Domestic Business Report

Domestic Business Report

Recitals

WHEREAS, Reporting Entity Name: is organized and conducting business within the domestic jurisdiction; and

WHEREAS, Service Provider Name: provides reporting, filing and advisory services to entities required to submit domestic business reports; and

WHEREAS, Reporting Entity desires to engage Service Provider to prepare and submit a Domestic Business Report and to document certain business information and obligations in accordance with the terms set forth below.

Business Information

Corporation    Limited Liability Company    Partnership    Other

Reporting Period

Reporting Period Start:    End:

Scope of Work

Service Provider shall prepare, review and, if authorized in writing, submit the Domestic Business Report on behalf of Reporting Entity. The scope includes compilation of entity information, verification of officer data, preparation of required statements, and coordination of filing logistics.

Payment Terms

Reporting Entity agrees to pay Service Provider the fees set forth below for services rendered under this Report. Fees for preparation and filing are earned upon submission and are non-refundable except as expressly provided in this Agreement.

Late payments shall incur a late fee of:    In addition to any collection costs, including reasonable attorneys' fees, incurred to secure payment.

Term and Termination

This Agreement commences on Start Date: and, unless earlier terminated in accordance with this section, continues through End Date:

Either party may terminate this Agreement for convenience upon written notice to the other party not less than days prior to termination. Termination for cause may be immediate upon material breach by the other party if the breach remains uncured after ten (10) days' written notice.

Confidentiality

Each party shall maintain in confidence all non-public information obtained from the other party in connection with the performance of this Report ("Confidential Information"). Confidential Information shall not include information that: (i) is or becomes generally available to the public other than through breach of this Agreement; (ii) was known to the receiving party prior to disclosure by the disclosing party; or (iii) is rightfully received from a third party without restriction. Each party shall use at least the same degree of care to protect Confidential Information as it uses to protect its own confidential information, but in no event less than reasonable care.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the jurisdiction of: without regard to conflict of laws principles. Venue for any dispute arising under this Agreement shall lie in the courts of that jurisdiction.

Entire Agreement

This instrument, including any attachments, schedules and the statements set forth herein, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings and communications, whether written or oral. No amendment or modification shall be binding unless in writing and signed by both parties.

Certification

The undersigned certifies that, to the best of their knowledge and belief, the information provided in this Domestic Business Report is true, correct and complete. The signatory affirms authority to execute this Report on behalf of the Reporting Entity and acknowledges that false statements made herein may result in civil or administrative penalties under applicable law.

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