1) PRIMARY CONTACT
Name: (Company or as Individual)
Entity Type: (Corp., Partnership, LLC, Sole-Proprietor, etc.)
State of Organization:
EIN/Federal Tax Number:
Address 1: (Location of Individual or Business if under Company name)
Country of Origin:
Please let us know how you heard of our services:
2) PERSONAL CONTACT (If filing as a Company, include contact information of person authorizing the filing.)
Name: (Contact Individual)
Address 1: (Location of Individual Authorized to File)
3) PURPOSE OF AGREEMENT AND GENERAL INFORMATION
On the following page, please describe, specifically, the nature of your business or website, and the purpose of the contract/agreement you are seeking. You may want to consider the following issues in forming your description:
a. What am I protecting?
b. Who do I want to bind?
e. General business model
f. Intellectual Property concerns
g. Legality of business activities (video linking, gambling, copyright concerns)
h. Security concerns
4) SPECIFIC CLAUSES
Please list any special or specific language or concerns you would like to address or include in your agreement:
5) COMPETITORS’ WEBSITES OR EXAMPLES
Please feel free to upload any other information relevant to your matter.