Legal Stat Declaration

LEGAL STAT DECLARATION

This Legal Stat Declaration is made on by Declarant Name: of Address: and in favor of Recipient Name: of Address: .

RECITALS

WHEREAS, Declarant possesses knowledge of certain facts and circumstances relevant to the matters described in this Declaration and is competent to make a sworn declaration concerning those facts;

WHEREAS, Recipient requires a written declaration evidencing the stated facts for reliance in connection with business, administrative or legal proceedings; and

WHEREAS, Declarant has agreed to provide a statutory-style declaration under penalty of perjury to induce Recipient to act or refrain from acting as described herein.

NOW, THEREFORE, in consideration of the mutual covenants contained in this Declaration and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

1. DECLARATION

Declarant hereby declares, affirms and certifies under penalty of perjury that the factual statements set forth below are true, accurate and complete to the best of Declarant's knowledge, information and belief as of the date of this Declaration.

2. REPRESENTATIONS AND WARRANTIES

Declarant represents and warrants that: (a) Declarant is competent to make this Declaration; (b) Declarant has personal knowledge of the matters stated herein or has obtained those facts from reliable sources and believes them to be true; and (c) there are no material facts known to Declarant that have been omitted which would render this Declaration materially misleading.

3. USE AND RELIANCE

Recipient may rely upon this Declaration in making determinations, taking actions, or refraining from actions in reliance on the truth of the statements herein. Recipient's reliance shall be limited to the recipient named in the opening paragraph unless otherwise agreed in writing.

4. CONFIDENTIALITY

Unless otherwise agreed in writing, Recipient shall maintain the confidentiality of information designated in writing by Declarant as confidential and shall not disclose such confidential information except as required by law, regulation, or court order; provided that Recipient gives prompt written notice to Declarant of any compelled disclosure.

5. REMEDIES AND INDEMNITY

Declarant agrees to indemnify and hold Recipient harmless from and against any losses, liabilities, claims, damages, costs and expenses (including reasonable attorneys' fees) arising from any material misrepresentation or omission in this Declaration. All remedies provided herein are cumulative and in addition to any other remedies available at law or in equity.

6. NOTICES

Any notice or communication required or permitted by this Declaration shall be in writing and delivered to the address for each party set forth in the opening paragraph or to such other address as a party may designate in writing by notice delivered in accordance with this section. Notices shall be deemed given upon personal delivery, or three (3) business days after deposit in the mail by certified mail, return receipt requested.

7. AMENDMENTS; WAIVER

This Declaration may be amended only by a written instrument executed by both parties. No failure or delay by either party in exercising any right under this Declaration shall operate as a waiver of such right, nor shall any single or partial exercise of any right preclude any other or further exercise of that or any other right.

8. GOVERNING LAW

This Declaration shall be governed by and construed in accordance with the laws of the jurisdiction specified by the parties below, without regard to its conflicts of law principles.

9. ENTIRE AGREEMENT

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

10. SEVERABILITY

If any provision of this Declaration 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.

11. COUNTERPARTS; ELECTRONIC SIGNATURES

This Declaration may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. Signatures transmitted by electronic means shall be deemed originals for all purposes.

12. ACKNOWLEDGMENT

Declarant acknowledges that this Declaration is made knowingly and voluntarily, and that Declarant understands the legal consequences of making a false statement in a sworn or statutory declaration, including potential civil and criminal penalties.

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