Signed Document Return Form

SIGNED DOCUMENT RETURN FORM

Parties and Document Identification

Client Name:

Service Provider / Custodian Name:

Document Title / Description:

Document Date:    Total Pages:    Return Due By:

WHEREAS

WHEREAS, Client Name has requested that Service Provider / Custodian prepare, assemble, or hold certain original or executed documents described above for temporary custody, delivery, or recordation;

WHEREAS, Service Provider / Custodian has agreed to return the specified original or executed documents to Client Name under the terms set forth in this Signed Document Return Form;

WHEREAS, the parties intend that this Signed Document Return Form governs the specific obligations related to the handling, return, and certification of the Documents and the related consideration described herein.

Scope of Work

Return Instructions and Delivery Terms

Return Method (select all applicable): Courier / Carrier Electronic transmission of copies In-person delivery

If shipped by courier: Tracking Number / Carrier Reference:

Payment Terms

Consideration for return and handling: $

Payment due within days of invoice. Late fee: % per month on overdue balances.

Term and Termination

Term Commencement Date:    Term Expiration Date:

Either party may terminate this agreement for convenience upon days' written notice to the other party. Termination for material breach may be immediate if the breaching party fails to cure within a commercially reasonable period after written notice.

Confidentiality

Each party acknowledges that in the performance of this Form they may receive or have access to non-public, proprietary, or confidential information of the other party ("Confidential Information"). Each party agrees to (a) hold Confidential Information in strict confidence, (b) use Confidential Information solely for the purposes of performing obligations under this Form, and (c) not disclose Confidential Information to any third party except to employees, contractors, or agents who need access for performance and who are bound by confidentiality obligations no less protective than those herein. Confidentiality obligations survive termination or expiration of this Form for a period of three (3) years.

Certification of Returned Documents

Service Provider / Custodian certifies that the documents identified in this form are complete and are being returned as specified. If originals are not available, Service Provider / Custodian shall provide a written explanation and a true and complete copy where permitted.

Governing Law and Entire Agreement

This Signed Document Return Form is governed by the substantive laws of the State of without regard to its conflict of law principles. The parties consent to exclusive jurisdiction of the state and federal courts located in that State for disputes arising under this Form.

This Form, together with any attachments and invoices expressly incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior written or oral agreements, understandings, or representations. Any amendment must be in writing and signed by both parties.

Administrative Information

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