Legal Application Letter

LEGAL APPLICATION LETTER

This Legal Application Letter (the "Application") is submitted on by Applicant Name: to Recipient Name: .

RECITALS

WHEREAS, Applicant seeks formal approval, authorization, or other affirmative action from Recipient with respect to the matter described in this Application; and

WHEREAS, Applicant has prepared and submits for consideration the facts, statements and supporting documentation set forth below and attached hereto; and

WHEREAS, Recipient is authorized under applicable law, regulation, or internal authority to review and decide upon the Application in accordance with the terms and conditions set forth herein.

NOW, THEREFORE, in consideration of the foregoing and the mutual covenants contained herein, Applicant hereby applies as follows:

1. APPLICATION

1.1 Subject of Application:

2. SUPPORTING DOCUMENTS

Applicant submits the following documents in support of this Application (check all that apply):

Affidavit or declaration of Applicant

Exhibits, annexes or evidence identified in the Detailed Statement

Other:

3. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants to Recipient that: (a) Applicant has full power and authority to submit this Application and to execute any documents required in connection therewith; (b) all statements made in this Application and in the supporting documents are true, complete and correct to the best of Applicant's knowledge and belief; and (c) the execution and performance of this Application will not violate any order, judgment or agreement to which Applicant is a party.

Applicant further warrants that Applicant will promptly notify Recipient of any material change in the facts or circumstances set forth in this Application during the pendency of the review.

4. AUTHORIZATION TO VERIFY

Applicant authorizes Recipient and its authorized agents to make inquiries and obtain records and information from third parties for the purpose of verifying any statement contained in this Application. Applicant expressly consents to such verification and agrees to provide reasonable assistance in obtaining third-party records if requested.

5. FEES AND PAYMENT

If applicable, Applicant shall pay the fee required for processing this Application in the amount of $. Payment shall be due by unless otherwise agreed in writing.

6. PROCESSING AND DECISION

Recipient will undertake a review of the Application and will use reasonable efforts to render a decision within calendar days from the date of receipt of a complete application package. Timeframes are estimates and do not create any binding entitlement to approval.

7. CONFIDENTIALITY

All information designated in writing as confidential by Applicant and provided to Recipient in connection with this Application shall be held in confidence to the extent permitted by applicable law. Recipient may disclose confidential information where required by law or regulation or to its professional advisors on a need-to-know basis provided such advisors are bound to confidentiality obligations.

8. NOTICES

All notices required or permitted under this Application shall be in writing and delivered to the addresses set forth below by hand, certified mail, or other nationally recognized overnight courier.

9. AMENDMENT; WAIVER; COUNTERPARTS

This Application may be amended only by a written instrument executed by both Applicant and Recipient. No failure or delay by either party in exercising any right will operate as a waiver. This Application may be executed in counterparts, each of which will be deemed an original, and all of which together constitute one and the same instrument.

10. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Application and any dispute arising out of or relating to this Application shall be governed by the laws of the state specified by Recipient's governing jurisdiction as set forth in Recipient's procedures. This Application constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior discussions and agreements. If any provision of this Application is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

11. CERTIFICATION

By signing below, Applicant certifies under penalty of perjury under the laws of the governing jurisdiction that the facts and statements contained in this Application and its supporting documents are true, correct and complete to the best of Applicant's knowledge and belief. Applicant acknowledges that knowingly providing false information may subject Applicant to civil or criminal penalties.

ADDITIONAL INFORMATION

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