Legal Swear and Affirmation

LEGAL SWEAR AND AFFIRMATION

This Legal Swear and Affirmation is made and entered into on by Affiant Name: (Affiant) and Recipient Name: (Recipient).

RECITALS

WHEREAS, Affiant is competent to make this sworn statement and has personal knowledge of the facts set forth herein, which are material to the matters described below;

WHEREAS, Recipient requires a written affirmation under oath or under penalty of perjury regarding the subject matter described as: to establish facts or support transaction, administrative, or legal action;

WHEREAS, the parties desire that the Affiant declare, swear or affirm the accuracy of the statements set forth in this instrument for reliance by Recipient and its authorized agents, successors and assigns.

NOW THEREFORE, in consideration of the foregoing recitals and the mutual covenants contained herein, the parties agree as follows:

1. DEFINITIONS

For purposes of this instrument, the following terms shall have the meanings set forth below unless the context otherwise requires:

"Affiant" means the person identified as Affiant Name in the opening paragraph who makes the sworn or affirmed statements herein.

"Recipient" means the person or entity identified as Recipient Name in the opening paragraph and any authorized representative who may reasonably rely on this affirmation.

2. NATURE OF AFFIRMATION

Affiant hereby declares and affirms, under oath or by solemn affirmation as indicated below, that the statements set forth in Section 3 are true and correct to the best of Affiant's knowledge, information and belief. Affiant acknowledges that this instrument is executed for use by Recipient and may be relied upon by Recipient, its agents, legal representatives, contractors and assigns.

Manner of declaration: Sworn under oath Affirmed (no religious oath)

3. STATEMENTS OF FACT

Affiant states, describes and verifies the following material facts and circumstances relevant to the Subject Matter:

4. VERIFICATION; PENALTIES

Affiant certifies under penalty of perjury that the foregoing statements are true and correct. Affiant acknowledges that knowingly making a false statement in a sworn document may expose Affiant to civil and criminal penalties, including but not limited to penalties for perjury under applicable law. Recipient may pursue any remedies available at law or in equity for material misstatements or fraudulent declarations.

5. REPRESENTATIONS AND WARRANTIES

Affiant represents and warrants that Affiant is competent to testify to the facts stated, that Affiant has personal knowledge of such facts where stated, and that Affiant has the full authority to execute this Legal Swear and Affirmation. Affiant further represents that no material fact has been intentionally omitted that would render the statements herein misleading.

6. RELIANCE; LIMITATION ON USE

Recipient may rely upon this affirmation for the specific purposes described in this document and for any related administrative, business or legal determinations. Recipient's reliance shall be limited to the contents of this instrument and any attachments expressly incorporated by reference. Recipient shall not construe this instrument as a guarantee of outcomes beyond the facts stated herein.

7. NOTICES

All notices under this instrument shall be in writing and shall be deemed given when delivered personally or sent by certified mail, return receipt requested, or other similarly reliable method, to the addresses set forth below or to such other address as either party designates by written notice to the other.

8. AMENDMENTS; WAIVER

No amendment of this Legal Swear and Affirmation shall be effective unless made in writing and signed by both Affiant and an authorized representative of Recipient. No waiver of any provision shall constitute a waiver of any other provision or of the same provision on any other occasion, unless in writing and signed by the party waiving compliance.

9. COUNTERPARTS; ELECTRONIC SIGNATURES

This document may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument. Electronic signatures and facsimile copies of signatures shall be treated as originals for all purposes.

10. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Legal Swear and Affirmation shall be governed by and construed in accordance with the laws of the state of without regard to conflicts of law principles.

This instrument contains the entire agreement of the parties with respect to the subject matter hereof and supersedes all prior agreements, understandings and communications, whether written or oral, relating thereto.

If any provision of this Legal Swear and Affirmation 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.

11. CERTIFICATION AND ATTESTATION

Affiant certifies under penalty of perjury that the statements contained in Section 3 are true and correct to the best of Affiant's knowledge and belief. Affiant further acknowledges that Affiant has read this instrument in full and understands the legal consequences of the declarations made herein.

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