Legal LPR Document

LEGAL LPR DECLARATION AND RELIANCE AGREEMENT

This Legal LPR Declaration and Reliance Agreement (the Agreement) is made and entered into as of Effective Date: by and between Declarant Name: with mailing address: (Declarant), and Recipient Name: with mailing address: (Recipient). The Declarant and Recipient are referred to collectively as the Parties.

RECITALS

WHEREAS, Declarant asserts that Declarant is a lawful permanent resident of the United States and possesses lawful permanent resident documentation as defined herein; and

WHEREAS, Recipient requires verification or reliance on Declarant's immigration status in connection with employment, benefits, compliance, or other legitimate business purposes; and

WHEREAS, the Parties desire to set forth Declarant's representations, the extent of Recipient's permitted reliance, the procedures for verification, confidentiality safeguards, and indemnity obligations in a binding written agreement.

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

1. DEFINITIONS

For purposes of this Agreement: (a) "Legal Permanent Resident" means an individual lawfully accorded the privilege of residing permanently in the United States as evidence by issuance of permanent resident documentation; (b) "Documentation" means any card, certificate, receipt, or other written evidence issued by competent authority that purports to establish Legal Permanent Resident status; and (c) "A-Number" means the unique Alien Registration Number associated with the Declarant's immigration record.

2. DECLARATION OF STATUS

The Declarant hereby affirms and represents under penalty of perjury that Declarant is a Legal Permanent Resident. Declarant provides the following identifying information for verification purposes: LPR Card Number: ; Alien Registration Number (A-Number): ; Country of Birth: ; Date Granted Permanent Residence: .

Declarant warrants that all Documentation presented to Recipient is true, complete and unaltered, that Declarant will provide certified copies upon request, and that Declarant will notify Recipient in writing within ten (10) calendar days of any revocation, expiration, or change in immigration status that would affect Declarant's ability to remain a Legal Permanent Resident.

3. AUTHORIZATION TO VERIFY

Declarant expressly authorizes Recipient and its agents to verify Declarant's status through such documentary review, third-party confirmation, or administrative inquiry as Recipient reasonably deems necessary for the purpose described in this Agreement. Such verification may include review of Documentation and confirmation of identity and status with relevant recordkeepers or custodians of such records. Recipient shall act reasonably and in good faith when initiating verifications.

4. RELIANCE; LIMITATION OF RELIANCE

Recipient is authorized to rely upon Declarant's representations and Documentation for purposes of employment eligibility, benefits eligibility, compliance, or other specified business purposes. Recipient's reliance is conditioned upon receipt of Documentation that, on its face, appears genuine and pertains to Declarant. Recipient shall not be obligated to conduct exhaustive investigation; however, if Recipient receives notice or otherwise becomes aware of facts that reasonably call into question Declarant's status, Recipient may suspend reliance and seek further verification.

5. CONFIDENTIALITY AND DATA HANDLING

Recipient shall maintain Documentation and any immigration-related information in a secure and confidential manner, implementing reasonable administrative, technical, and physical safeguards to protect against unauthorized disclosure. Recipient shall limit access to such information to personnel with a legitimate need to know and shall not use Documentation for any purpose other than the purposes set forth in this Agreement, except as required by law or valid legal process.

6. INDEMNIFICATION

Declarant agrees to indemnify, defend and hold harmless Recipient and its officers, directors, employees and agents from and against any and all claims, damages, liabilities, fines, costs and expenses (including reasonable attorneys' fees) arising out of or resulting from: (a) any material misrepresentation, omission or falsification by Declarant regarding Declarant's immigration status or Documentation; or (b) Declarant's failure to notify Recipient of a change in status as required under this Agreement.

7. TERM AND TERMINATION

This Agreement shall commence on the Effective Date and shall continue until terminated by either Party upon thirty (30) days' prior written notice to the other Party, provided that Recipient's obligations to maintain confidentiality and obligations with respect to records that accrued prior to termination shall survive expiration or termination.

8. NOTICES

Notices shall be deemed given when delivered in person, by nationally recognized overnight courier, or three (3) business days after deposit in the U.S. mail, postage prepaid, addressed to the notice address specified above (or such other address as a Party may designate by notice in accordance with this Section).

9. AMENDMENT; WAIVER

No amendment, modification or waiver of any provision of this Agreement shall be effective unless in writing and signed by both Parties. No failure or delay by a Party in exercising any right or remedy shall constitute a waiver of that right or remedy.

10. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles. Each Party consents to the exclusive jurisdiction of the state and federal courts located in that State for resolution of disputes.

11. ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the Parties with respect to its subject matter and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written.

12. SEVERABILITY

If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect and the Parties shall negotiate in good faith to replace the invalid provision with a valid provision that effectuates the Parties' intent as closely as possible.

13. COUNTERPARTS; ELECTRONIC SIGNATURES

This Agreement 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. Signatures transmitted by electronic means (including facsimile or electronic image) shall be treated as original signatures for all purposes.

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