Proof of Signature

PROOF OF SIGNATURE

THIS AGREEMENT AND CERTIFICATION is made and entered into by the parties identified below for the purpose of documenting and certifying the authenticity of a signature appearing on a separate instrument described herein and to set forth related business terms between the parties.

WHEREAS

WHEREAS, Client Name: (the "Client") requires verification that the signature on a specified document is genuine;

WHEREAS, Certifying Party Name: (the "Certifier") has reviewed the records and attests as set forth in this Proof of Signature;

WHEREAS, the parties wish to set forth the scope, payment, confidentiality and governing law applicable to this certification and any related services.

SCOPE OF WORK

CERTIFICATION OF SIGNATURE

Document Title:

Original Signing Date:    Location of Signing:

Name of Signatory:    Capacity/Title of Signatory:

Notary acknowledgment reviewed    Witness affidavit reviewed    Signature comparison to known exemplar

Certification Statement: The Certifier hereby affirms, under penalty of perjury where applicable, that following reasonable inquiry and review the signature identified above appears to be authentic and was made by the signatory identified above on the date indicated. The Certifier's certification is based upon the methods and facts described in this Certification of Signature and the Scope of Work. The Certifier does not guarantee title or other legal effect of the underlying document beyond authentication of the signature.

PAYMENT TERMS

Fee Amount:    Payment Schedule:

Late Payment Fee: A late fee of or interest at the lesser of 1.5% per month and the maximum lawful rate shall apply to overdue balances. Client shall also be responsible for reasonable collection costs and attorneys' fees incurred in enforcing payment.

TERM AND TERMINATION

Effective Date:    Termination Date:

Either party may terminate this Agreement for convenience upon written notice delivered at least days prior to the intended termination date. Termination for cause may be immediate if a party materially breaches this Agreement and fails to cure such breach within 10 days after written notice.

CONFIDENTIALITY

The parties acknowledge that information exchanged in connection with this certification that is labeled confidential or that reasonably should be understood to be confidential ("Confidential Information") shall be held in confidence and not disclosed to third parties except as required by law, court order, or to enforce rights under this Agreement. The receiving party shall use at least the same degree of care to protect Confidential Information as it uses to protect its own confidential information, but no less than reasonable care.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the substantive laws of the jurisdiction identified by the Client's principal place of business. The parties agree that disputes arising under this Agreement shall be resolved in the courts of that jurisdiction unless the parties mutually agree otherwise in writing.

ENTIRE AGREEMENT

This Agreement, including the Scope of Work, Certification of Signature, and 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 agreements, understandings, negotiations and discussions, whether oral or written.

REPRESENTATIONS AND WARRANTIES

Each party represents and warrants that it has full power and authority to enter into this Agreement and to perform its obligations hereunder. The Certifier represents that its certification is based on reasonable inquiry and the facts available to it at the time of certification.

ATTESTATION

Certifier Name:

Relationship to Signatory:

Business Address:

Additional Declarations:

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