Legal Witness Form

LEGAL WITNESS FORM

This Legal Witness Form is entered into by the undersigned parties on the date of witnessing. Client Name: , Client Address: (hereinafter "Signer"), and Witness Name: , Witness Address: (hereinafter "Witness"). Date of witnessing: Day Month Year .

RECITALS

WHEREAS, the Signer has requested that one or more signatures be witnessed in connection with one or more instruments, records or documents as described in Section 3 below; and

WHEREAS, the Witness represents that the Witness is competent, above the legal age required by applicable law, and capable of observing and attesting to the execution of the described document(s); and

WHEREAS, the parties desire to set forth in writing the Witness's attestation and certain representations, acknowledgments and obligations related to the witnessing.

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

1. DEFINITIONS

For purposes of this Form, "Document(s)" means the instrument(s), agreement(s), record(s) or other writing(s) identified in Section 3 that the Signer has executed in the Witness's presence on the Date of Witnessing.

2. WITNESS ATTESTATION

The Witness hereby affirms and attests that: (a) the Witness personally observed the Signer execute the Document(s) identified below; (b) at the time of execution the Signer appeared to be of sound mind and under no duress, undue influence or coercion; and (c) the signature(s) appearing on the Document(s) are the genuine signature(s) of the Signer.

3. DESCRIPTION OF DOCUMENT(S) WITNESSED

Title or Type of Document(s):

Date(s) of Document(s) (if different from Date of Witnessing): Day Month Year .

4. WITNESS REPRESENTATIONS AND WARRANTIES

The Witness represents and warrants to the Signer that: (a) the Witness is not a party to the Document(s) and has no direct pecuniary interest in the transaction evidenced by the Document(s) except as disclosed in writing; (b) the Witness has valid identification as set forth below; (c) the statements contained in this Form are true and correct to the best of the Witness's knowledge and belief; and (d) the Witness will provide further cooperation or testimony if reasonably required to authenticate the Document(s).

Witness Identification: ID Type: , ID Number: .

5. OATH OR AFFIRMATION

The Witness declares under penalty of perjury under the laws of the governing jurisdiction that the statements in this Form are true and correct. The Witness further affirms that the Witness understands the legal significance of attesting to the execution of the Document(s) and consents to this attestation.

6. ACKNOWLEDGEMENT OF IDENTIFICATION

The Witness acknowledges having examined the identification presented by the Signer and confirms that the identification appeared to be genuine at the time of witnessing. Description of identification presented by Signer:

7. INDEMNITY AND LIMITATION OF LIABILITY

The Signer agrees to indemnify, defend and hold harmless the Witness from and against any claim, loss or liability incurred by reason of the Witness's good faith performance of the duties described in this Form, except to the extent arising from the Witness's gross negligence or willful misconduct. The Witness's liability for any claim relating to this Form is limited to direct damages and shall not include consequential or punitive damages.

8. NOTICES

Any notice required or permitted under this Form shall be in writing and delivered to the addresses provided below:

9. AMENDMENTS; WAIVER

This Form 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 party granting the waiver.

10. GOVERNING LAW

This Form shall be governed by and construed in accordance with the laws of the jurisdiction where the Document(s) were executed, without regard to conflicts of law principles.

11. ENTIRE AGREEMENT

This Form contains the entire agreement between the parties relating to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and discussions, whether oral or written.

12. SEVERABILITY

If any provision of this Form is held invalid, illegal or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in full force and effect and the invalid provision shall be reformed to the minimum extent necessary to make it valid and enforceable.

13. COUNTERPARTS

This Form 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.

14. ADDITIONAL ACKNOWLEDGMENTS

The Witness acknowledges that the Witness has had the opportunity to ask questions concerning the purpose and effect of this Form and that the Witness signs voluntarily and without reservation.

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