Legal Patriot Act Document

LEGAL PATRIOT ACT DOCUMENT

This Legal Patriot Act Document (the "Document") is entered into on this day, by and between Institution Name: (the "Institution") and Client Name: (the "Client").

Client Entity Type: Individual Corporation LLC Partnership Other

RECITALS

WHEREAS, the Institution is subject to federal anti-money laundering and counter-terrorist financing obligations, including obligations arising under enacted statutes commonly referenced as the Patriot Act and associated implementing regulations, and must establish and maintain a Customer Identification Program and related due diligence; and

WHEREAS, the Client seeks to obtain or maintain one or more accounts, services or relationships with the Institution and, as a condition to such relationship, must provide identity verification, beneficial owner information, and make certifications to enable the Institution's compliance with applicable legal requirements; and

WHEREAS, the parties desire to set forth the Client's representations, warranties, certifications and the Institution's reliance rights with respect to identification, beneficial ownership, record retention, and reporting obligations in order to document compliance practices and to allocate related obligations and remedies.

NOW, THEREFORE

In consideration of the mutual covenants and agreements contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Document, the following terms shall have the meanings set forth below. "Account" means any banking, securities, custodial or other financial relationship between the Client and the Institution. "Beneficial Owner" means any natural person who, directly or indirectly, owns or controls the Client or on whose behalf a transaction is being conducted, including persons exercising substantial control. "CIP" means Customer Identification Program as required by applicable law.

2. CLIENT REPRESENTATIONS AND CERTIFICATIONS

The Client represents, warrants and certifies to the Institution as of the date hereof and at all times during the relationship that:

(a) Identity: The Client has provided true, accurate and complete identification documentation and information, including legal name: and address:

(b) Beneficial Ownership: The Client has disclosed to the Institution the name, date of birth, address and government identification number of each Beneficial Owner and has provided supporting documentation where required. List primary beneficial owners and titles in the space below; attach additional pages if necessary.

(c) No Prohibited Status: The Client is not an individual or entity that is subject to sanctions or otherwise designated on any applicable prohibited persons list; the Client will notify the Institution promptly if the Client becomes subject to any newly applicable designation, restriction or sanction.

3. INSTITUTION'S RELIANCE; SCREENING AND RECORDS

The Institution may, in its sole discretion, verify the Client's identity and beneficial ownership information by reviewing government-issued identification, public records, private databases and other sources. The Client authorizes the Institution to obtain and retain copies of identification documents and to conduct such screening and recordkeeping as required by law. The Institution's reliance on the Client's representations shall be reasonable so long as the Institution follows its ordinary compliance procedures.

4. ONGOING DUE DILIGENCE; DUTY TO UPDATE

The Client shall promptly notify the Institution in writing of any material change to the information provided, including changes in beneficial ownership, legal name, address, or any material activity that might reasonably be expected to affect the Institution's obligations under applicable law. Notification shall be delivered to the Institution's notice address set forth below.

5. NOTICES

All notices, requests, demands and other communications required or permitted under this Document shall be in writing and shall be delivered to the addresses set forth below or to such other address as a party may designate by written notice to the other party.

6. CONFIDENTIALITY AND LIMITED DISCLOSURE

Except as required by law, regulation or valid subpoena, the Institution shall maintain the confidentiality of information provided by the Client. Notwithstanding the foregoing, the Institution may disclose Client information to its affiliates, auditors, regulators, law enforcement, or as otherwise necessary to comply with its legal obligations, including obligations under the Patriot Act and related regulations.

7. INDEMNIFICATION

The Client shall indemnify, defend and hold harmless the Institution and its officers, directors, employees and agents from and against any and all losses, claims, damages, liabilities, fines or expenses (including reasonable attorneys' fees) arising out of or resulting from (a) any false representation, warranty or certification made by the Client under this Document; (b) the Client's failure to provide required information or to update the Institution; or (c) the Client's violation of applicable anti-money laundering, sanctions, or related legal obligations.

8. REMEDIES

In addition to any remedies at law or equity, the Institution may, in its sole discretion, (i) suspend, restrict or close Accounts or services, (ii) require additional documentation or enhanced due diligence, or (iii) take such other action as reasonably necessary to ensure compliance with legal obligations. The Institution shall not be liable for any damages resulting from good faith compliance with statutory or regulatory obligations.

9. GOVERNING LAW

This Document shall be governed by and construed in accordance with the substantive laws of the state specified below, excluding its conflicts of law principles. The parties submit to the exclusive jurisdiction of the competent courts located within that state for resolution of disputes arising under this Document.

10. ENTIRE AGREEMENT; SEVERABILITY

This Document constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements, understandings and communications, whether written or oral. If any provision of this Document is held invalid or unenforceable, such provision shall be severed and the remaining provisions shall remain in full force and effect.

11. AMENDMENT; WAIVER; COUNTERPARTS

No amendment to this Document shall be effective unless in writing and signed by authorized representatives of both parties. No waiver of any provision shall be effective unless in writing. This Document 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.

12. CERTIFICATION UNDER PATRIOT ACT OBLIGATIONS

By signing below, the Client certifies under penalty of perjury that the information provided in connection with this Document is true, correct and complete to the best of the Client's knowledge, and acknowledges that the Institution may rely upon these certifications for compliance with the Patriot Act and related regulatory obligations. The Client further acknowledges that failure to provide accurate information may result in account closure, reporting to government authorities, or other legal consequences.

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