Document Data Authorization Form

Document Data Authorization Form

Parties

Client Name:

Individual Corporation LLC Other:

Data Recipient Name:

Individual Corporation LLC Other:

Recitals

WHEREAS, Client Name: is the lawful owner or authorized custodian of certain documents and data described herein and desires to permit limited access to such documents and data for the purposes set forth below;

WHEREAS, Data Recipient Name: has represented that it has a legitimate purpose and the technical and administrative safeguards necessary to receive, use and protect the Client's documents and data; and

WHEREAS, the parties wish to set forth the terms under which data access, transfer, use, retention and disposition will be authorized and controlled.

Authorization

Client hereby authorizes Data Recipient to access, receive, copy, process and retain the documents and data described in this form strictly for the Permitted Purpose described below, subject to the confidentiality, security and retention provisions set forth in this document. This authorization does not transfer ownership of the original documents or underlying data.

Financial records Personal identifying information Contracts and agreements Other:

Scope of Work

Payment Terms

Compensation Amount:

Late Fee:

Term and Termination

Commencement Date:    Termination Date:

Either party may terminate this authorization for convenience by providing written notice to the other party at least days prior to the intended effective date of termination. Termination shall not affect obligations accrued prior to the effective date of termination, including payment and confidentiality obligations.

Confidentiality

Data Recipient shall maintain the confidentiality of all non-public documents and data received under this authorization, and shall not disclose such information except (a) to employees, contractors or agents who have a need to know and who are bound by obligations of confidentiality at least as restrictive as those set forth herein, (b) as required by applicable law or court order (in which case Recipient shall provide prompt written notice to Client where permitted), or (c) as otherwise authorized in writing by Client. Recipient shall implement and maintain administrative, physical and technical safeguards appropriate to the sensitivity of the data and consistent with industry standard practices.

Data Security and Retention

Retention Period (maximum): . Upon expiration of the retention period or termination of this authorization, Recipient shall securely return or destroy the documents and data as directed by Client and shall provide written certification of destruction upon request.

Revocation and Audit Rights

Client may revoke this authorization at any time by providing written notice to Recipient. Revocation shall be effective days after Recipient's receipt of such notice, except to the extent Recipient has already acted in reliance on the authorization. Client grants Recipient permission to undergo reasonable audits or assessments upon days' prior notice to verify compliance with the terms of this authorization.

Indemnification

Each party shall indemnify, defend and hold harmless the other party from and against any claims, liabilities, losses, damages and expenses (including reasonable attorneys' fees) arising out of the indemnifying party's breach of this authorization, negligent or willful acts or omissions, or unauthorized use or disclosure of documents or data.

Governing Law; Entire Agreement

Governing Law: This authorization shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles.

Entire Agreement: This document constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether written or oral. No amendment or modification of this authorization will be effective unless in writing and signed by both parties.

Certifications and Acknowledgments

By signing below, Client certifies that Client is authorized to provide access to the documents and data specified in this form and that such disclosure will not violate any agreement or legal obligation. Recipient acknowledges receipt of this authorization and agrees to comply with all terms contained herein.

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