Monthly Financial Verification

Monthly Financial Verification

Parties and Recitals

This Monthly Financial Verification Agreement (the Agreement) is made by and between Client Name: and Verifying Party Name: .

WHEREAS, Client requests that Verifier review and confirm Client's monthly financial information for the period set forth below to enable Client's application, compliance, or business decision-making; and

WHEREAS, Verifier has the capability and agrees, subject to the terms of this Agreement, to obtain and examine supporting documentation and to deliver a written verification report reflecting monthly income, regular expenditures, assets and liabilities; and

WHEREAS, the parties desire to set forth their respective responsibilities, scope, timing, compensation and confidentiality obligations in writing.

Verification Period

Verification Period Start Date:    End Date:    Reporting Month: Year:

Scope of Work

Financial Information to be Verified

Total Monthly Net Income: $

Amount: $    Frequency:

Amount: $    Frequency:

Supporting Documents

Required documents (check all provided):

Recent pay stubs (last 2 months)

Bank statements (last 2 months)

Recent tax returns (if applicable)

Other supporting documents    Describe:

Payment Terms

Verification Fee: $. Payment Schedule: Late Fee: for overdue balances.

Client agrees to pay all reasonable costs of collection, including attorneys' fees and court costs, if payment is not made as required by this Agreement.

Term and Termination

Term Commencement Date: . Termination Date (if applicable): .

Either party may terminate this Agreement for material breach or upon written notice no less than days prior to the intended termination date. Termination does not relieve Client of payment obligations for services performed prior to termination.

Confidentiality

Verifier shall treat all non-public information obtained in connection with this verification as Confidential Information and shall not disclose such information except (a) as necessary to perform the services under this Agreement, (b) with Client's prior written consent, or (c) as compelled by law, provided Verifier gives Client prompt notice of such requirement where permitted. Confidential Information does not include information that is or becomes publicly available other than through breach of this Agreement.

Authorization and Certification

Client hereby authorizes Verifier to obtain and review the supporting documents listed above and to contact employers, financial institutions, and other relevant third parties as reasonably necessary to verify the financial information provided. Client certifies that the information and documents provided to Verifier are true, accurate and complete to the best of Client's knowledge, and that no material fact has been omitted.

Client acknowledges that Verifier may rely upon the information provided and that Verifier's role is solely to confirm the existence and amounts of the items specified herein. Verifier makes no representations or warranties, express or implied, concerning Client's financial stability or future financial performance.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles.

Entire Agreement

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous communications, proposals, representations and agreements, whether oral or written. Any amendment or modification to this Agreement must be in writing and signed by both parties.

Indemnification

Client agrees to indemnify, defend and hold harmless Verifier and its officers, directors, employees and agents from and against any claims, liabilities, losses, damages and expenses (including reasonable attorneys' fees) arising out of Client's breach of this Agreement, the submission of false or misleading information, or Client's negligent acts or omissions.

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