Legal Signature Application

LEGAL SIGNATURE APPLICATION

Applicant Name:   Entity Type: Individual Corporation LLC Partnership Other

Approving Authority Name:   Title:

RECITALS

WHEREAS, Applicant seeks formal designation and approval to execute certain documents and instruments on behalf of Applicant or on behalf of entities under Applicant's control, subject to the terms set forth herein; and

WHEREAS, Approving Authority has the power to grant, limit, and record signature authority and requires documentation evidencing the scope, limitations, and methods of such authority; and

WHEREAS, the parties desire to establish a binding order and certification authorizing specified signature methods and defining associated responsibilities and liabilities.

NOW THEREFORE

In consideration of the mutual covenants and conditions contained herein, Applicant and Approving Authority hereby agree as follows.

1. DEFINITIONS

For purposes of this Application: "Authorized Signatory" means the person nominated by Applicant and approved by Approving Authority to sign documents; "Documents" means contracts, certificates, agreements, financial instruments, filings, or other writings identified in Section 3.

2. APPOINTMENT AND APPROVAL

Applicant nominates the following individual as Authorized Signatory: Name:   Title:

Approving Authority, by executing below, grants approval for the person named above to act as Authorized Signatory within the scope set forth in Section 3, subject to the limitations and conditions herein.

3. SCOPE OF AUTHORITY

Maximum single-transaction authority (if applicable): $   Cumulative periodic limit (specify period):

4. SIGNATURE METHODS

The following signature methods are authorized for use by the Authorized Signatory (check all that apply):

Wet ink signature Electronic signature Digital certificate

Use of electronic or digital signatures shall be consistent with applicable law and internal policy; the Authorized Signatory is responsible for ensuring authenticity and retention of underlying records that establish authority and intent.

5. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants that (a) the person named as Authorized Signatory is duly authorized by Applicant to perform the acts described herein; (b) the execution of Documents by the Authorized Signatory in the authorized manner will bind Applicant to the same extent as if executed by Applicant in person; and (c) no other authorization inconsistent with this Application exists as of the Effective Date.

6. RECORDS, AUDIT, AND RETENTION

Applicant will maintain records evidencing authority and all instruments executed under this Application for a minimum of five (5) years, or such longer period as required by law, and shall permit Approving Authority reasonable inspection of such records upon request.

7. LIMITATIONS, INDEMNITY AND LIABILITY

The Authorized Signatory shall not exceed the scope or limits set forth herein. Applicant agrees to indemnify and hold harmless Approving Authority from any loss, liability, or expense arising from acts of the Authorized Signatory beyond the authority granted, or from unauthorized use of signature methods, except to the extent caused by Approving Authority's gross negligence or willful misconduct.

8. TERM; TERMINATION

This Application is effective as of: and shall continue until revoked in writing by Applicant or Approving Authority in accordance with Section 9.

9. NOTICES

Notices shall be in writing and shall be effective upon receipt when delivered personally, by certified mail, or by documented courier to the addresses set forth above or such other address as either party may designate in writing.

10. AMENDMENT; WAIVER; COUNTERPARTS

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

11. GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

Governing Law: This Application shall be governed by and construed in accordance with the laws of the state of , without regard to conflict of laws principles.

Severability: If any provision of this Application is held invalid or unenforceable, the remaining provisions shall continue in full force and effect and shall be construed so as to effectuate the original intent to the greatest extent permitted by law.

Entire Agreement: This Application constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior oral and written agreements, representations, and understandings.

12. CERTIFICATION

The undersigned certify under penalty of perjury and corporate authorization, where applicable, that the information provided in this Application is true, that the Authorized Signatory identified herein has been duly nominated by Applicant, and that the execution of this Application and any documents executed pursuant to it are within the authority of the signatories.

Sign Now