Client Signature Missing Form

CLIENT SIGNATURE MISSING FORM

This Client Signature Missing Form documents circumstances in which the client signature is absent from an otherwise executed agreement and records actions taken to resolve the missing signature. Client Name: Service Provider Name:

Agreement Title: Original Agreement Date: Reference Number:

WHEREAS

WHEREAS, the Service Provider and Client entered into the agreement referenced above for the provision of services described therein;

WHEREAS, at the time of execution copies of the agreement were exchanged but the signature page executed by the Client is not present in the Service Provider's file, and the absence of the Client signature must be documented and remedied in accordance with the parties' intent;

WHEREAS, the parties wish to confirm the scope, payment terms, and effective date of the agreement and to record measures taken to obtain a complete, signed agreement;

SCOPE OF WORK

REASON FOR MISSING SIGNATURE

ACTIONS TAKEN TO OBTAIN SIGNATURE

Check all methods used to obtain the Client's signature:

Email sent to client
Contract mailed to client for signature
In-person signing attempted
Telephone confirmation / arrangement attempted
Other — specify:

PAYMENT TERMS

Outstanding Amount Due: $

Late Fee: or Flat Fee: $

TERM AND TERMINATION

Effective Start Date: Contract End Date:

Notice Period for Termination:

Either party may terminate the agreement consistent with the original termination provisions. Where the signature is subsequently obtained, it shall relate back to the Effective Start Date stated above unless the parties otherwise agree in writing.

CONFIDENTIALITY

The parties acknowledge that in the performance of the agreement each may have access to information that is confidential. Confidential Information shall mean non-public information marked or reasonably understood to be confidential. Each party shall maintain such information in confidence and shall not disclose it except to its employees, agents, or professional advisors who have a need to know and are bound by confidentiality obligations at least as protective as those in this document.

GOVERNING LAW

This form and the underlying agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles.

ENTIRE AGREEMENT

This Client Signature Missing Form, together with the original agreement referenced above, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous communications, proposals, and understandings, whether oral or written, except as expressly preserved in the original agreement.

CLIENT REPRESENTATION AND CERTIFICATION

The undersigned Client represents and certifies that the information provided in this form is true and accurate to the best of their knowledge, that the Client has the authority to execute the original agreement, and that the absence of a signature on the Service Provider's copy was unintentional. The Client agrees to execute any remaining signature pages or documents necessary to reflect the parties' intent as stated herein.

Sign Now