E-Signature Client Consent Form

E-Signature Client Consent Form

This E-Signature Client Consent Form (the "Agreement") is entered into between Client: and Service Provider: . Agreement Date:

RECITALS

WHEREAS, Client has requested certain services from Service Provider and desires and intends to execute and receive contracts, notices, disclosures, invoices and other records in electronic form in connection with those services; and

WHEREAS, Service Provider is willing to provide such communications and to permit Client to sign electronically, subject to the terms and conditions set forth herein; and

WHEREAS, the parties intend this Agreement to govern the use and legal effect of electronic records and electronic signatures pertaining to the relationship between Client and Service Provider.

SCOPE OF WORK

PAYMENT TERMS

Late payments shall incur a finance charge of % per month (or the maximum permitted by law, whichever is less), plus any reasonable collection costs and attorney fees.

TERM AND TERMINATION

This Agreement commences on and terminates on , unless earlier terminated in accordance with this section.

Either party may terminate this Agreement for material breach if the breaching party fails to cure the breach within the notice period specified above following written notice. Termination shall not relieve either party of obligations accrued prior to termination, including payment obligations.

CONFIDENTIALITY

Each party shall maintain in confidence all confidential information disclosed by the other party that is marked confidential or that reasonably should be understood to be confidential. Confidential information shall not include information that is public through no fault of the receiving party, independently developed, or rightfully received from a third party without restriction. The receiving party agrees to use at least the same degree of care to protect confidential information as it uses to protect its own confidential information, but not less than reasonable care.

ELECTRONIC RECORDS AND SIGNATURES

By checking the boxes below and executing this Agreement, Client acknowledges and agrees that:

I consent to the use of electronic signatures in lieu of handwritten signatures where permitted by law.

I consent to receiving contracts, notices, disclosures, invoices, and other records in electronic form and agree that such electronic records satisfy any legal requirement that the record be in writing.

Client represents that Client has the necessary hardware and software to access and retain electronic records and that Client will promptly notify Service Provider if Client's electronic contact information changes or if Client withdraws consent. Withdrawal of consent does not affect the legal validity of electronic records or signatures obtained before withdrawal.

I confirm I have the necessary device and software to view, print, and retain electronic records and to sign electronically.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the jurisdiction indicated below without regard to conflict of laws principles:

ENTIRE AGREEMENT

This Agreement, together with any exhibits, schedules and executed electronic records, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral. No amendment to this Agreement shall be effective unless in writing and signed (physically or electronically) by both parties.

ACKNOWLEDGMENT AND CERTIFICATION

By signing below, the undersigned certifies under penalty of perjury that the information provided is true and correct, that the undersigned is authorized to act for the party identified, and that the undersigned consents to conduct transactions electronically and to the electronic signature(s) applied to this Agreement. The parties agree that electronic signatures shall have the same legal force and effect as manual signatures.

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