Signature Samples Template

Signature Samples Template

Parties

Effective Date:

Recitals

WHEREAS, Client Name: desires to establish and record authorized signature specimens for the purpose of authenticating documents executed on behalf of Client; and

WHEREAS, Provider Name: has expertise in preparing, collecting, and certifying signature samples and agrees to collect and hold such specimens in accordance with the terms of this Agreement; and

WHEREAS, the parties desire that the signature specimens set forth herein be treated as the official reference for future document execution and verification by the parties and their authorized agents.

Scope of Work

Services shall include collection of specimen signatures, retention of specimen records in secure form, preparation of an official signature index, and delivery of a certified copy of the signature index to Client upon request. Provider shall follow reasonable procedures to verify the identity and authority of each signatory.

Payment Terms

Total Fee: $

Late Payment: If any undisputed amount is not paid within days after the due date, interest will accrue at the lesser of 1.5% per month or the maximum rate permitted by law, plus a late fee of $ .

Invoicing: Provider shall submit invoices in writing specifying services performed and any reimbursable expenses. Client shall pay invoiced amounts in accordance with the Payment Schedule above.

Term and Termination

Term Commencement Date:

Term Expiration Date:

Either party may terminate this Agreement for convenience upon written notice delivered not less than days prior to the effective termination date. Termination for material breach may be immediate if the non-breaching party provides written notice and the breach is not cured within days.

Confidentiality

Definition: "Confidential Information" means any non-public information disclosed by one party to the other that is marked confidential or that a reasonable person would understand to be confidential given the nature of the information and the circumstances of disclosure, including specimen signatures, identity verification documents, and signature index records.

Obligations: Receiving party shall (i) hold Confidential Information in strict confidence, (ii) not disclose it to third parties except to those employees, contractors, or agents who have a need to know and are bound by confidentiality obligations at least as protective as those herein, and (iii) use Confidential Information solely to perform obligations under this Agreement.

Signature Samples

The parties agree that the following specimens comprise the official signature samples for the named signatory. Each specimen below is to be executed in the presence of a witness where indicated and retained by Provider as the signature reference.

Signatory Name:

Signature Specimen:

Date Signed:

Initials Specimen:

Date Recorded:

Electronic Signature Text:

Format Notes:

Certification: By checking the box below, the signatory certifies that the specimens above are accurate, were executed by the named individual(s), and may be relied upon for authentication of future documents until revoked in writing.

I certify that the signature specimens provided are genuine and authorized.

General Provisions

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles.

Notices: All notices under this Agreement shall be in writing and delivered to the addresses set forth above and shall be deemed given when delivered in person, by nationally recognized overnight courier, or three days after being deposited in the United States mail, postage prepaid.

Amendment: This Agreement may be amended only by a written instrument signed by both parties.

Entire Agreement: This Agreement, including any attachments and the specimen records collected by Provider, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral.

Sign Now