Legal Verification Request

LEGAL VERIFICATION REQUEST

This Legal Verification Request (the "Request") is made on Date: by and between Requesting Party: and Verifying Party: .

RECITALS

WHEREAS, Requesting Party seeks verification of certain facts, records, or the authenticity of specified documents concerning Subject: , Date of Birth: , for use in legal, regulatory, or transactional matters; and

WHEREAS, Verifying Party maintains or controls records, personnel, or systems reasonably necessary to provide the requested verification and is willing to provide such verification subject to the terms and conditions set forth herein; and

WHEREAS, the parties desire to set forth the scope, procedures, use limitations, and responsibilities with respect to the requested verification.

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

1. DEFINITIONS

For purposes of this Request, the following definitions apply: "Verification" means the confirmation by Verifying Party of facts, records, document authenticity, employment or account status, or other items expressly requested in Section 2. "Subject" means the individual or entity identified above. "Confidential Information" means information designated as confidential by either party or that reasonably should be understood to be confidential given its nature.

2. REQUEST FOR VERIFICATION

Requesting Party hereby requests that Verifying Party provide one or more of the following verifications (select applicable items and supplement with required details):

3. SCOPE, FORMAT AND TIMING

Verifying Party shall make a commercially reasonable effort to provide written verification in a signed and dated format, delivered by the method agreed in Section 9, within Number of Days: calendar days from receipt of this Request and any required releases or fees. Verification shall identify the records reviewed and the basis for any conclusions.

4. SUBJECT AUTHORIZATION

Requesting Party represents and warrants that it has obtained, or will obtain and deliver to Verifying Party prior to the release of information, a valid written authorization from the Subject permitting the requested verification and release of information to Requesting Party and its counsel. Indicate whether a release is attached: Release attached.

5. CONFIDENTIALITY AND PERMITTED USE

All Verifications, underlying records, and communications hereunder constitute Confidential Information. Requesting Party shall use Verifications solely for the purpose stated in this Request and shall not disclose Confidential Information to third parties except: (a) to its legal counsel, insurers, auditors or as compelled by law; or (b) with the prior written consent of Verifying Party. Any permitted disclosure shall require reasonable protective measures and, where appropriate, a protective order.

6. FEES AND PAYMENT

Unless otherwise agreed in writing, Requesting Party shall reimburse Verifying Party for reasonable fees and expenses incurred in providing the Verification. If fees apply, indicate billing contact and purchase order or reference:

7. INDEMNIFICATION

Requesting Party shall indemnify, defend and hold harmless Verifying Party and its officers, directors and employees from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of Requesting Party's use, dissemination or retention of any of the Verifying Party's responses or records, except to the extent caused by Verifying Party's gross negligence or willful misconduct.

8. REPRESENTATIONS AND WARRANTIES

Each party represents that (a) it has the full right, power and authority to enter into this Request and to perform its obligations; and (b) the person executing this Request on its behalf is duly authorized to bind it. Verifying Party further represents that any information provided will be accurate to the best of its knowledge as of the date of issuance, based on the records reviewed.

9. NOTICES

All notices required or permitted under this Request shall be in writing and delivered by hand, overnight courier, or certified mail to the address for each party set forth below or to such other address as a party may designate in writing.

10. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Request shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles. This Request constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior proposals, agreements, or understandings. If any provision of this Request is held invalid or unenforceable, that provision shall be reformed to the extent necessary and the remaining provisions shall remain in full force and effect.

11. AMENDMENTS, WAIVER, COUNTERPARTS

No amendment or waiver of any provision of this Request shall be effective unless in writing and signed by both parties. The failure of either party to enforce any provision shall not constitute a waiver. This Request 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.

12. ATTACHMENTS

The following documents are attached and incorporated by reference: list attachments, releases, copies of documents to be verified and any fee schedules.

EXECUTION

The parties have caused this Legal Verification Request to be executed by their duly authorized representatives as of the date first written above.

Sign Now