Legal G-28 Document

LEGAL G-28 DOCUMENT

Client Name:   A-Number:   Date of Birth:

Representative Name:   Bar/Accreditation No.:

Attorney    Accredited Representative    Organization/Firm

RECITALS

WHEREAS, Client Name: desires the assistance and representation of Representative Name: in connection with immigration-related matters identified herein;

WHEREAS, Representative has represented that Representative is duly authorized to provide legal or accredited representation and is qualified to represent Client in matters before applicable administrative tribunals and tribunals of competent jurisdiction;

WHEREAS, Client wishes to designate Representative to act on Client's behalf for the matters described in this document and to receive notices and communications related to those matters.

NOW, THEREFORE

In consideration of the mutual covenants set forth below, the parties hereby agree as follows:

1. APPOINTMENT AND SCOPE OF REPRESENTATION

Client retains Representative to provide representation in relation to the following matter(s): . Representative's authority includes preparing and filing applications, petitions, responses, and appeals, and representing Client in interviews, hearings, and other proceedings reasonably necessary to pursue the identified matter(s).

2. AUTHORITY TO RECEIVE DOCUMENTS AND NOTICES

Client authorizes Representative to receive on Client's behalf all correspondence, notices, decisions, and other documents related to the matters described above. Representative shall be authorized to accept service of notices and to receive and inspect protected information relating to Client's case unless Client expressly revokes such authority in writing.

Representative mailing address for notices is:

3. CLIENT CONSENT AND AUTHORIZATIONS

Client authorizes Representative to sign and file relevant forms and to communicate with government officials, administrative bodies, third-party service providers, and others as necessary to carry out representation. Client further authorizes the disclosure of Client's records and information related to the representation to Representative.

Client acknowledges that fees, costs, and any retainer arrangements are governed by a separate fee agreement between Client and Representative. Representative does not guarantee any particular result and will provide representation consistent with professional standards and applicable rules of practice.

4. CONFIDENTIALITY AND PRIVILEGE

All communications between Client and Representative made for the purpose of securing legal advice are protected by the attorney-client privilege or applicable privilege for accredited representatives to the fullest extent permitted by law. Representative shall maintain the confidentiality of Client information except as authorized by Client or required by law.

5. TERMINATION; WITHDRAWAL

Client may revoke this designation at any time by providing written notice to Representative and any relevant authorities. Representative may withdraw from representation in accordance with applicable professional rules and after reasonable notice to Client, subject to any obligations to protect Client interests during withdrawal.

6. NOTICES

All notices under this document shall be in writing and deemed given when delivered personally, sent by certified mail to the mailing addresses provided above, or delivered by electronic mail to addresses provided by the parties, subject to confirmation of receipt.

7. REPRESENTATIONS AND CERTIFICATIONS

Representative certifies that Representative is authorized to practice before the relevant authorities and, where applicable, is in good standing with the appropriate licensing or accrediting body. Representative further certifies that the information provided in this document is true and correct to the best of Representative's knowledge.

8. MISCELLANEOUS

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

Entire Agreement: This instrument constitutes the entire agreement between the parties regarding the subject matter hereof and supersedes any prior written or oral agreements relating to the designated representation.

Severability: If any provision of this document is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Amendments; Waiver: No amendment or waiver of any provision is effective unless in writing and signed by both parties. The waiver of a breach of any provision shall not operate as a waiver of any subsequent breach.

Counterparts: This document may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

ACKNOWLEDGMENT

By signing below, Client confirms that Client authorizes Representative to act on Client's behalf as set forth in this document, understands the scope and limitations of the representation, and acknowledges receipt of a copy of this signed designation.

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