Owner Information Form

OWNER INFORMATION FORM AND BUSINESS AGREEMENT

Effective Date:

Parties and Recitals

Owner Name: | Title/Role:

Company / Client Name:

WHEREAS, Owner represents that Owner is the duly authorized owner or authorized representative of the business identified above and possesses the authority to provide the information and to enter into the terms set forth in this document;

WHEREAS, the parties intend for the Owner to perform services or to provide information as described in the Scope of Work below and to set forth payment, confidentiality, and term provisions governing that relationship;

NOW, THEREFORE, in consideration of the mutual covenants set forth below, the parties agree as follows.

Owner Information

Individual Corporation LLC Partnership Trust Other

Scope of Work

The Owner shall perform or provide the services and deliverables described below. The description below is incorporated into this Agreement and defines the Owner's responsibilities, deliverables, milestones, and acceptance criteria.

Payment Terms

Compensation for the services shall be as set forth below. Unless otherwise agreed in writing, invoices rendered by Owner are due in accordance with the schedule below. Late payments shall accrue interest and may give rise to suspension of services.

Term and Termination

This Agreement shall commence on the Start Date and shall continue in effect until the End Date unless earlier terminated in accordance with this section.

Start Date:    End Date:

Either party may terminate this Agreement for material breach if the breaching party fails to cure the breach within days after written notice specifying the breach.

Confidentiality

Each party acknowledges that in the course of performance it may receive Confidential Information of the other party. "Confidential Information" means non-public information disclosed in writing or identified at disclosure as confidential, or by its nature should reasonably be understood as confidential. The receiving party shall: (a) use Confidential Information solely for the performance of this Agreement; (b) restrict disclosure to those employees or contractors who have a need to know and who are bound by confidentiality obligations at least as protective as those herein; and (c) not disclose Confidential Information to third parties without prior written consent. Confidential Information does not include information that is or becomes publicly available without breach, was known to the receiving party prior to disclosure, or is required to be disclosed by law, provided the disclosing party is given prompt notice of such requirement.

Confidentiality Acknowledged:

Governing Law

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

Entire Agreement and Amendments

This document, together with any exhibits or attachments executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous negotiations, representations, and agreements, whether written or oral. Any amendment or modification of this Agreement must be in writing and signed by both parties to be effective.

Owner Certification

The undersigned Owner certifies that the information provided in this Owner Information Form is true, complete, and accurate to the best of Owner's knowledge and that Owner has the authority to enter into this Agreement. The Owner further certifies that any payments received will be reported for tax purposes as required by applicable law.

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