Legal Information Release Form

LEGAL INFORMATION RELEASE FORM

This Legal Information Release Form (the Agreement) is entered into on this date: by and between Disclosing Party: with address and Receiving Party: with address .

RECITALS

WHEREAS, Disclosing Party possesses certain legal records, files, documents, and related information (collectively, the "Information") that are relevant to the matters identified below and which Disclosing Party has authority to disclose; and

WHEREAS, Receiving Party has requested access to the Information for the lawful purpose(s) described below and represents that such access is necessary for the legitimate exercise of its rights, duties, or obligations; and

WHEREAS, the parties wish to set forth the terms, conditions, and limitations under which the Information may be released, used, retained, and disclosed.

NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties agree as follows:

1. AUTHORIZATION TO RELEASE INFORMATION

Disclosing Party hereby authorizes and directs any person or entity in possession of the Information to disclose and release to Receiving Party the categories of information checked below and any information reasonably necessary to accomplish the stated purpose. This authorization includes disclosure to Receiving Party's authorized representatives, agents, counsel, and experts where required to fulfill the purpose set forth in this Agreement.

2. PURPOSE AND SCOPE

The Information shall be released solely for the following purpose(s): . The release granted herein is limited to information reasonably necessary to accomplish the stated purpose and does not authorize unrelated uses.

This authorization is effective as of the Effective Date set forth above and shall remain in effect until unless earlier revoked in writing pursuant to Section 6.

3. CONSENT, ACKNOWLEDGMENT AND AUTHORITY

Disclosing Party represents and warrants that it has the full legal right and authority to authorize the release of the Information identified herein and that no further consent from a third party is required except as identified in writing below. Disclosing Party further acknowledges that Receiving Party may use the Information for the stated purpose and may provide copies to its authorized agents, counsel, and experts on a need-to-know basis.

Disclosing Party initial to confirm authority to release (initials):

4. LIMITATIONS AND EXCLUSIONS

Nothing in this Agreement shall be construed to waive or authorize the disclosure of information that is protected by statutory privilege, subject to a court order, or otherwise prohibited by law except to the extent expressly waived in writing by the holder of such privilege. Attorney-client communications, where privilege is asserted, are excluded unless expressly waived in a separate written instrument.

5. DISCLOSURE, USE AND RETENTION

Receiving Party agrees to use reasonable administrative, technical, and physical safeguards to protect the confidentiality of the Information and to limit access to persons who have a legitimate need to know. Receiving Party shall not retain copies of the Information longer than necessary to accomplish the stated purpose, except as required by law, regulation, or court order.

Receiving Party may further disclose Information only as follows: Yes — provided disclosures are to counsel, experts, or agents who agree to abide by the confidentiality and use restrictions herein.

6. REVOCATION AND TERMINATION

Disclosing Party may revoke this authorization at any time by providing written notice to Receiving Party in accordance with the Notices provision below. Revocation shall be effective upon actual receipt by Receiving Party, except that disclosures made in reliance on this authorization prior to receipt of the revocation shall not constitute a breach of this Agreement.

7. INDEMNIFICATION AND LIMITATION OF LIABILITY

Disclosing Party agrees to indemnify and hold harmless Receiving Party and its employees, agents, counsel, and representatives from and against any claims, liabilities, losses, damages, or expenses (including reasonable attorneys' fees) arising out of Disclosing Party's breach of any representation, warranty, or obligation under this Agreement, except to the extent caused by Receiving Party's gross negligence or willful misconduct.

8. FEES AND COSTS

If applicable, fees for copying, retrieval, or production of the Information shall be handled as follows: Disclosing Party pays    Receiving Party pays    Other:

9. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the parties at the addresses set forth below or to such other address as either party designates in writing.

10. GOVERNING LAW; VENUE

This Agreement shall be governed by and construed in accordance with the laws of the jurisdiction selected below, without regard to conflict of laws principles. The parties agree that exclusive venue for any disputes arising under this Agreement shall be the courts located within that jurisdiction unless otherwise agreed in writing.

11. ENTIRE AGREEMENT; AMENDMENT; WAIVER; SEVERABILITY; COUNTERPARTS

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, and communications, whether written or oral. Any amendment or modification to this Agreement must be in writing and signed by both parties. No failure or delay by either party in exercising any right shall operate as a waiver of that right. If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Agreement may be executed in counterparts, each of which shall be deemed an original, and facsimile or electronic signatures shall be binding for all purposes.

12. MISCELLANEOUS

If any party is an entity, the person signing below represents and warrants that he or she is duly authorized to execute this Agreement on behalf of that entity. Nothing in this Agreement shall be construed to create a partnership, joint venture, or agency relationship between the parties except as expressly set forth herein.

CERTIFICATION

By signing below, Disclosing Party certifies under penalty of perjury that the information provided in this form is true and that Disclosing Party has the authority to authorize the release of the Information specified. Receiving Party accepts the Information subject to the terms and conditions set forth above.

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