Digital Millennium Copyright Agent Engagement Letter and Authorization

Brach Eichler LLC is designated as the Digital Millennium Copyright Agent (Agent) for the entity identified below (Entity).

Brach Eichler agrees to provide the following services: provide the necessary DMCA registration form and Internet site DMCA notice language to Entity for Internet site posting; perform Internet site DMCA compliance review; conduct a mandated periodic certification of DMCA compliance; provide a DMCA renewal monitoring service; perform a no-cost audit of your website to ensure proper copyright language and contacts on the site; advise Entity of infringement claims; and recommend initial response to said claims.

The Entity agrees to pay Brach Eichler $100 for two years of service and post the Digital Millennium Copyright Act notice below on their Internet site.

Parties may terminate this Agreement at any time with notice. This agreement shall be governed by the laws and courts of the state of New Jersey.

I, an Authorized Entity Representative agree.

Full Name (Digital Signature)*

Please enter the following Entity Information:

Internet Address*

Internet Address 2

Full Legal Name*

First Middle Initial Last

Physical Street Address*

Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country

Any Alternate Names used by the Entity

Brach Eichler Customer Number

Contact Name*

Contact Phone Number*

Contact Fax Number

Contact Email Address*

Please check to confirm that the notice below is posted on the Entity Internet site*

Yes, I confirm.

If you are a copyright owner or agent thereof and believe that content posted on this site Internet site infringes upon your copyright, please submit notice, pursuant to the Digital Millennium Copyright Act (17 U.S.C. § 512(c)) to our Copyright Agent with the following information: (a) an electronic or physical signature of the person authorized to act on behalf of the owner of the copyright; (b) a description of the copyrighted work that you claim has been infringed; (c) the URL of the location on our Website containing the material that you claim is infringing; (d) your address, telephone number, and email address; (e) a statement by you that you have a good faith belief that the disputed use is not authorized by the copyright owner, its agent, or the law; and (f) a statement by you, made under penalty of perjury, that the above information in your notice is accurate and that you are the copyright owner or authorized to act on the copyright owner's behalf. Our Copyright Agent can be reached by mail at: Jonathan Bick at copyrightagent@pagconcepts.com (Phone: 973.228.5700), Brach Eichler LLC, 101 Eisenhower Parkway, Roseland, NJ 07068. To execute this form, confirm CAPTCHA and click submit.

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