Personal Interests Manifestation

PERSONAL INTERESTS MANIFESTATION

PARTIES

Declarant:

Recipient:

RECITALS

WHEREAS, Declarant has specific personal interests, values, goals and preferences that Declarant desires to state formally and have acknowledged by Recipient for the purpose of guiding discretionary decisions, planning, or services described in this Manifestation;

WHEREAS, Recipient is willing to receive, record, and reasonably consider Declarant's stated interests and, where applicable, to take actions consistent with those interests in accordance with the terms of this Manifestation;

WHEREAS, the parties wish to reduce to writing the scope, limitations, and assurances related to the Declarant's personal interests as set forth below.

EFFECTIVE DATE

Effective Date:

SCOPE OF INTERESTS

Examples of interests to be considered include, without limitation, personal values, relationship priorities, types of activities preferred or not preferred, cultural or spiritual practices, and any specific instructions for routine decisions or discretionary events. The Declarant's expressed interests are statements of preference and shall be applied in a manner consistent with law and Recipient's reasonable operational capacity.

ENGAGEMENT AND OBLIGATIONS

Recipient agrees to document, acknowledge, and, where reasonable and lawful, act in accordance with the Declarant's expressed interests set forth in this Manifestation. Recipient's obligations are limited to reasonable efforts to align decisions and recommendations with the Declarant's stated interests and do not create fiduciary duties beyond those expressly stated herein.

PAYMENT TERMS

Fee Amount: $

Late Payment Fee:

If payment is not received when due, Recipient may suspend non-essential actions under this Manifestation until outstanding amounts are cured. All sums payable under this agreement are non-refundable except as expressly stated herein.

TERM AND TERMINATION

Term Start:      Term End:

Either party may terminate this Manifestation without cause by giving written notice to the other party at least days in advance. Termination will not relieve either party of obligations accrued prior to the effective termination date, including payment obligations.

CONFIDENTIALITY

The parties acknowledge that certain personal information and records relating to Declarant's interests may be confidential. Recipient will treat such information as confidential and will not disclose it to third parties except (a) as required by law, (b) with Declarant's express written consent, or (c) to agents or service providers who need access to perform obligations under this Manifestation and who are bound to confidentiality obligations at least as protective as those set forth herein.

LIMITATION OF LIABILITY

Recipient shall exercise reasonable care in considering and applying the Declarant's expressed interests. Except for willful misconduct or gross negligence, Recipient's liability for claims arising from or relating to this Manifestation shall be limited to direct damages not to exceed the total fees paid under this Manifestation during the twelve (12) months preceding the claim.

GOVERNING LAW

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

ENTIRE AGREEMENT

This Manifestation, including all attachments and schedules executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous oral and written agreements, understandings, and representations. Any amendment must be in writing and signed by both parties.

REPRESENTATIONS AND CERTIFICATIONS

Each party represents and warrants that (a) it has the full power and authority to enter into this Manifestation, (b) the signatory executing this Manifestation on its behalf is duly authorized, and (c) the obligations contained herein do not violate any other agreement to which such party is bound.

NOTICES

ACKNOWLEDGMENT

The parties acknowledge that this Manifestation is intended to record personal interests and guidance. It is not intended to supplant formal legal instruments when such instruments are required by law. Recipient's compliance will be subject to applicable legal duties and reasonable operational considerations.

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