Forms Use Agreement

You have requested access to a form provided as a courtesy by LNIC. We are providing this form free of charge, but your use of the form is subject to the following conditions:

• These forms may create or affect legal relationships. They are supplied "as is." These forms come with NO WARRANTY of any kind, either express or implied, including but not limited to the implied warranties of fitness for a particular purpose, merchantability, and freedom from infringement. WARNING: It would be a MISTAKE to use any of these forms without first determining their suitability and legal effect within the state or states in which you hope to use them.

• If you download any form you must be aware that downloading carries with it the possibility of transmitting a COMPUTER VIRUS to your computer. Viruses have been known to destroy computer software and hardware. We cannot prevent this risk and you will assume it if you elect to download any of these forms. If you prefer, you may contact us directly and request that we send you the form by e-mail or regular mail.

• Lexington National provides these forms through its offices in Baltimore, Maryland. Any use by you of these forms or any information contained in the forms will act as consent by you to the exclusive venue and jurisdiction of the courts in Baltimore City of Baltimore County, Maryland, for purposes of ANY CLAIM ASSERTED BY YOU against Lexington National in respect to these forms.

• Since we cannot control your use of these forms, you must HOLD US HARMLESS from any claims or expenses we suffer as a result of your use of these forms. This duty of indemnity should underscore your need to be very careful in how you use these forms.