Can the form be signed electronically?

Yes. Electronic signatures are legally valid in the United States under ESIGN and UETA when intent, consent, attribution, and retention are demonstrated. Ensure consumer disclosures where required and retain the audit trail for evidentiary support.

Do I need a notary or witnesses?

Notarization or witnesses depend on state law and the transaction's nature. Many contracts do not require notarization, but certain filings or jurisdictional rules may. Verify local requirements and consider Remote Online Notarization where permitted.

What level of signer authentication is recommended?

Use email or SMS code for low-risk matters; adopt knowledge-based authentication, ID credentialing, or multi-factor methods for higher-risk transactions. Stronger authentication and retained audit data increase evidentiary weight.

Which supporting documents should be attached?

Attach relevant contracts, prior referral records, fee schedules, W-9s if taxpayer identification is required, and any exhibits supporting exceptions. Label and reference exhibits clearly to preserve context and enforceability.

How long must I retain executed forms?

Retain executed forms for the full agreement term and at least three years after termination for general records. Healthcare matters generally require six years; tax, real estate, or regulatory records may require longer retention.

What if signer names or TINs do not match?

Name or TIN mismatches can create authority or tax-reporting problems. Correct via amendment, attach explanatory documentation or identification, and consider re-execution to eliminate ambiguity and reduce enforcement risk.

Electronic Signature
Templates
Miscellaneous
Miscellaneous Anti Steering Form

Miscellaneous Anti Steering Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

MISCELLANEOUS ANTI STEERING FORM

Parties

Client Name: Company / Provider Name: Primary Contact & Address:

Recitals

WHEREAS, Company provides advisory, brokerage, placement or procurement services in the ordinary course of its business and may propose multiple product or service options to the Client; and

WHEREAS, Client desires to receive information and recommendations from Company and to confirm that Company will not direct, recommend, or otherwise steer Client to any product or service based primarily upon compensation arrangements rather than Client's best interest; and

WHEREAS, the parties wish to memorialize their respective duties, disclosures and remedies regarding steering and compensation.

Scope of Work

Services to be provided (describe in detail):

Anti-Steering Representations and Acknowledgements

Company represents, warrants and covenants that in making recommendations or presenting options to Client it shall not steer Client toward any product, service, vendor or transaction for the primary purpose of obtaining greater compensation, commission or other financial benefit to Company, its employees, agents or affiliates.

Company will disclose in writing any direct or indirect compensation arrangements for each option presented, including any fees, commissions, overrides, or contingent payments that reasonably could influence the recommendation.

Client acknowledges receipt of a written summary of available options and compensation disclosures and confirms that such disclosures were provided prior to selection of any option below.

Acknowledgements (check all that apply):

I acknowledge I received a written compensation disclosure prior to selection.

I acknowledge that reasonable alternatives were presented and explained.

Company affirms it did not condition recommendations solely on the basis of its compensation.

Payment Terms

Total Fee / Amount Payable: Payment Schedule (timing and method): Late Payment Fee:

Term and Termination

This Agreement commences on and shall continue until unless earlier terminated in accordance with this Section.

Either party may terminate this Agreement for convenience upon written notice to the other party delivered not fewer than days prior to the effective date of termination. Termination for cause is permitted immediately upon written notice upon material breach subject to any cure period expressly provided.

Confidentiality

"Confidential Information" means non-public information disclosed by one party to the other, whether disclosed orally, in writing, or by inspection, that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure. Confidential Information excludes information that is (a) known to the receiving party prior to disclosure without obligation of confidentiality, (b) becomes publicly available through no fault of the receiving party, (c) is rightfully received from a third party without obligation of confidentiality, or (d) is independently developed by the receiving party without use of the disclosing party's Confidential Information.

Each party agrees to maintain the confidentiality of the other's Confidential Information using at least the same degree of care it uses to protect its own confidential information, but in no event less than reasonable care. Disclosure permitted by law or compelled by a court or regulatory authority is allowed provided, where lawful, prior written notice is given to the disclosing party to permit protective measures.

Indemnity and Remedies

Company shall indemnify and hold harmless Client from and against any and all losses, claims, liabilities, damages and expenses (including reasonable attorney fees) arising from a material breach of the anti-steering representations or from any undisclosed compensation arrangements that materially influenced the recommendation. Remedies provided herein are cumulative and in addition to any rights available at law or in equity.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the jurisdiction indicated below without regard to conflicts of law principles.

Governing Jurisdiction:

Entire Agreement

This Agreement, together with any exhibits, schedules and written disclosures executed or delivered pursuant hereto, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, communications and understandings, whether written or oral. Any modification must be in writing and signed by authorized representatives of both parties.

Acknowledgement and Certification

By signing below, Company certifies that it has disclosed in writing all compensation arrangements that reasonably could influence its recommendations. Client acknowledges receipt of disclosures and confirms that Company provided reasonable alternatives consistent with Client's stated objectives. Both parties confirm they have authority to enter into this Agreement.

Company — Printed Name:

By (Signature):

Date:

Client — Printed Name:

By (Signature):

Date:

What the Miscellaneous Anti Steering Form Is

The Miscellaneous Anti Steering Form documents an agreement between parties to prohibit steering or referral practices that could influence a consumer's selection of vendors, providers, or service channels. It identifies the parties, effective date, specified prohibited conduct, permitted exceptions, remedies for breach, and signature blocks. The form can be executed on paper or electronically where signers demonstrate intent and consent. This guide covers required fields, step-by-step completion, state variations, supporting documents, retention expectations, and considerations for secure electronic signing.

Why Use this Form

A Miscellaneous Anti Steering Form clarifies acceptable referral conduct, reduces conflicts of interest, and documents remedies for violations. It supports contractual and regulatory compliance and produces an auditable record that can be relied on in disputes, audits, or internal reviews.

Who Typically Completes and Reviews This Form

Typical users who complete or require this form include procurement managers, vendor compliance officers, and legal counsel in regulated industries.

Procurement managers enforcing vendor selection policies and documenting exceptions across internal departments.
Vendor compliance officers reviewing referral arrangements, disclosures, and adherence to contract terms.
In-house counsel or outside attorneys advising on enforceability and drafting enforcement provisions.

The form is also relevant to auditors, contract administrators, and business owners responsible for monitoring referral and vendor-selection policy adherence.

Signatory Roles and Typical Profiles

Company Signatory

A senior officer with authority to bind the organization should sign on the company's behalf. Include title and corporate capacity (for example, Chief Procurement Officer). If authority is delegated, attach a board resolution or power of attorney to document signing authority.

Individual Signatory

When an individual (consultant or referrer) signs, provide full legal name, contact information, and taxpayer identification if required. The signer should confirm intent and consent to electronic execution and verify identity per the form's authentication requirements.

Security and Compliance Features to Note

Encryption (in transit): TLS 1.2 and 1.3 transport encryption

Encryption (at rest): AES-256 encryption for data at rest

Certifications: SOC 2 Type II and ISO 27001 certified

Privacy Controls: GDPR and CCPA privacy controls enforced

Healthcare: HIPAA compliant; BAA available upon request

Regulatory Support: ESIGN and UETA recognized; 21 CFR Part 11 support

Key Risks and Potential Consequences

Contract Remedies: Damages and injunctive relief

Regulatory Fines: Agency penalties if noncompliant

Reputational Risk: Client trust and referral decline

Enforceability Risk: Invalid if signatures are defective

Tax Withholding: Backup withholding if TIN missing

Recordkeeping Penalties: Fines for retention violations

Common Preparation Mistakes to Avoid

Failing to define prohibited activities precisely, leaving ambiguity about what constitutes steering and creating enforcement challenges and disputes.
Not recording effective dates or execution order, which can create conflicts about which version controls and when obligations take effect.
Using inconsistent party names or omitting corporate capacity, causing signatory authority questions and potential invalidation of the form.
Skipping authentication steps for electronic signatures and failing to retain audit trails undermines enforceability in court or arbitration.

Step-by-Step: Completing the Form

Complete the form in order: identify parties, state prohibitions, specify the effective date, obtain signatures, and distribute executed copies to stakeholders.

01

Identify Parties: Enter full legal names and contact details.
02

State Prohibitions: Describe prohibited steering practices precisely.
03

Effective Date: Use MM/DD/YYYY; determines enforcement start.
04

Sign & Distribute: All signatories sign, date, and receive copies.

Typical Processing Flow

This outlines common routing: drafting, internal approvals, execution, and archival to support auditability and compliance.

Draft: Prepare terms, exceptions, and remedies.
Approve: Legal and procurement review and sign-off.
Execute: Signatures collected physically or electronically with authentication.
Archive: Store executed copies with audit trail for retention.

Core Sections Every Professional Form Should Include

A professional Miscellaneous Anti Steering Form organizes parties, prohibited conduct, exceptions, remedies, dates, and execution details to ensure clarity and enforceability.

Parties

Identify contracting entities and individuals with full legal names, organizational capacity, contact information, and a designated compliance coordinator for notices; specify whether agents, affiliates, or subcontractors are covered by the restrictions.

Prohibited Conduct

List specific steering behaviors that are prohibited, such as directed referrals, undisclosed incentives, mandated vendor lists, or any practice that limits a party's free choice of provider or vendor.

Permitted Exceptions

Enumerate reasonable exceptions such as preexisting contracts, disclosed referral fees, regulatory obligations, or activities expressly permitted under separate written agreements, and require documentation for any claimed exception.

Remedies

Specify remedies for breach including injunctive relief, damages calculation methodology, termination rights, reimbursement of compliance costs, and the chosen dispute resolution process.

Effective Date

Record when the agreement takes effect, whether obligations survive termination, clarify retroactivity, and specify triggers for renewal or automatic extension if applicable.

Signature Block

Provide signature blocks for each party with printed name, title, date, and space for witness or notary acknowledgment when required by state law or company policy.

Configuring an Online Completion Workflow

Configure an e-submission workflow to set authentication, signing type, audit trail capture, file format, and retention policies before sending.

Field	Configuration
Authentication	Email link or SMS code; optional knowledge-based authentication
Signature Type	Typed name, drawn signature, or digital certificate options
Audit Trail	Capture IP address, timestamp, and action history
Retention Format	Store signed PDF/A with certificate and metadata

Platform and File Requirements

Compatible platforms include desktop and mobile browsers, native mobile apps, and integration endpoints for common cloud storage and CRM systems.

Browsers: Modern Chrome, Edge, and Safari supported
Integrations: Salesforce, NetSuite, Microsoft 365 integrations
File Types: PDF, DOCX, and HTML formats accepted

Key Timing and Notice Considerations

Key timing considerations include response windows, effective date, notice periods for amendments, and retention start dates for compliance and audit purposes.

Provide form promptly upon written request:

Supply to requesting party within the contractual timeframe.

Required amendment notice period before changes:

Specify notice period for changes, for example 30 days.

Clarify effective date versus execution date:

State whether effective date is signing date or a later specified date.

Set a signature completion window:

Set a deadline by which all required signatures must be obtained.

Record Retention Start Date Policy:

Retention begins on effective date or signing; specify which applies.

Export, Exhibits, Versions, and Secure Storage

Useful features include export formats, attached exhibits, version control, granular access, and secure archival copies for auditability and long-term storage.

Export Formats

Provide signed copies in PDF/A for archival, standard PDF for distribution, and DOCX for editable internal copies; include an audit certificate that records signer identity and timestamps for verification.

Supporting Exhibits

Attach vendor agreements, prior referral records, fee schedules, or required disclosures that substantiate exceptions; clearly label all exhibits and reference them in the main form for enforceability.

Version Control

Record version numbers, revision dates, and approver names on each iteration; maintain change logs and restrict editing to authorized users to prevent conflicting versions.

Secure Copies

Store original executed files in tamper-evident format with metadata, maintain redundant backups, and enforce role-based access controls combined with encryption.

eSignature Pricing and Feature Comparison

Basic pricing and common feature differences across vendors to consider for executing the Miscellaneous Anti Steering Form electronically.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently Asked Questions

Answers to frequent questions about completing, signing, and enforcing the Miscellaneous Anti Steering Form, including electronic execution and recordkeeping.

Need help? Contact support

Can the form be signed electronically?
Yes. Electronic signatures are legally valid in the United States under ESIGN and UETA when intent, consent, attribution, and retention are demonstrated. Ensure consumer disclosures where required and retain the audit trail for evidentiary support.
Do I need a notary or witnesses?
Notarization or witnesses depend on state law and the transaction's nature. Many contracts do not require notarization, but certain filings or jurisdictional rules may. Verify local requirements and consider Remote Online Notarization where permitted.
What level of signer authentication is recommended?
Use email or SMS code for low-risk matters; adopt knowledge-based authentication, ID credentialing, or multi-factor methods for higher-risk transactions. Stronger authentication and retained audit data increase evidentiary weight.
Which supporting documents should be attached?
Attach relevant contracts, prior referral records, fee schedules, W-9s if taxpayer identification is required, and any exhibits supporting exceptions. Label and reference exhibits clearly to preserve context and enforceability.
How long must I retain executed forms?
Retain executed forms for the full agreement term and at least three years after termination for general records. Healthcare matters generally require six years; tax, real estate, or regulatory records may require longer retention.
What if signer names or TINs do not match?
Name or TIN mismatches can create authority or tax-reporting problems. Correct via amendment, attach explanatory documentation or identification, and consider re-execution to eliminate ambiguity and reduce enforcement risk.

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