General Case Intake

Data is sent to private investigator for evaluation and acceptance. Agreement, if accepted, will be between the herein named, and will hereinafter be referred to as ‘CLIENT’ and EnlightenMineEyes Investigations, hereinafter referred to as EME. EME will endeavor to provide the services requested, or as amended in writing, as permitted by law. Requests for modifications must be made in writing. Retainer and all payments are to be submitted here, no work will be performed prior to receipt of payment.

Client General Case Intake

FULL LEGAL NAME *

First

Middle

Last

Date Of Birth *

Social Security Number *

Drivers License Number and Issuing State *

Please indicate & identify phone numbers where you may be reached (include home, cell & work) *

FULL Street Address (Street, City, State, Zip) *

Email *

Indicate Case Type (Select ONLY ONE) *

Domestic / Infidelity
Child / Elder Abuse or Endangerment
Custodial Exchange Monitoring
Missing Persons - Please use missing persons intake form
Other - Please provide DETAILED information

Do you CURRENTLY or have you EVER had a restraining order against you? (select one) *

If above question is answered in the negative, please type N/A in this paragraph. If you currently have, or have EVER had, a restraining order issued against you please explain. *

Have you ever hired a private investigator in the past? (Select One) *

If you have hired a private investigator in the past, was it regarding this case? If so, why was the investigation stopped and when? If it is still ongoing please explain in detail why you want to change investigators. Please provide FULL CONTACT information for any previous investigators. *

Checkboxes - ALL MUST BE CHECKED. *

CLIENT affirms that that he/she is not a named party in a Petition (or) Order for Protection Against Domestic Violence (or) charged with domestic violence, stalking (or) aggravated stalking.
CLIENT understands and agrees that that he/she is prohibited from using any information provided by AGENCY for purposes of harassment, defamation, domestic violence, stalking, intimidation, threatening or any other illegal purposes(s) whatsoever against any subject(s) of the investigation or any other person or entity.
CLIENT understands and agrees that CLIENT must disclose and identify to AGENCY whether any other investigators were previously retained to work on this case at any time.

Please provide the PRIMARY SUBJECT's information (include their FULL LEGAL NAME, DOB, FULL STREET ADDRESS, CONTACT NUMBERS, and their RELATIONSHIP to you. *

Does the above indicated PRIMARY SUBJECT have a criminal record? (choose one) *

Yes
No
Unsure

Does the above indicated PRIMARY SUBJECT own or carry any weapons? (choose one) *

Yes
No
Unsure

Please indicate your EXPECTATIONS, ANTICIPATIONS, and DESIRED OUTCOME for this investigation, what you hope to discover, reveal or expose, and what intentions you have with the results. *

Criminal Information *

Please indicate IN DETAIL all criminal charges and their resolution. False information will be cause for forfeiture of any/all retainers paid. If not applicable reply N/A.

Please provide as much detailed information as you possibly can to help me evaluate your case. This will help me determine how to best help you, how your money can be best spent to accomplish the goal/s you indicated above, and to do so as efficiently as possible. *

Full Legal Name Of Person Submitting Request For Assistance *

Email *

Phone Number Of Person Requesting Assistance *

Full Mailing Address Of Person Requesting Assistance *

CASE CONTRACT: I have read the included agreement and filled out all of the information above to the best of my knowledge, and I agree to ALL of the terms on this page. I understand that by completing and submitting this request for service, that I hereby state that all information provided is factual to the best of my knowledge. Please type your FULL LEGAL NAME and TODAYS DATE before hitting submit as this intake shall constitute a legal, binding agreement. This is a legal binder of this agreement between CLIENT & AGENCY. Upon review of the provided case information, a copy of this agreement will be emailed to the CLIENT at the email address provided herein for their records if the investigation is accepted, fee is agreed upon and paid indicating the agreement has been bound between the parties. This agreement, IF ACCEPTED, will be between the herein described, referenced and indicated in above intake details, and will hereinafter be referred to as 'CLIENT' and EnlightenMineEyes Investigations, hereinafter referred to as AGENCY. AGENCY will endeavor to provide the services requested, or as amended in writing, as permitted by law. Requests for modifications must be made in writing. AGENCY shall provide CLIENT with investigative services which may result in verbal or written reports as set forth in the conditions described. CLIENT agrees that reports may be delivered by facsimile, eMail, or telephonically, written reports may not be available in every case and are at the sole discretion of AGENCY, and whenever possible reports shall be provided not later than five business days following conclusion of all activity. PARTIES: This Agreement is made and entered into by and between the herein named party; Hereinafter referred to as “CLIENT” and EnlightenMineEyes Investigations, hereinafter referred to as “AGENCY”, a licensed Florida private investigative agency #A-1100060. EXTENT OF SERVICE: CLIENT agrees that unless otherwise stated, the representation begins on or about the date of this Agreement and payment of any retainer fees and costs required, and ends upon the conclusion of the investigation or termination of this Agreement by either party as provided herein. CLIENT agrees unless extended in writing, this Agreement shall expire upon completion of the service(s) stated in paragraph three (3), or thirty (30) days from the date of this Agreement, whichever occurs first. CLIENT agrees that under Chapter 493.6119 F.S. all reports and information created, gathered or otherwise obtained by AGENCY shall be deemed confidential and shall not be disseminated to any third parties without CLIENT’S written authorization or court order. DESCRIPTION OF SERVICE(S): herein described in above intake. Any issue not directly indicated is NOT included. CLIENT COOPERATION: CLIENT understands and agrees that CLIENT must fully cooperate with AGENCY in providing accurate and timely information as it becomes available. Particularly with regard to surveillance, CLIENT agrees to update AGENCY immediately with any pertinent information during the investigation such as newly learned locations, dates, times, vehicle descriptions, color/types of clothing, etc. regarding the subject of the investigation. FEES: CLIENT agrees to pay, AGENCY for the services described in paragraph three (3) above for a period of up to 4.5 total hours. CLIENT agrees that this is the maximum number of agreed hours, and if the investigative goal(s) listed in paragraph three (3) is/are accomplished in fewer hours the investigation may be closed as successfully completed. The lump sum flat fee due per this agreement for the stated maximum hours is $ 500 (five hundred dollars) in United States Dollars, plus .07% Florida sales tax applicable to Florida residents and businesses only. CLIENT agrees that the hourly rate extends from portal to portal and that AGENCY accounts for time at the minimum rate of ½ of an hour including but not limited to travel, surveillance, research, conferences, telephone calls, database research and ½ hour per each 8 hours of investigation for preparation of a final report, whether written or verbal. CLIENT understands and agrees that upon receipt, the lump sum flat fee stated herein is non-refundable and non-reversible. COSTS: CLIENT further agrees to pay the AGENCY for necessary costs and disbursements upon demand. Costs are at AGENCY’s exclusive professional discretion and may include but shall not be limited to postage, photocopies at $.25 per page, filing fees, airline fees, lodging, vehicle rentals, database expenses, video & photography costs and any other expenses that AGENCY considers reasonable and necessary to effectively perform the investigation. Database searches to identify the owner of any vehicle license plate or physical address discovered during the investigation are billed separately and itemized. CLIENT agrees that AGENCY will not release any results of the investigation until all costs due are paid in full. CLIENT NON-INTERFERENCE: CLIENT agrees that AGENCY’s licensed investigators are trained, experienced professionals and must maintain exclusive control regarding all aspects of conducting the investigation. CLIENT shall in no manner become engaged, involved or otherwise interfere with AGENCY while conducting the investigation. Non-interference includes but is not limited to appearing at or driving by or near a surveillance location; following or stalking the subject or other party; questioning or requesting a change in AGENCY investigative policies, procedures or techniques, personally, or through any third party; contacting or confronting any person(s) directly or indirectly involved in the investigation; and except as stated in paragraph 4, repeated non-essential contact with AGENCY via phone, email, or text during the ongoing investigation. CLIENT understands and agrees that because any such interference can negatively impact the investigation and may endanger the safety of an agent of AGENCY or other individual, AGENCY must maintain a zero-tolerance policy on CLIENT non-interference. If AGENCY perceives any failure to strictly adhere to this policy, AGENCY will immediately cease all services and terminate the investigation and the payment provisions stated in Paragraph 5 remain in full force and effect. CLIENT does hereby agree that EME shall conduct investigation at its sole discretion via lawful means at its disposal. AGENCY may employ multiple agents, specialists, or subcontractors at its sole discretion. Further, CLIENT understands, accepts and agrees that such interference by CLIENT may endanger AGENCY, it's agents, subcontractors and is cause for immediate termination of this agreement; and termination of this agreement for such interference shall be grounds for the loss of any retainer/s on file, and CLIENT shall remain responsible for any un-billed costs and expenses that exceed said retainer. In the event of such occurrence and the violation of this paragraph, payment in full is required within twenty-four hours. In the event, payment is not received within the twenty-four hours as herein indicated, CLIENT agrees to liability for all legal or other necessary fees in pursuit of outstanding balances. INTERIM UPDATES: CLIENT understands and agrees that that facts and evidence often change dramatically throughout the course of an investigation. Incomplete information gathered during an investigation is incomplete and therefore should never be used as a basis to form any conclusions. Accordingly, absent prior written agreement AGENCY does not provide routine interim updates during an ongoing investigation. AGENCY will provide CLIENT with a complete final report of all evidence gathered within five (5) business days after the conclusion of the investigation. FEE ENFORCEMENT: CLIENT agrees that if AGENCY is forced to take action to enforce the terms and provisions of this Professional Services Agreement, CLIENT agrees to pay reasonable costs and expenses of the litigation including all costs of collection, attorney’s fees, and the value of lost time in preparation for enforcement of this Agreement. CLIENT further agrees that this Agreement shall be governed by the laws of the State of Florida and venue shall be in the appropriate court of competent jurisdiction within the Circuit Court of Florida, Duval County or the Federal District Court for the Northern District of Florida, Jacksonville Division (county of residence for the investigator). AGENCY REPRESENTATIONS: AGENCY affirms that AGENCY is licensed under Chapter 493, Florida Statutes, to perform investigative and related services. AGENCY warrants to provide all services with the degree of care and skill required and in conformity with accepted professional standards in the investigative industry, and to comply with all local, state and federal laws and regulations. Except as specifically provided herein, AGENCY disclaims any and all other warranties, whether expressed or implied. INVESTIGATION RESULTS: CLIENT understands and agrees that AGENCY provides information as gathered and does not make any promise or guarantee whatsoever of the outcome of the investigation or the facts and information gathered. CLIENT agrees she/he/it is paying for professional investigative services only and that results of investigations by their nature are not guaranteed, are limited by time and CLIENT resources, and information obtained may not be what the CLIENT expects, desires or be in favor of the CLIENT. Accordingly, CLIENT agrees that CLIENT is prohibited from disparaging or defaming AGENCY or any if its directors, officers, agents or investigators through libel, slander or negative commentary in any print, broadcast or online media should CLIENT be dissatisfied or disagree with the results of the investigation. CLIENT understands and agrees that if she/he/it fails to strictly comply with this paragraph, AGENCY will seek legal redress against CLIENT including but not limited to injunctive relief, damages, attorney’s fees and costs of suit. CLIENT further understands and agrees that in the event AGENCY is forced to take legal action against CLIENT pursuant to this paragraph, CLIENT waives the confidentiality provisions of Ch. 493.6119 FS and all previously confidential information gathered by AGENCY in the course and scope of the investigation shall be subject to full public disclosure. CLIENT MISREPRESENTATIONS: CLIENT represents that all information provided AGENCY shall only be used in a lawful manner and shall not be used to cause any harm whatsoever upon the subject of the investigation or any other third party. CLIENT attests that he/she/it has not misrepresented any information or facts provided herein. CLIENT agrees that AGENCY reserves the right to refuse or discontinue service at any time for any issue or potential issue of security, safety, illegal, unethical or immoral reasons as determined exclusively by AGENCY. COURT APPEARANCES: CLIENT agrees that if any AGENT of AGENCY is called as a witness in any legal proceeding or to appear in court by any party, whether during or after completion of AGENCY’s contracted services, CLIENT agrees to pay AGENCY the daily rate of $ 2,500.00 for a full day, or $ 1,200.00 for one half day, per agent, paid in advance plus all reasonable and necessary costs and expenses incurred. The (1) day or (½) day minimum appearance fee is due in full no later than seven (7) calendar days before the date of the legal proceeding or court appearance. CLIENT agrees to pay all costs and any additional hourly fees due immediately upon receipt of invoice from AGENCY. AGENCY is entitled to lost or wasted time (cancellation, postponement) regardless of cause of loss/waste, whether the loss/waste is caused by CLIENT, witness, court, Hearing Officer, attorney(s), defendant(s), or opposing side, and is therefore non-refundable. INDEMNIFICATION: Upon receipt from AGENCY of any written or oral reports, photographs, videos or other information regarding the investigation detailed herein, with the exception of those arising from criminal acts, intentional torts, reckless acts, and acts of gross negligence, as determined by a court of competent jurisdiction, CLIENT agrees to fully indemnify, defend and hold harmless AGENCY, its directors, employees, agents, assigns, successor, heirs, owners, independent contractors and sub-contractors from any and all legal actions, claims, liabilities, expenses and fees including attorney’s fees, costs and/or judgments that may result at any time regarding the investigation. CLIENT further agrees that CLIENT’S request for information is permitted by law, and that CLIENT intends to use the information for a purpose permitted by law and none other. AGENCY does not assume any liability arising out of the use of AGENCY work product, by CLIENT or others. CLIENT, CLIENT'S heirs, beneficiaries, devisees, legatees, administrators and assigns, or any user of the product provided to CLIENT by AGENCY agree/s to indemnify and hold AGENCY, its officers, agents, subcontractors and employees harmless from any and all causes of action, liabilities, claims, damages and demands, including attorney fees, expenses, costs, and judgments arising from CLIENT’S use or possession of the information provided by AGENCY. CLIENT USE OF INFORMATION: CLIENT agrees that AGENCY in not a credit reporting agency. AGENCY promotes the responsible use of any information it provides and reserves the right to withhold any information that AGENCY deems is outside the scope of permissible purpose or otherwise defined by state and federal law and/or regulation. CLIENT understands and agrees to safeguard all information provided from unauthorized third party disclosure as defined by the Graham-Leach-Bliley Act (GLBA), Fair Credit Reporting Act (FCRA), Fair and Accurate Credit Transactions Act (FACTA), Drivers Privacy Protection Act (DPPA), Right to Financial Privacy Act (RFPA) and all other applicable state and federal laws and regulations and to seek legal counsel for advice regarding same. QUALITY/ACCURACY OF INFORMATION: CLIENT understands that AGENCY makes every reasonable, professional effort to ensure the quality and accuracy of all information provided; however, AGENCY cannot be responsible for, or testify to the validity of information contained in database reports where AGENCY has no control over the content. CLIENT understands that covert surveillance videos and photos by their nature are not professional media type productions and because they are often taken from long distances, unusual locations and during extreme weather and lighting conditions the quality can be variable. CLIENT agrees that AGENCY only provides copies of reports, videos and photos to herein named CLIENT. As required under Ch. 493 F.S. all original notes, reports, videos and photos are AGENCY’s protected work product, shall remain the exclusive property of AGENCY, maintained for two (2) years from the date of this Agreement and will only be released upon CLIENT’S written authorization or court order. CANCELLATION OF AGREEMENT: CLIENT agrees that after this Agreement is executed either party can terminate this Agreement, with or without cause, effective upon receipt of written notice of cancellation to the other party via electronic mail, facsimile, U.S. Mail or hand delivery. CLIENT agrees that if CLIENT elects to cancel this Agreement at any time, the fee provisions as stated in Paragraph five (5) herein remain in full force and effect. CLIENT agrees that early termination of the investigation by CLIENT will be considered a satisfactorily completed investigation. MANDATORY CLIENT DISCLOSURES: A. CLIENT affirms that that he/she is not a named party in a Petition (or) Order for Protection Against Domestic Violence (or) charged with domestic violence, stalking (or) aggravated stalking. B. CLIENT understands and agrees that that he/she is prohibited from using any information provided by AGENCY for purposes of harassment, defamation, domestic violence, stalking, intimidation, threatening or any other illegal purposes(s) whatsoever against any subject(s) of the investigation or any other person or entity. C. CLIENT understands and agrees that CLIENT must disclose and identify to AGENCY whether any other investigators were previously retained to work on this case at any time. SUSPENSION OF SERVICES: CLIENT understands and agrees that AGENCY will not authorize the use of any illegal activity in the course of the investigation, including but not limited to excessive speed to maintain mobile surveillance, or conduct surveillance if it is determined to be in a known dangerous or high crime area. AGENCY may, at its own discretion suspend the investigation at any time AGENCY perceives that the safety of any investigator, contractor, subcontractor or other third party may be in jeopardy. CLIENT acknowledges and agrees that interfering with the case, including but not limited to specific directive requirements, exposing or endangering investigators or the investigation; or interfering with any investigation including calling operatives, showing up, driving by a surveillance location, or alerting the subject etc., shall be cause for cessation of contract. If AGENCY determines that any of these conditions have been violated AGENCY will stop work immediately and CLIENT forfeits any remaining retainer and any balance is due immediately. Any of these behaviors will cause loss of retainer and/or any prepaid funds, as well as any/all costs incurred in the defense of contract, investigators, and legal protections necessary. CLIENT, by online signature (typed legal name and date), agrees and accepts responsibility for any such losses incurred. AUTHORITY TO BEGIN REPRESENTATION: As indicated by my initials on each preceding page and my signature below, CLIENT hereby affirms that I have read each page of this Professional Services Agreement in its entirety and I fully understand and agree to all of the terms and conditions contained herein. SECURITY: AGENCY will NOT provide information that could result in harm or confrontation, such as physical locations of the primary subject or offending party as indicated in the above intake document. In 'LOCATE' cases, such as 'lost loves' or 'adoption' AGENCY will contact the sought party and provide them the opportunity to refuse contact. CLIENT may provide a written statement to the sought party for delivery by AGENCY, and this written statement may not exceed more than three paragraphs, cannot be in a sealed container, and it is herein understood that AGENCY shall determine if such written statement is appropriate to deliver to sought party. At no time shall threats, whether veiled or overt, be delivered to any party at any time. Should such contact by sought party be refused, CLIENT, hereby agrees and acknowledges that services have been provided as requested and the agreement has been fulfilled. CLIENT understands that knowingly providing false, misleading or incomplete statements or information as related to this agreement shall result in an immediate termination of this agreement, forfeiture of all retainers and all monies due shall be immediately payable to AGENCY. DISCLAIMER: CLIENT accepts and acknowledges, with submission of form, that AGENCY is here to help you with your investigative need/s. Any information or leads acquired, or provided, will be used to meet that goal. While AGENCY makes every effort to fulfill the expectations and goals of the CLIENT, AGENCY will not fabricate information to substantiate desired results. CLIENT understands and agrees that there is NO GUARANTEE the outcome will meet CLIENT'S expectations or goals. CLIENT acknowledges and accepts that incorrect data sources, safety factors, legal issues, poor lighting and other unforeseeable factors may influence work product and outcome of case. CHARGEBACKS: CLIENT agrees and accepts that chargebacks shall be collectible at treble the amount charged back. CLIENT agrees to pay AGENCY for all work performed within 48hours of receipt of invoice. Mileage is calculated at $0.60 (sixty cents) per mile. Optional services provided at CLIENT'S, request or necessity, shall be subject to such specialists rates, and rates may vary dependent upon specialist required. (Examples include Forensics Specialists for phones, computers, etc). CLIENT understands and agrees to pay all billed expenses, including but not limited to media, equipment, phone calls, administrative, postage, travel, hotel, and per diem expenses within forty-eight hours of receipt. For the purposes of clarification, telephonic, email, texts, and instant message conversations with CLIENT and others are considered part of the investigation; as is report preparation, (including verbal reports, dictation, and written reports) reviews of all data, correspondence, travel time, legal and other research necessary and any other services requested or required to meet CLIENT goals, and are billable and payable upon not later than forty-eight hours of receipt. A minimum of (4) four hours shall be charged for all cases; additional time is billed in (4) hour increments as needed after the initial hours. Rounding time shall be permitted by AGENCY at their sole discretion (up after the quarter hour and down prior to). RETAINER: CLIENT shall submit a minimum retainer as instructed upon acceptance and review of case intake, and prior to commencement of any work. AGENCY will notify CLIENT in the event additional retainer is required. AGENCY shall not extend credit and should additional retainer be advised further work will not be performed until such time as additional retainer is received. AGENCY shall not be held accountable for work not performed during such time as funds are due and not received regardless of necessity for case outcome. Should such additional retainer become due, it is payable immediately upon notification of CLIENT, and notification shall be accepted as eMail, text message or telephonically. Retainer is required prior to the initiation of services and is non-refundable once services have begun. LEGAL COMPLIANCE: In the process of pursuing CLIENT goals, AGENCY shall comply with all provisions of Federal, State and local laws and regulations. AGENCY assumes, and CLIENT assures, that any information provided to CLIENT shall be used for lawful purposes only. CLIENT warrants that all information provided to CLIENT shall be used in accordance with all Local, State and Federal laws. AGENCY shall cancel this agreement, at it's sole judgement and discretion, if at any time the investigation is determined to jeopardize the safety of it's agents or others, or if it is discovered that CLIENT has made misrepresentations to AGENCY, or is in violation of any Local, State or Federal laws. CONFIDENTIALITY: AGENCY will keep and maintain all information strictly confidential. Except where required by law, to prevent harm to another, or to enforce this agreement, no information from reports shall be revealed to any person reported on or to any other person unless CLIENT gives express written consent. Nonpayment, misrepresentation, or other agreement violations shall constitute a waiver of CLIENT’S right to confidentiality, as required by AGENCY to collect on monies owed, or to prevent harm. RESPONSIBILITY: CLIENT agrees that EME is engaged solely by CLIENT, regardless of any third party’s ability and/or willingness to pay, and further agrees that if any monies owed are not paid by CLIENT within forty-eight hours after request is rendered, CLIENT will be subject to the maximum legal interest rate allowable per month and CLIENT shall be responsible for any reasonable expenses associated with collections including, but not limited to, AGENCY time at standard hourly rate (even if hourly rate had been herein discounted), and all attorney fees and costs related to collection of any past due amounts from CLIENT. A failure to pay shall void all confidentiality agreements herein. CLIENT further warrants that CLIENT is in a position to enter into this agreement on behalf of CLIENT or herein named party, and that CLIENT has the authority to hire AGENCY. CLIENT personally guarantees payment of all charges incurred and payable to AGENCY whether billed or not at the time of voiding confidentiality/agreement or completion of agreement. Credit card chargebacks and stop payments are covered under this agreement and in the event of CLIENT initiating either chargeback or stop payment, AGENCY shall pursue payment in accordance with the debt collection process as permissible by law. In addition, CLIENT shall be responsible for any overdraft fees, returned deposit fees, or chargeback fees associated with CLIENT’s payment, chargeback or stop payment. ENTIRE AGREEMENT: The online submission of this form is acceptance of agreement in its entirety. This submitted document contains the entire agreement between CLIENT & AGENCY, EXCEPT the hourly rate for any additional time this investigation requires beyond the initial flat fee, which shall be provided via email after submission of intake form and evaluation of case data submitted; and determination that additional time is requested/required. There are no other promises or conditions, oral or written, concerning the subject matter of this agreement. If the parties agree to the rate as determined by AGENCY, submitted to the client (telephonically, via text message or email) and as accepted by CLIENT, verified and validated by submission of payment in amount and in format as agreed upon. It is understood by CLIENT and AGENCY that this agreement supersedes any prior written or oral agreements between the parties. SEVERABILITY: If any provision of this agreement shall be determined invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If a court finds that any provision of this agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision will be deemed to be written, construed, and enforced as so limited. A faxed or emailed copy of this agreement shall serve as an original. Photocopies of this agreement shall be considered as valid as the original. AMENDMENTS: Modifications or amendments to this agreement shall be in writing, must be agreed upon by both parties, and such agreement shall be signed by the party obligated under the amendment before accepted or assumed accepted by either party. NOTICE: Any notice or communication required or permitted under this agreement shall be sufficiently given if delivered via eMail read-receipt verified to EnlightenMineEyes@gmail.com or Admin@EnlightenMineEyes.com, by facsimile to (904) 512-5334 via delivery-receipt verified, by hand delivery, or to such other accommodation as one party may have furnished to the other in writing and confirmed receipt thereof. Submission of this online form is agreement to this agreement in its entirety, and acknowledgement that CLIENT has fully read, and understands agreement. In witness whereof receipt of the agreed upon retainer has been received and accepted by AGENCY, the parties, AGENCY by acceptance of retainer as herein described; and CLIENT, by completion of online intake form, submission and payment thereof, shall accept agreement as a signed and legally binding contract; and indicates acceptance of agreement by typing CLIENT’S full legal name into the above form and submitting same online. Both CLIENT and AGENCY agree to acceptance of these terms as herein described using the online forum represented and agree to be bound by same. Please email any/all supporting documentation (pictures, videos, etc) to the email indicated below. Submission of this intake form does not constitute an agreement between the parties until such time as the retainer/payment has been paid by CLIENT and accepted by AGENCY. EMAIL SUPPORTING DOCUMENTATION AND DATA TO: Admin@EnlightenMineEyes.com *

You MUST place your initials in this block that you have read/understand/agree & have received this contract agreement.

Type FULL LEGAL NAME & Date of agreement. *

Message

*** ATTENTION BE SURE TO print INTAKE FORM for your records BEFORE HITTING SUBMIT, you are agreeing to these terms if you submit the form

EMAIL PICTURES & ANY SUPPORTING DATA TO: Admin@EnlightenMineEyes.com

*** ATTENTION ***BE SURE TO print INTAKE FORM for your records BEFORE HITTING SUBMIT, you are agreeing to these terms if you submit the form***

*** ATTENTION BE SURE TO print INTAKE FORM for your records BEFORE HITTING SUBMIT, you are agreeing to these terms if you submit the form