Indemnification Request Form

Indemnification Request Form — Form Fields

This legal template includes 5 fields. Allows employees or officers to formally request indemnification from the company for costs arising from legal proceedings related to their company role. Free to customize and use on ZenBuild.

• Requestor Name (text, required)
• Role at Time of Alleged Action (dropdown selection, required) — options: Director, Officer (CEO, CFO, etc.), Employee, Contractor
• Description of Legal Proceeding (long text, required)
• Estimated Legal Costs ($) (number, optional)
• Supporting Documentation (file upload, optional)