Signature Declaration Form

SIGNATURE DECLARATION FORM

Parties

Recitals

WHEREAS, Declarant: is party to certain agreements, instruments, or obligations for which the authenticity of signatures must be affirmed; and

WHEREAS, Recipient: requires a formal declaration that signatures appearing on the attached or referenced documents are the true signatures of the identified signatories as of the Effective Date: .

WHEREAS, the parties desire to set forth the scope of the declaration, the representations each party makes regarding signature authenticity, and the remedies and responsibilities applicable to misuse or misrepresentation of signatures.

Scope of Declaration

Declarant hereby declares and affirms that the signatures on the documents identified below were executed by the persons and entities represented, and that Declarant possesses the authority to make this declaration as to those signatures. Identify documents, document dates, and other identifying details in the space below.

Payment Terms (if applicable)

If services are provided in connection with this declaration (for example, notarization, attestation, or administrative processing), fees and schedule are set forth below. If no payment is required, enter "N/A" in the amount field.

Term and Termination

This declaration is effective as of the Term Start Date and will remain in force until the Term End Date, unless earlier terminated in accordance with the provisions below.

Either party may terminate this declaration for cause upon material breach by the other party that remains uncured for the notice period set above. Termination does not relieve any party of obligations incurred prior to the effective date of termination, including payment obligations.

Confidentiality

The parties acknowledge that information exchanged or identified in connection with this declaration may be Confidential Information. Each party agrees to (a) hold Confidential Information in strict confidence, (b) not disclose Confidential Information to third parties except as required by law or with the prior written consent of the disclosing party, and (c) use Confidential Information solely to effectuate the purposes of this declaration.

Notwithstanding the foregoing, Confidential Information does not include information that: (i) was already known to the recipient without restriction at the time of disclosure; (ii) becomes publicly known through no act or omission of the recipient; (iii) is rightfully received from a third party without restriction; or (iv) is independently developed by the recipient without use of or reference to the discloser's Confidential Information.

Representations and Declarations

Declarant represents and warrants that: (i) Declarant has reviewed the signatures referenced in the Documents and believes them to be authentic; (ii) Declarant has authority to make this declaration with respect to the identified signatories; and (iii) to the best of Declarant's knowledge, no signature was made under duress or as a result of fraud. These representations are made to induce Recipient to rely on the declared signatures.

Governing Law; Remedies; Entire Agreement

This declaration shall be governed by and construed in accordance with the laws of the State of without regard to conflict of laws principles. The parties agree that any dispute arising under this declaration shall be subject to the exclusive jurisdiction of the courts located in that state.

The parties acknowledge that monetary damages may be inadequate to remedy a breach of the confidentiality provisions and that injunctive relief may be sought in addition to other remedies. No waiver of any provision of this declaration shall be effective unless in writing signed by the party waiving compliance.

This declaration, together with any attachments and any documents expressly incorporated by reference, 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.

Acknowledgement of Electronic Signature (Optional)

By checking the box below, the signatory acknowledges that an electronic signature executed in an electronic format is intended to have the same legal effect as a handwritten signature.

Certification

The undersigned declarant certifies under penalty of perjury that the information provided in this declaration is true and correct to the best of the declarant's knowledge and belief, and that the declarant is authorized to make this declaration on behalf of the party named herein.

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