Party Identification Document

PARTY IDENTIFICATION DOCUMENT

This Party Identification Document (the "Document") is made effective as of by and between Party A: , an entity organized as with principal place of business at (hereinafter "Party A"), and Party B: , an entity organized as with principal place of business at (hereinafter "Party B"). Party A and Party B may be referred to individually as a "Party" and collectively as the "Parties."

RECITALS

WHEREAS, the Parties desire to record and verify the legal identities, organizational details, and authorized representatives of each Party for use in contracts, compliance, and administrative records; and

WHEREAS, each Party is willing to provide such identifying information and to make certain representations and warranties regarding the accuracy and authority of the information delivered under this Document; and

WHEREAS, the Parties intend that this Document serve as the official identification record incorporated by reference into any subsequent agreements between the Parties unless superseded in writing.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and for other good and valuable consideration, the Parties agree as follows:

1. IDENTIFICATION OF PARTIES

Each Party shall provide the following identifying information. The information supplied in the fields below constitutes the official identification data for the purposes of this Document and related transactions.

2. PARTY B IDENTIFICATION

3. AUTHORITY; REPRESENTATIONS AND WARRANTIES

Each Party represents and warrants that: (a) the information provided in this Document is true, correct and complete as of the date hereof; (b) it has full power and authority to enter into this Document and to perform its obligations hereunder; and (c) the individual executing this Document on behalf of each Party is duly authorized to bind that Party.

Each Party shall promptly notify the other Party in writing of any material change in the identifying information provided herein and shall provide updated documentation that reasonably substantiates such change.

4. USE AND LIMITED DISCLOSURE

The Parties agree that identification information supplied under this Document shall be used only for purposes of contractual formation, compliance, anti‑fraud verification, payment processing, and other legitimate business purposes related to transactions between the Parties. A receiving Party may disclose such information only to its employees, advisors, auditors, or contractors who have a need to know and who are subject to confidentiality obligations at least as protective as those set forth herein.

5. CONFIDENTIALITY

All non-public identifying information and documentation provided under this Document is Confidential Information. A Party receiving Confidential Information shall (a) protect it with the same degree of care it uses to protect its own confidential information but in no event less than a reasonable degree of care; (b) use it only for the purposes set forth in Section 4; and (c) not disclose it except as permitted by this Document or required by law, provided the disclosing Party is given prompt notice and the receiving Party cooperates in any lawful effort to obtain confidential treatment.

6. NOTICES

All notices required or permitted under this Document shall be in writing and delivered to the contact information set forth in Sections 1 and 2, or to such other address as a Party may designate in writing. Notices shall be effective upon receipt when delivered personally, by nationally recognized overnight courier, or by certified mail, return receipt requested.

7. AMENDMENT; WAIVER

No amendment or waiver of any provision of this Document shall be effective unless set forth in a written instrument signed by both Parties. No failure or delay by either Party in exercising any right shall operate as a waiver of that right.

8. GOVERNING LAW

This Document shall be governed by and construed in accordance with the laws of the jurisdiction provided below, without regard to conflict of laws principles. The Parties submit to the exclusive jurisdiction of the courts of that jurisdiction for any dispute arising out of or relating to this Document.

9. ENTIRE AGREEMENT; SEVERABILITY

This Document constitutes the entire agreement between the Parties with respect to the subject matter herein and supersedes all prior and contemporaneous agreements and understandings relating thereto. If any provision of this Document is held invalid or unenforceable, the remainder of this Document shall remain in full force and effect.

10. COUNTERPARTS; ELECTRONIC EXECUTION

This Document 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. Signatures exchanged by electronic facsimile or as a scanned image of an original signature shall be effective as original signatures.

11. CERTIFICATION

By signing below, each Party certifies under penalty of perjury that the information provided in this Document is true, complete and accurate to the best of its knowledge, that the signer is authorized to bind the Party, and that the Party will promptly notify the other Party of any material changes to the information provided.

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