Legal Reinstatement Request

Legal Reinstatement Request

This Legal Reinstatement Request (the "Request") is executed on this by and between Applicant Name: ("Applicant") and Respondent Name: ("Respondent").

RECITALS

WHEREAS, Applicant was previously in good standing with Respondent as of the date of initial registration or execution of the underlying instrument, and such status was subsequently terminated, suspended, forfeited, administratively dissolved, or otherwise revoked under the authority or agreement administered by Respondent; and

WHEREAS, Applicant seeks reinstatement of its rights, privileges, registration, license, or contract previously held, and requests that Respondent take the affirmative steps necessary to reinstate the status described herein upon satisfaction of the conditions set forth in this Request; and

WHEREAS, Respondent is authorized under applicable statutes, regulations, or contract terms to accept a reinstatement request, prescribe conditions for reinstatement, and to document such reinstatement in writing;

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 Request, the following terms have the meanings set forth below: "Reinstatement" means the restoration of the Applicant's status, registration, license, or contractual relationship to the condition that existed immediately prior to termination to the extent permitted by law; "Effective Date" means the date on which Respondent executes a written instrument or takes official action acknowledging reinstatement.

2. Background Statement and Requested Relief

Applicant submits the following summary of events and the relief sought. Applicant certifies under penalty of perjury that the statements in this Request are true and correct to the best of Applicant’s knowledge.

3. Grounds for Reinstatement

Applicant asserts one or more of the following grounds for reinstatement and requests that Respondent consider the documentation attached in support:

4. Conditions, Fees and Documentation

Applicant agrees to satisfy the following conditions prior to or as a condition of reinstatement. Applicant understands and acknowledges that Respondent's acceptance of this Request is discretionary and conditioned upon full compliance with all applicable legal requirements.

5. Representations and Warranties

Applicant represents and warrants to Respondent that: (a) all information provided in this Request and in the attached documentation is true, complete and accurate in all material respects; (b) the execution and delivery of this Request and the performance of Applicant’s obligations hereunder do not violate any agreement to which Applicant is a party; and (c) Applicant has full authority to request reinstatement and to bind itself to the terms set forth in this Request.

6. Covenants and Continuing Obligations

If reinstated, Applicant covenants to comply with all continuing obligations and reporting requirements imposed by applicable law, regulation, or contract terms and acknowledges that failure to do so may result in subsequent administrative action by Respondent.

7. Indemnification and Costs

Applicant shall indemnify, defend and hold harmless Respondent and its officers, agents and employees from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of or relating to misrepresentations made by Applicant in this Request or the failure of Applicant to satisfy the conditions of reinstatement.

8. Notices

All notices, requests, consents, demands and other communications required or permitted under this Request shall be in writing and shall be delivered to the parties at the addresses set forth below or to such other address as a party may specify by written notice delivered in accordance with this section.

9. Governing Law; Venue

This Request shall be governed by and construed in accordance with the laws of the jurisdiction where Respondent maintains its principal administrative office, without regard to conflict of law principles. The parties agree that exclusive venue for any dispute arising under this Request shall lie in the courts of that jurisdiction.

10. Entire Agreement; Amendments; Waiver; Severability

This Request constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings. Any amendment to this Request must be in writing and executed by both parties. No failure or delay by a party in exercising any right under this Request shall operate as a waiver of that right. If any provision of this Request is determined to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

11. Counterparts

This Request may be executed in two or more counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument. Signatures transmitted by electronic means shall be effective to bind the signatory.

12. Certification

By signing below, Applicant certifies under penalty of perjury that the information contained herein and in any attachments is true, correct and complete, and that Applicant has the authority to request reinstatement. Respondent's signature below constitutes acceptance of this Request subject to the terms and conditions set forth herein and any additional conditions noted by Respondent at the time of acceptance.

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