Legal Unsigned Application

LEGAL UNSIGNED APPLICATION

This Legal Unsigned Application (the "Application") is made on by and between Applicant Name: and Recipient Name: (each a "Party" and together the "Parties").

RECITALS

WHEREAS, Applicant seeks to submit information and requests authorization from Recipient to evaluate, process, or provide legal or administrative services in connection with the matter described in Section 2 below; and

WHEREAS, Recipient is willing to accept, review, and process Applicant's submission subject to the terms, representations, and certifications set forth in this Application; and

WHEREAS, the Parties desire to establish the terms on which the Application will be considered pending execution of any subsequent engagement, agreement, or authorization.

NOW, THEREFORE, in consideration of the mutual covenants contained herein, the Parties agree as follows:

1. DEFINITIONS

For purposes of this Application: (a) "Application Materials" means all documents, statements, attachments, exhibits, and other information submitted by Applicant to Recipient in connection with this Application; (b) "Confidential Information" means non-public information identified as confidential in accordance with Section 5.

2. PURPOSE AND SCOPE OF APPLICATION

Nature of Request:

3. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants that: (a) all information submitted in the Application Materials is true, complete, and correct to the best of Applicant's knowledge as of the date signed; (b) Applicant has authority to provide the Application Materials and to permit Recipient to review and rely upon them; and (c) no information has been omitted that would make the Application Materials misleading.

4. AUTHORIZATIONS AND CONSENTS

Applicant hereby authorizes Recipient to request, obtain, and review records and information reasonably necessary to evaluate the Application, including but not limited to public records, third-party reports, and other documents identified in the Application Materials. Applicant further authorizes third parties to disclose such records to Recipient.

Applicant expressly authorizes the release of:

5. CONFIDENTIALITY

Recipient will treat Application Materials as Confidential Information and will not disclose such materials except to the extent required by law, to internal personnel with a need to know, or as otherwise authorized in writing by Applicant. Confidential Information does not include information that is or becomes publicly available other than by breach of this Application.

6. FEES AND EXPENSES

Submission of this Application does not by itself create an obligation to retain Recipient or to pay fees. Applicant acknowledges that Recipient may require a separate written engagement agreement that will set forth fees, retainers, and expense reimbursement. Applicant agrees to pay any fees or costs expressly set forth in a separate engagement agreement.

7. ATTACHMENTS AND SUPPORTING DOCUMENTS

Check all attachments included with this Application:

Government-issued identification
Financial statements or records
Court documents or pleadings
Other supporting documents (describe below)

8. NOTICES

All notices required or permitted under this Application shall be in writing and shall be deemed given when delivered by hand, by electronic mail confirmed in writing, or three business days after deposit in the mail, postage prepaid, addressed to the notices address provided above.

9. REPRESENTATIVE CAPACITY AND AUTHORITY

If Applicant signs on behalf of an entity or another individual, Applicant represents that he or she has full legal authority to bind that entity or individual and will provide documentation evidencing such authority upon request.

10. CERTIFICATIONS; PENALTIES

Applicant certifies that the Application Materials are true and correct to the best of Applicant's knowledge and belief. Applicant acknowledges that knowingly submitting materially false information in connection with this Application may result in denial, rescission of any engagement, and may expose Applicant to civil or criminal penalties under applicable law.

Applicant's Certification: I certify under penalty of law that the foregoing is true and correct.

Acknowledgment of Receipt: Recipient acknowledges receipt of the Application Materials for review only and may require additional documentation prior to any further action.

11. AMENDMENTS; WAIVER; COUNTERPARTS

This Application may be amended only by a written instrument executed by both Parties. No failure or delay by either Party in exercising any right shall operate as a waiver. This Application may be executed in counterparts, each of which shall be an original and all of which together shall constitute one instrument.

12. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

Governing Law: This Application shall be governed by and construed in accordance with the laws of the applicable jurisdiction in which Recipient maintains its principal place of business, without regard to conflict of law principles.

Entire Agreement: This Application constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior understandings and communications.

Severability: If any provision of this Application is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

ADDITIONAL INFORMATION

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