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Use of Representative Agreement

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USE OF REPRESENTATIVE AGREEMENT

This Use of Representative Agreement ("Agreement") is entered into as of by and between Principal Name: , whose principal address is (the "Principal"), and Representative Name: , whose principal address is (the "Representative").

RECITALS

WHEREAS, the Principal requires one or more persons to act on its behalf to perform certain tasks, transact specified matters, and receive notices on behalf of the Principal; and

WHEREAS, the Representative has represented that it has the experience, authority, and capacity to perform the duties described herein and agrees to accept such appointment subject to the terms and conditions of this Agreement; and

WHEREAS, the parties desire to set forth the scope of the Representative's authority, duties, compensation, reporting obligations and other terms governing the relationship.

NOW THEREFORE, in consideration of the mutual covenants and promises contained herein, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement, the following terms shall have the meanings set forth below. "Confidential Information" means non-public information disclosed by the Principal to the Representative that is designated as confidential or which a reasonable person would understand to be confidential. "Authority" means the powers granted to the Representative pursuant to Section 2.

2. APPOINTMENT AND SCOPE OF AUTHORITY

2.1 Appointment. The Principal hereby appoints the Representative as its representative and agent, and the Representative accepts such appointment, on the terms and conditions of this Agreement.

2.2 Scope of Authority. The Representative is authorized to perform the following acts on behalf of the Principal (check all that apply):

Receive notices, correspondence and service of process related to the Principal's matters.
Execute and deliver agreements, acknowledgments, and other instruments that are within the scope expressly delegated by the Principal.
Negotiate terms and enter into non-capital commitments on behalf of the Principal as expressly authorized in writing.
Inspect and request copies of records necessary to perform Representative duties.

2.3 Limitations. The Representative shall not, without the Principal's prior written consent, incur indebtedness, make payments in excess of authorized limits, convey or encumber real property, or take any action that would materially alter the Principal's legal or financial position.

3. TERM

This Agreement commences on the Effective Date set forth above and shall continue until terminated in accordance with Section 11. The parties may also specify an optional termination date: Termination Date:

4. REPRESENTATIVE DUTIES; STANDARD OF CARE

The Representative shall perform its duties in good faith, with the care an ordinarily prudent professional would exercise in similar circumstances, and in compliance with applicable law. The Representative shall promptly disclose to the Principal any matter that reasonably could be expected to materially affect the Principal's interests.

5. CONFIDENTIALITY

The Representative shall hold Confidential Information in strict confidence and shall not use or disclose such information except as necessary to perform its duties under this Agreement or as required by law. Upon request or upon termination, the Representative shall return or destroy Confidential Information as directed by the Principal.

6. COMPENSATION AND EXPENSES

6.1 Compensation. The Principal shall compensate the Representative as follows:

6.2 Expenses. The Principal shall reimburse the Representative for reasonable, documented out-of-pocket expenses incurred in performing duties under this Agreement, subject to any limits set by the Principal in writing.

7. RECORDS AND REPORTING

The Representative shall maintain accurate records of actions taken, documents executed, and expenses incurred on behalf of the Principal and shall furnish such records to the Principal upon request or at such regular intervals as the parties agree in writing.

8. CONFLICTS OF INTEREST

The Representative shall promptly disclose any actual or potential conflict of interest arising during the term of this Agreement. The parties shall endeavor to resolve conflicts in good faith; absent resolution, the Principal may terminate the Representative's appointment in accordance with Section 11.

9. INDEMNIFICATION

The Representative shall indemnify, defend and hold harmless the Principal from and against claims, liabilities, losses, damages and costs (including reasonable attorneys' fees) arising from the Representative's gross negligence, willful misconduct, or material breach of this Agreement. The Principal shall indemnify the Representative for liabilities resulting from the Principal's breach or misrepresentation hereunder.

10. LIMITATION OF LIABILITY

Except for liabilities arising from willful misconduct or gross negligence, neither party shall be liable to the other for consequential, incidental, punitive or indirect damages, and the parties' aggregate liability under this Agreement shall be limited to direct damages not exceeding the fees paid to the Representative in the twelve (12) months preceding the claim.

11. TERMINATION

11.1 Termination for Convenience. Either party may terminate this Agreement for any reason upon days' prior written notice to the other party.

11.2 Termination for Cause. Either party may terminate immediately upon written notice if the other party materially breaches this Agreement and fails to cure such breach within days after receipt of written notice of the breach.

12. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered by personal delivery, certified mail (return receipt requested), or nationally recognized overnight courier to the addresses set forth below or such other address as a party may designate by notice:

13. AMENDMENTS

This Agreement may be amended, modified or supplemented only by a written instrument executed by authorized representatives of both parties.

14. WAIVER

The waiver by either party of a breach of any provision of this Agreement shall not operate or be construed as a waiver of any subsequent breach.

15. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflicts of law principles.

16. ENTIRE AGREEMENT

This Agreement constitutes the entire agreement and understanding between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether written or oral.

17. SEVERABILITY

If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect, and the parties shall negotiate in good faith to replace the invalid provision with a valid provision that, to the greatest extent possible, achieves the original intent of the parties.

18. COUNTERPARTS

This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. Signatures delivered by electronic means shall be effective as originals.

19. MISCELLANEOUS

The parties acknowledge that the Representative acts as an independent contractor and not as an employee or partner of the Principal for any purpose. Nothing in this Agreement shall be construed to create a fiduciary relationship beyond that expressly set forth herein.

Principal

Printed Name:

By:

Date:

Representative

Printed Name:

By:

Date:

Enter text✕

What the Use of Representative Agreement Is and when it applies

A Use of Representative Agreement is a written document that authorizes an individual or organization to act on behalf of a principal for defined matters, such as submitting filings, receiving notices, or making decisions within a specified scope. The agreement typically identifies the principal, the representative, the scope of authority, effective dates, and any conditions or limitations. Depending on jurisdiction and subject matter, it may require witness signatures, notarization, or additional consumer disclosures. Clear scope and signature attribution reduce disputes about authority and ensure records meet legal and audit requirements.

Why a formal agreement matters for representation

A written Use of Representative Agreement documents authority, reduces ambiguity, and creates an auditable record that supports compliance with statutory and administrative processes. It protects the principal, clarifies obligations for the representative, and helps third parties verify signing authority quickly.

Why a formal agreement matters for representation

Who typically prepares or signs these agreements

Use clear names, dates, and signature blocks so third parties can confirm authority without additional documentation.

  • Businesses and in-house legal teams that appoint agents for regulatory filings or contract execution.
  • Healthcare administrators delegating billing or records access under HIPAA-covered workflows.
  • Private individuals appointing representatives for tax, immigration, or property matters.

Step-by-step completion checklist

Follow this quick sequence to prepare, verify, and finalize a representative agreement with minimal rework.

  • 01
    Draft Scope: Define exact tasks and limits for the representative.
  • 02
    Verify Identities: Confirm legal names and credentials for both parties.
  • 03
    Select Authentication: Choose eSignature method and any required notarization.
  • 04
    Record and Store: Retain signed copy and audit trail per retention rules.

Essential elements to include for a professional agreement

A complete Use of Representative Agreement includes clearly labeled clauses so third parties can rely on the document without follow-up. Include these six core elements.

Parties

Identify principal and representative with legal names, business addresses, and contact details so identity checks and service procedures are clear.

Authority

List specific powers granted, including any limitations or exclusions, to avoid overbroad delegation and third-party rejection.

Term

State the effective date and termination condition so obligations and revocation windows are unambiguous for all stakeholders.

Authentication

Specify accepted signing methods, authentication steps, and whether notarization or witnesses are required for enforceability.

Revocation

Describe how the principal can revoke the agreement and how revocation is communicated to third parties and agencies.

Compliance

Include applicable governing law and statements addressing privacy or regulatory requirements relevant to the document’s subject matter.

Security and compliance considerations

Encryption: TLS 1.2/1.3; AES-256 at rest
Audit Trail: Timestamped signing event records
HIPAA: BAA available where required
Certifications: SOC 2 Type II; ISO 27001
21 CFR Part 11: Compliance options available
Accessibility: WCAG 2.0 Level AA support

Common preparation errors to avoid

  • Using informal or ambiguous scope language that leads third parties to refuse recognition of the representative’s authority.
  • Mismatched names or titles between the agreement and government or corporate records, causing verification failures or returned filings.
  • Failing to specify the effective date or expiration, which can create disputes over whether the representative had authority at a particular time.
  • Omitting required authentication, notarization, or witness signatures where a receiving agency or statute mandates them.

Risks and potential penalties for incorrect agreements

Unauthorized Acts: Liability exposure for principal or third parties
Void Authorization: Agreement may be unenforceable without proper formalities
Regulatory Fines: Possible fines when filings are improper
Tax Consequences: Backup withholding or reporting errors
I-9 Violations: Paperwork fines if employer forms are mishandled
Fraud Allegations: Criminal exposure for intentional misuse

How electronic completion and delivery typically works

This workflow outlines the usual online signing sequence from upload to archive, highlighting verification and audit steps.

  • Upload Document: Sender uploads agreement to signing platform.
  • Place Fields: Add signature, date, and identity fields.
  • Authenticate Signer: Use email, SMS code, or stronger methods.
  • Capture Audit Trail: Platform records IP, timestamp, and actions.

Configuration checklist for digital execution

Configure the eSigning workflow to match legal needs: choose auth strength, retention, and notifications before sending.

Field Configuration
Authentication Level Email or SMS OTP; KBA or advanced where required
Notifications Enable recipient and sender email confirmations
Conditional Fields Show or hide clauses based on signer choices
Retention Settings Automate archive and export of audit trail

Delivery and platform requirements for eSubmission

Confirm the chosen solution supports any industry-specific compliance (for example HIPAA BAA) and long-term archival exports.

  • Integrations: Salesforce, NetSuite, Microsoft 365 supported
  • File Formats: PDF, DOCX, HTML, Excel supported
  • Authentication: SMS, email, KBA, and advanced options

Typical timing and response expectations

Processing times vary by recipient and whether notarization or agency filing is required. Plan for verification and third-party response windows.

Provide on Request:

W-9-style identification documents should be provided when requested by payer

Agency Filing Delay:

Allow multiple business days for third-party acceptance and validation

Revocation Notice:

Effective upon receipt by third party; allow 5–10 business days processing

Notarization Scheduling:

Allow extra time if in-person or RON notarization is required

Record Retention Start:

Retention clocks start on effective date or filing date, as applicable

Key milestones from draft to archived record

Track these stages as a sequential timeline to ensure authority, signature validity, and compliant retention.

01

Draft Approved

Document language and scope finalized by principal.

02

Identity Verified

Representative identity and credentials are confirmed.

03

Signed and Notarized

Signatures captured and notarization completed if required.

04

Archived with Audit

Signed PDF and audit trail stored in secure repository.

Representative agreement eSignature pricing and capability snapshot

Compare starting prices and core capabilities for high-volume and individual users. signNow appears first as the baseline for cost and capability comparison.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial (no credit card) Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Real-world examples of representative agreements in use

These short examples show how organizations apply representative agreements for common business needs.

Martin Properties (Real Estate)

Local brokerage needed remote closing authority for agents

  • Document limited authority to property closings and escrow instructions
  • Martin Properties used an executed representative agreement with notarization and secure eSign audit trails to accelerate closings without on-site principal signatures.

Fertility Centers of Illinois (Healthcare)

Clinic required delegated access to patient billing and insurance claims

  • Agreement included HIPAA BAA and limited data access clauses
  • The signed agreement specified audit logging and role-based access to comply with patient privacy and payer verification.

Frequently asked questions about Use of Representative Agreement

Answers to common questions on legality, notarization, revocation, and electronic signing help prevent common execution and acceptance problems.


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