Legal I-824 Form

LEGAL I-824 FORM

This Legal I-824 Form is entered into as of the date of signature below by and between Applicant Name: (hereinafter "Applicant") and Representative Name: (hereinafter "Representative"). Applicant and Representative are each a "Party" and collectively the "Parties."

RECITALS

WHEREAS, Applicant submitted an application or petition identified by Case Number: and received an approval action on Approval Date: ; and

WHEREAS, Applicant requests the issuance of a follow-on administrative action, correction, duplicate approval, or notification to a designated office or consular post, as further described in this form; and

WHEREAS, Representative is authorized by Applicant to act on Applicant's behalf for the limited purposes set forth herein.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the Parties agree as follows:

1. DEFINITIONS

For purposes of this Form, the following definitions apply: "Approved Application" means the application or petition referenced by the Case Number field above; "Requested Action" means the administrative action described in Section 2; "Supporting Documents" means any materials submitted in support of the Requested Action.

2. REQUESTED ACTION

Applicant requests that Representative prepare and submit the following action on Applicant's Approved Application (select all that apply):

Duplicate approval document or certificate
Notify another administrative office or processing center
Request consular notification or forwarding of approval
Correct clerical or typographical error on approved documentation
Other:

3. SCOPE OF AUTHORIZATION

Applicant hereby authorizes Representative to prepare, sign where permitted, file, and otherwise take such ministerial and non-substantive actions as are necessary to effectuate the Requested Action, including the preparation and delivery of Supporting Documents, the payment of required fees on Applicant's behalf, and communications with administrative offices. Representative shall not amend the Approved Application in any substantive manner without express prior written authorization from Applicant.

4. SUPPORTING DOCUMENTS

Representative shall submit the Supporting Documents identified below with the Request for Action. Applicant certifies that all Supporting Documents are true, complete, and authentic to the best of Applicant's knowledge.

5. FEES AND PAYMENT

Applicant shall be responsible for all official filing fees and any fees charged by Representative for services rendered. Unless otherwise agreed in writing, Representative may advance fees on Applicant's behalf and Applicant shall reimburse Representative within thirty (30) days of invoicing.

6. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants that: (a) Applicant is authorized to execute this Form; (b) the facts set forth in the Approved Application and Supporting Documents are true and accurate; and (c) Applicant will notify Representative promptly of any material changes in circumstances that may affect the Requested Action. Representative represents that it will perform services in a professional manner and in accordance with applicable laws and regulations.

7. CONFIDENTIALITY

Representative shall maintain the confidentiality of Applicant's non-public information and shall not disclose such information except (a) as necessary to perform the Requested Action, (b) as required by law, or (c) with Applicant's prior written consent. Notwithstanding the foregoing, Representative may retain copies of submitted documentation for its records.

8. NOTICES

All notices and other communications required or permitted under this Form shall be in writing and delivered to the addresses set forth below or to such other address as a Party may designate by notice in accordance with this Section.

9. AMENDMENTS; WAIVER

Any amendment to this Form must be in writing and signed by both Parties. No failure or delay by either Party in exercising any right under this Form will operate as a waiver thereof, nor will any single or partial exercise of any right preclude other or further exercise of that or any other right.

10. COUNTERPARTS

This Form may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. Facsimile, digital image, or electronically transmitted signatures shall be considered original signatures for all purposes.

11. GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

This Form shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of laws principles. If any provision of this Form is held invalid or unenforceable, that provision shall be severed and the remaining provisions shall remain in full force and effect. This Form constitutes the entire agreement between the Parties with respect to its subject matter and supersedes all prior agreements and understandings, whether written or oral.

12. CERTIFICATION

Applicant certifies under penalty of perjury that the statements made in this Form and in any Supporting Documents are true and correct to the best of Applicant's knowledge and belief. Applicant authorizes Representative to provide and receive information necessary to carry out the Requested Action.

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