Legal Signature Card

LEGAL SIGNATURE CARD

This Legal Signature Card (the "Card") is entered into as of this date: by and between Organization Name: with principal place of business at ("Organization") and Authorized Signatory Name: of Address: ("Signatory").

RECITALS

WHEREAS, Organization requires a record of the specimen signature and authority of individuals authorized to execute documents and to bind Organization in transactions and administrative matters; and

WHEREAS, Signatory desires to provide an official specimen of his or her signature and to be designated as an authorized signatory for the purposes set forth herein; and

WHEREAS, the parties intend that this Card be relied upon by the Organization, its agents, financial institutions, and other third parties to verify and authenticate signatures and authority until revoked in writing in accordance with this Card.

NOW, THEREFORE

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

1. DEFINITIONS

For purposes of this Card, the following terms shall have the meanings set forth below: "Authorized Instruments" means any checks, drafts, negotiable instruments, contracts, agreements, certificates, notices, filings, account documents, and other writings that Organization directs Signatory to execute or that Signatory is authorized to execute on behalf of Organization.

2. AUTHORITY AND SCOPE

Organization hereby certifies that Signatory is authorized to execute Authorized Instruments on behalf of Organization in the ordinary course of Organization's business, subject to any limitations set forth in Section 4. Persons and entities relying in good faith upon the specimen signature(s) provided on this Card shall be fully protected and entitled to act thereon until Organization provides written notice of revocation in accordance with Section 9.

3. SPECIMEN SIGNATURES

Signatory sets forth below the specimen signature(s) which are the genuine signatures of the person(s) authorized to act for Organization. The signatory certifies that the signature(s) are current and official.

4. LIMITATIONS OF AUTHORITY

Signatory's authority is subject to the following express limitations: Signatory may bind Organization in transactions and execute Authorized Instruments up to the amount of $ unless otherwise approved in writing by Organization's governing body. Any limitation specified on internal authorization records held by Organization controls external reliance only to the extent Organization provides such records to the relying party.

5. REPRESENTATIONS AND WARRANTIES

Each party represents and warrants that it has full corporate or organizational power and authority to enter into this Card and to perform the obligations hereunder. Organization represents that the persons executing this Card on its behalf are duly authorized to do so and that the specimen signatures provided are authentic.

6. INDEMNIFICATION

Organization shall indemnify, defend, and hold harmless any third party that in good faith relies upon the specimen signature(s) against any loss, liability, claim, damage, or expense (including reasonable attorneys' fees) arising from such reliance, except to the extent such loss results from that third party's gross negligence or willful misconduct.

7. RECORDS; RETENTION

Organization shall maintain a copy of this Card in its official records and will make reasonable efforts to provide notice of any revocation or amendment to persons and institutions known to rely upon this Card. Absent receipt of written notice, third parties may rely upon the current Card retained by Organization.

8. NOTICES

All notices, requests, consents and other communications hereunder shall be in writing and delivered to the addresses set forth below or such other address as either party may designate by notice in accordance with this Section. Notices shall be deemed given when personally delivered, one business day after deposit with a nationally recognized overnight carrier, or three business days after deposit in the mail.

9. AMENDMENT; REVOCATION; WAIVER

This Card may be amended, supplemented, or revoked only by a written instrument signed by an authorized representative of Organization. No waiver of any provision of this Card shall be effective unless in a writing signed by the waiving party.

10. COUNTERPARTS

This Card may be executed in two or more counterparts, each of which will be deemed an original, and all of which together will constitute one and the same instrument. Facsimile or electronic image signatures shall be treated as originals.

11. GOVERNING LAW

This Card shall be governed by and construed in accordance with the internal laws of the state or jurisdiction of Organization's formation without regard to conflicts of law principles.

12. ENTIRE AGREEMENT

This Card constitutes the entire agreement between the parties concerning the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written.

13. SEVERABILITY

If any provision of this Card is held to be invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

ADDITIONAL ADMINISTRATIVE INFORMATION

Corporation Limited Liability Company Partnership

Sole Proprietorship Other:

CERTIFICATION

The undersigned certifies under penalty of perjury that he/she is authorized to execute this Card on behalf of Organization and that the information and specimen signature(s) contained herein are true, complete and accurate to the best of his/her knowledge.

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