Legal Application Package

LEGAL APPLICATION PACKAGE

This Legal Application Package (the Agreement) is made and entered into as of the date set forth below by and between Applicant Name: , Applicant Address: , and Legal Service Provider Name: , Provider Address: . Application Date:

RECITALS

WHEREAS, Applicant seeks to submit certain information, documentation and certifications to Provider for the purpose of evaluating, processing and, if approved, providing legal services or certification of eligibility in accordance with Provider's procedures; and

WHEREAS, Provider is willing to accept and review the application materials provided by Applicant, subject to the representations, warranties, disclosures and fees set forth herein; and

WHEREAS, the parties desire to set forth their respective duties, responsibilities and the terms under which Provider will process the Application and Applicant will provide accurate and complete information.

NOW THEREFORE

In consideration of the mutual covenants contained in this Agreement and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

1.1 "Application" means the completed application form, supporting documents, certifications and any supplemental materials submitted by Applicant to Provider pursuant to this Agreement. 1.2 "Confidential Information" means non-public information disclosed by either party that is designated as confidential or that reasonably should be understood to be confidential under the circumstances.

2. APPLICATION MATERIALS

Applicant shall submit to Provider all materials required by Provider for evaluation. Applicant represents that all information and documentation submitted is true, complete and accurate as of the date of submission. Applicant shall promptly supplement or correct any material change to submitted materials.

3. ENTITY TYPE AND AUTHORIZATION

Applicant selects the applicable entity type and certifies that the person signing below is authorized to bind Applicant.

Individual Corporation Limited Liability Company Partnership Other

4. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants to Provider that: (a) Applicant has full power and authority to enter into and perform this Agreement; (b) all information and materials submitted are true, accurate, and complete in all material respects; (c) no material fact has been omitted that would render any submitted information misleading; and (d) Applicant will promptly notify Provider of any material change to submitted information.

5. DISCLOSURES; BACKGROUND CHECKS

Applicant authorizes Provider to conduct background, identity, and records checks as reasonably necessary to evaluate the Application. Applicant consents to Provider's collection and review of third-party records and acknowledges that unfavorable information may affect Provider's decision. Provider will comply with applicable legal restrictions governing such checks.

6. FEES AND PAYMENT

Applicant shall pay the fees set forth for processing the Application. Fees are non-refundable except as otherwise required by law. Provider shall invoice Applicant for fees, which are due within thirty (30) days of invoice unless otherwise agreed in writing.

7. CONFIDENTIALITY

Except as required by law, regulatory authority or as necessary to enforce this Agreement, Provider will maintain the confidentiality of Applicant's non-public information and will use such information solely for the purpose of assessing and processing the Application. Confidential Information shall not include information that is or becomes publicly available through no fault of the recipient.

8. COMPLIANCE WITH LAW

Each party shall comply with all applicable laws, regulations and professional obligations in performing its duties under this Agreement. Applicant acknowledges that Provider's obligations are subject to the limits of applicable law and professional standards.

9. NOTICES

All notices under this Agreement shall be in writing and delivered to the addresses provided in the opening paragraph or such other address as a party may designate in writing. Notice is effective upon personal delivery, delivery by nationally recognized overnight courier, or three (3) days after deposit in the U.S. mail when sent by certified mail, return receipt requested.

10. AMENDMENTS; WAIVER

No amendment or modification of this Agreement shall be effective unless in writing and signed by both parties. No failure or delay by either party in exercising any right under this Agreement shall operate as a waiver of that right.

11. COUNTERPARTS

This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. Signatures delivered by electronic transmission shall be binding.

12. 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.

13. ENTIRE AGREEMENT

This Agreement, together with any schedules and attachments hereto, 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.

14. SEVERABILITY

If any provision of this Agreement is held to be invalid, illegal, or unenforceable, the remaining provisions shall remain in full force and effect and shall be construed so as to give effect to the parties' intent to the greatest extent permitted by law.

15. CERTIFICATION

By signing below, Applicant certifies under penalty of perjury that the statements made in this Application and all attachments are true, correct and complete to the best of Applicant's knowledge. Applicant acknowledges that knowingly making a false statement may subject Applicant to civil or criminal penalties under applicable law.

ATTACHMENTS AND SUPPLEMENTAL MATERIALS

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