NIJ CTP Electronic Signature Agreement

Document Name: NIJ CTP Electronic Signature	Approval Date: dd Mmm yyyy
Revision: 16 Dec 2015	Implementation Date: dd Mmm yyyy
OMB Number: 1121-0321	Expires: dd Mmm yyyy

National Institute of Justice Compliance Testing Program

_{Electronic Signature Agreement}

In accordance with the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless it displays a valid OMB control number. The OMB number for this collection is 1121-0321. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information.

This information is being requested pursuant to 6 U.S.C. 162(b)(4) and 6 U.S.C.

162(b)(6)(B). The disclosure is voluntary. The information provided on this form will be used by the National Institute of Justice (NIJ) to administer the NIJ Compliance Testing Program (NIJ CTP), a conformity assessment program for products used by criminal justice practitioners. This information and the associated products are submitted voluntarily.

PRIVACY ACT NOTICE: The information provided in this document is not considered Confidential Commercial Information and may be released without limitations or restrictions.

This NIJ CTP Electronic Signature Agreement is dated when signed by the Applicant Signatory, and is between the Applicant Signatory and the Conformity Assessment Body (“CAB”), which consists of both NIJ and the recipient of the Cooperative Agreement Number 2014-IJ-CX-K004 issued by the Office of Justice Programs, NIJ.

The CAB implements the functions of the NIJ CTP, a program funded by NIJ, which in turn is part of the U.S. Department of Justice (DOJ), Office of Justice Programs (OJP). NIJ monitors and directs the administration of the NIJ CTP.

This agreement shall supersede all previous National Institute of Justice Compliance Testing Program Electronic Signature Agreements between the Applicant Signatory and the CAB.

Please provide business headquarters information below.

Applicant Name: Applicant Address:

Telephone:

Document Name: NIJ CTP Electronic Signature	Approval Date: dd Mmm yyyy
Revision: 16 Dec 2015	Implementation Date: dd Mmm yyyy
OMB Number: 1121-0321	Expires: dd Mmm yyyy

1. Applicants are not required to use electronic signatures when completing NIJ CTP agreements. They may continue to use manual handwritten signatures on paper representations of the agreements.

2. However, this agreement provides applicants with the option to use an electronic signature as a legally binding electronic signature when submitting completed agreements and forms concerning the NIJ CTP. All representatives authorized by the applicant to supply information concerning product submittals and surveillance on which the NIJ CTP may act must complete this form before utilizing an electronic signature as a legally binding electronic signature.

3. By completing this agreement and applying your electronic signature on this Agreement and all other NIJ CTP agreements where it is used, the Applicant Signatory hereby expressly acknowledges and agrees as follows:

a) that your use of a keyboard, mouse or other device to enter the electronic signature constitutes the legally binding equivalent of your manual handwritten signature,

b) that no certification authority or other third-party verification is necessary to validate your electronic signature and that the lack of such certification or third-party verification will not in any way affect the enforceability of your legally binding electronic signature or any resulting contract between you and the CAB,

c ) that each use of your electronic signature on NIJ CTP forms and agreements constitutes your agreement to be bound by the terms and conditions of the agreement to which your electronic signature has been applied.

Applicant Signatory

(Officer or representative of the Applicant who has the authority to bind it)

(Name/Title): Telephone Number: Email:

The Applicant Signatory agrees to the terms of this agreement and warrants that they have made no alterations to its text. The undersigned represents and warrants that he/she is authorized to execute this agreement on behalf of the Applicant and is signing this agreement on the date stated opposite the Applicant Signatory’s signature.

Applicant Signatory Date

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