AND SERVICES AGREEMENT

This Client Receiver Information and Services Agreement (the Agreement) is entered into by and between Client Name: and Receiver Name: . Effective Date: .

WHEREAS

WHEREAS, Client engages Receiver to receive, process, hold, or otherwise act on Client information, funds, or materials in furtherance of the parties' business relationship; and

WHEREAS, Receiver requires specific contact, banking, and authorization details from Client to perform the services described in this Agreement and Client agrees to provide accurate and current information; and

WHEREAS, the parties intend to set forth their respective rights, obligations, and the terms under which Receiver will receive and handle Client materials and information.

CLIENT INFORMATION

RECEIVER INFORMATION

SCOPE OF WORK

Receiver shall perform the services described below on behalf of Client. The described services constitute the full scope of Receiver's obligations unless otherwise amended in writing and signed by both parties.

PAYMENT TERMS

Total Compensation: $ . Payment Schedule: .

Payment Due: Invoices are due within days of invoice date. Late Fee: A late fee of will apply to overdue balances after a grace period of days.

TERM AND TERMINATION

Term: This Agreement commences on Start Date: and continues until End Date: , unless earlier terminated as provided herein.

Termination: Either party may terminate this Agreement for convenience upon days' prior written notice. Either party may terminate for material breach upon written notice if the breach is not cured within days after receipt of notice.

CONFIDENTIALITY

Definition: Confidential Information means non-public, proprietary or sensitive information disclosed by one party to the other, whether oral, written, electronic, or observed, that is designated confidential or that reasonably should be understood to be confidential.

Obligations: Recipient shall (a) use Confidential Information solely to perform obligations under this Agreement; (b) restrict disclosure to employees and agents who have a need to know and are bound by confidentiality obligations at least as protective as those herein; and (c) take commercially reasonable measures to protect Confidential Information from unauthorized use or disclosure.

Exceptions: Confidential Information does not include information that is or becomes publicly available through no fault of Recipient, is independently developed by Recipient without reference to Confidential Information, or is rightfully obtained from a third party not under an obligation of confidentiality.

BANKING / RECEIPT INSTRUCTIONS

Complete the following to authorize Receiver to accept or transmit funds on Client's behalf where applicable. Submit any changes in writing and signed by an authorized representative.

REPRESENTATIONS, WARRANTIES AND COVENANTS

Each party represents and warrants that it has full power and authority to enter into this Agreement and to perform its obligations. Client warrants that the information provided in this form is accurate and complete and will promptly notify Receiver of any changes.

GOVERNING LAW

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

ENTIRE AGREEMENT

This Agreement, including all schedules and attachments, constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous agreements, proposals, and communications, whether written or oral. Any amendment must be in writing and signed by both parties.

MISCELLANEOUS PROVISIONS

Severability: If any provision is found unenforceable, the remaining provisions remain in full force. Waiver: Failure to enforce a provision is not a waiver of rights. Assignment: Neither party may assign this Agreement without the prior written consent of the other, except to an affiliate or successor in interest.

CERTIFICATION

By checking the box below and signing, the undersigned certifies under penalty of perjury that the information provided in this form is true, accurate, and complete to the best of their knowledge and that they are authorized to execute this Agreement on behalf of the named party.

I certify that the information provided is true and accurate and I am authorized to bind the party identified above.

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