State Documentation Sheet

STATE DOCUMENTATION SHEET

Parties and Identification

Client Name:

Service Provider / Company Name:

State of Formation/Registration:    State Registration Number:

State Tax ID / Employer ID:    Business License No.:

Recitals

WHEREAS, Client is organized and authorized to conduct business in the state identified above and requires Provider to prepare, collect and maintain state-specific documentation necessary for regulatory compliance and transactional purposes; and

WHEREAS, Provider represents that it is qualified to assemble, verify and deliver the state forms, certificates and documentary items listed in this sheet and to certify their accuracy to the extent required by applicable state law; and

WHEREAS, the parties desire to set forth the scope, timing and terms under which such documentation will be provided as of Effective Date: .

Scope of Work

Provider shall prepare, collect and, where authorized, file the following items on behalf of Client. Check all that apply:

Payment Terms

Compensation for the services described in this sheet shall be as follows.

Late Payment: Unpaid amounts shall incur a late fee equal to percent per month on the outstanding balance, compounded monthly, and Provider may suspend services upon ten (10) days' written notice for overdue accounts.

Term and Termination

Term Start Date:    Term End Date (if any):

Either party may terminate this sheet for convenience upon days' prior written notice to the other party. Termination for material breach shall be effective upon written notice if the breach is not cured within thirty (30) days following written notice.

Confidentiality

Each party shall maintain in confidence all non-public information and documentation furnished by the other party that is designated as confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure. Provider shall not disclose Client's confidential state filings, tax information or licensing documentation to third parties without Client's prior written consent, except as compelled by law or as necessary to perform the services described herein.

Governing Law

This Sheet, including all disputes arising out of or relating to the interpretation, performance or breach hereof, shall be governed by and construed in accordance with the laws of the State of without regard to choice-of-law principles that would apply the laws of another jurisdiction.

Entire Agreement; Certifications

This State Documentation Sheet, together with any attachments, exhibits and referenced schedules executed by the parties, constitutes the entire agreement between Client and Provider with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals and communications, whether oral or written.

Certification: By signing below, each signatory affirms that the information provided on this sheet is true, correct and complete to the best of their knowledge, that copies of attached documentation are true and accurate reproductions of the originals, and that they are authorized to execute this Sheet on behalf of the party they represent.

Recordkeeping and Delivery

Provider shall retain copies of all filed and unfiled state documentation generated under this Sheet for a minimum of three (3) years following completion of services and shall deliver to Client, upon request, certified copies of any documents filed with state authorities. Any certificates of filing or good standing delivered to Client will reflect the state authority's record and, where allowed, Provider's verification that a copy was obtained.

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