Legal LPR Form

LEGAL LPR FORM

This Limited Power of Representation Agreement (the "Agreement") is made and entered into on Effective Date: by and between Client Name: with address ("Client") and Representative Name: with address ("Representative").

RECITALS

WHEREAS, Client is a lawful permanent resident or other individual who requires legal representation or administrative assistance in matters described below;

WHEREAS, Representative is authorized under this Agreement to perform specified acts on behalf of Client in connection with the matters set forth herein and has agreed to provide such services under the terms of this Agreement;

WHEREAS, Client desires to grant Representative limited authority to act on Client's behalf for the specific purposes and subject to the limitations described in this Agreement.

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

1. APPOINTMENT AND SCOPE

Client hereby appoints Representative as Client's limited agent and representative to undertake, perform and complete the following matters (the "Matters"):

Representative's authority shall include the power to prepare, execute, sign and deliver documents, to communicate with relevant third parties and agencies, and to undertake all acts reasonably necessary to accomplish the Matters, but only to the extent expressly authorized in this Agreement.

2. SPECIFIC AUTHORITY AND LIMITATIONS

Representative is expressly authorized to perform the following acts on behalf of Client (select applicable powers):

Sign and execute documents necessary for the Matters Appear and represent Client before administrative agencies Receive and inspect confidential information related to the Matters Make or authorize payments on behalf of Client related to the Matters

Representative is not authorized to: (a) make medical decisions on behalf of Client; (b) convey, encumber, or transfer real property except as specifically set forth in a separate written instrument; or (c) compromise or settle claims in excess of the monetary limit set forth below without Client's prior written consent.

3. TERM AND TERMINATION

This Agreement shall commence on the Effective Date and shall continue until Termination Date: unless earlier revoked in writing by Client or terminated by the Representative for good cause upon ten (10) days' written notice to Client.

4. FEES, COSTS AND PAYMENT

Client shall pay Representative fees for services rendered according to the fee arrangement set forth below. Client shall also reimburse Representative for reasonable costs and expenses incurred in connection with the performance of the Matters.

5. CLIENT REPRESENTATIONS AND WARRANTIES

Client represents and warrants that Client has the full legal capacity to grant the powers contained in this Agreement, that the information provided to Representative is true and complete to the best of Client's knowledge, and that no other person or instrument has granted authority that conflicts with the authority granted herein.

6. CONFIDENTIALITY

Representative shall hold in strict confidence all communications and documents received from Client and shall use such information solely for the purpose of performing the Matters, except as otherwise required by law or court order. Representative may disclose information to employees or consultants as necessary to carry out the Matters, provided they are bound by confidentiality obligations.

7. INDEMNIFICATION

Client agrees to indemnify, defend and hold harmless Representative from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of or related to Representative's good faith performance of the authorities granted herein, except to the extent caused by Representative's willful misconduct or gross negligence.

8. NOTICES

All notices, demands or other communications required or permitted under this Agreement shall be in writing and shall be delivered personally, by nationally recognized overnight courier, or by U.S. mail, postage prepaid, to the addresses below or to such other address as either party may designate by written notice to the other.

9. AMENDMENT; WAIVER; COUNTERPARTS

This Agreement may be amended only by a written instrument signed by both parties. No waiver of any provision of this Agreement shall be effective unless in writing signed by the party against whom the waiver is asserted. This Agreement may be executed in counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument.

10. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Agreement shall be governed by and construed in accordance with the laws of the state governing_state: without regard to choice-of-law principles. This Agreement constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous agreements and understandings. If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect.

11. MISCELLANEOUS

Representative shall keep accurate records of all actions taken and funds disbursed on behalf of Client and shall provide such records to Client upon request. Nothing in this Agreement shall be construed to create a partnership, joint venture or employer-employee relationship between the parties.

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