Legal Threats Form

LEGAL THREATS REPORT AND NOTICE ACKNOWLEDGMENT

This Legal Threats Report and Notice Acknowledgment (the Agreement) is made and entered into by and between Reporting Party Name: and Recipient Party Name: with an Effective Date of:

RECITALS

WHEREAS, Reporting Party believes that one or more communications or conduct received by Reporting Party constitute unlawful threats or intimidation directed toward Reporting Party's person, property, or lawful interests; and

WHEREAS, Recipient Party is an individual, employer, organization, or designated recipient authorized to receive notification of incidents and to take reasonable steps to preserve evidence and respond as required by law; and

WHEREAS, the parties desire to document the reported threats, clarify the parties' respective obligations with respect to preservation, notice, and potential legal remedies, and set forth the mutual acknowledgments below.

NOW, THEREFORE

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

1. REPORT OF THREATENING INCIDENT(S)

1.1 Date(s) of Incident(s):

1.2 Time(s):    Location(s):

2. REPRESENTATIONS AND CERTIFICATIONS

2.1 Reporting Party certifies under penalty of perjury that the information provided in this Report is true, complete and based on the Reporting Party's personal knowledge to the best of Reporting Party's information and belief. Reporting Party understands that knowingly making a false statement may subject Reporting Party to civil or criminal liability.

2.2 Recipient Party acknowledges receipt of this Report for the purpose of investigation and preservation of evidence and represents that it will treat the Report in accordance with applicable law and internal policies.

3. PRESERVATION OF EVIDENCE

3.1 Recipient Party shall take all reasonable steps to preserve physical, electronic, and documentary evidence reasonably related to the reported threat, including but not limited to communications records, logs, surveillance footage, access records, and device data. Recipient Party shall not alter, delete, or destroy such evidence pending reasonable notice of an investigation or legal process.

3.2 If Recipient Party receives a request by law enforcement or a court for the same evidence, Recipient Party shall promptly notify Reporting Party in writing, unless prohibited by law.

4. DEMAND AND NOTICE OF INTENT

4.1 Reporting Party hereby expressly demands that any threatening conduct cease immediately. Reporting Party reserves the right to pursue criminal prosecution, injunctive relief, statutory damages, compensatory and punitive damages, and attorney's fees to the fullest extent permitted by law.

4.2 Indicate Reporting Party's requested remedies (check all that apply):

5. COOPERATION AND INVESTIGATION

5.1 The parties agree to cooperate in any lawful investigation arising from the reported threats, including interviews, document production, and testimony. Cooperation shall be conducted in a manner that protects privileged information and does not waive legal protections absent explicit written waiver.

5.2 Recipient Party shall, to the extent permitted by law, provide a written acknowledgment of receipt within five (5) business days and an interim status update within fifteen (15) business days describing actions taken to preserve evidence and investigate the matter.

6. CONFIDENTIALITY AND PRIVACY

6.1 Except as required by law, Recipient Party shall not disclose the contents of this Report or any non-public information related to the investigation to unauthorized third parties. Nothing in this Agreement prevents reporting to law enforcement, legal counsel, or as otherwise legally obligated.

7. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses and contacts set forth below by certified mail, courier, hand delivery, or electronic delivery with confirmation:

8. AMENDMENT, WAIVER, COUNTERPARTS

8.1 This Agreement may be amended only by a written instrument executed by both parties. No waiver of any provision shall be effective unless in writing and signed by the waiving party. The failure of either party to enforce any right shall not constitute a waiver of future enforcement of that right.

8.2 This Agreement 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 or facsimile signatures shall be binding for all purposes.

9. GOVERNING LAW; SEVERABILITY; ENTIRE AGREEMENT

9.1 This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction selected by the parties: , without regard to conflict of laws principles.

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

9.3 This Agreement 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. ADDITIONAL INFORMATION

Sign Now