Terms and Conditions
Version 2.0 · Effective 6 September 2026
Replaces the Terms of Service dated December 2024.
These terms apply worldwide. We hold ourselves to EU consumer standards everywhere. A few clauses exist only because EU or national law requires them; those are marked (EU consumers) or by country, and they apply to the people they name.
1. Who we are
1.1 AstroDexa is operated by Dexa LLC ("AstroDexa", "we", "us").
Postal address: published here once company registration completes; until then write to [email protected].
Email: [email protected]. We aim to answer within one working day, and we answer complaints within 14 days.
1.2 When you buy a consultation through AstroDexa, you are buying it from the astrologer, not from us. Section 10 explains that in full.
1.3 Using AstroDexa means you accept these terms. If you do not accept them, do not use the service.
2. Words we use
- AstroDexa, we, us — the platform and the company operating it.
- You — the person using the service.
- Consumer — someone using AstroDexa outside their trade, business or profession.
- Astrologer — an independent professional who holds an Astrologer subscription and offers consultations through AstroDexa. Astrologers are business users, not consumers, in respect of that subscription and their use of the marketplace.
- Client — someone who books a consultation with an astrologer.
- Digital content — a single item delivered once, such as a generated chart.
- Digital service — ongoing access to the app and its evolving features, such as an Elara Subscriber or Astrologer subscription. These two terms track the definitions in EU Directive 2019/770, and the withdrawal rules in section 8 differ between them.
3. What AstroDexa is
3.1 AstroDexa has three parts:
- The app — astrological calculation and chart tools: natal, transit, synastry, composite, progressed and return charts, workspaces, and a private journal.
- The directory — public profiles of practising astrologers.
- The marketplace — booking and paying for consultations with those astrologers.
3.2 The app calculates charts and presents astrological data. Section 17 says what that is and is not.
3.3 We may change, add or retire features. If a change materially reduces what a paid plan gives you, section 21 applies.
3.4 We do not promise uninterrupted service. We do aim for it, and we will not treat routine maintenance as a licence to be careless.
4. Accounts
4.1 Age. You must be at least 16 to hold an account.
4.2 Signing in. AstroDexa has no passwords. You sign in with a one-time code sent to your email address, or through Google or Apple.
4.3 Accurate information. Give us correct account details and keep them up to date. Astrologers must give accurate identity, qualification and payout information.
4.4 Keeping your account secure. Because sign-in runs through your email or your Google or Apple account, access to those is access to AstroDexa. You must keep them secure, not share your one-time codes with anyone, and tell us promptly at [email protected] if you think someone else has got in.
4.5 What that does and does not mean. If someone uses your account because you gave away your codes, shared your mailbox, or ignored a compromise you knew about, the consequences are yours. Where the cause was something on our side — a defect, a breach, a security failure of ours — the consequences are ours, and nothing in this section shifts them to you. (EU consumers) Nothing here removes your statutory protections, including the limits on your liability for unauthorised payment transactions.
4.6 One account per person. Accounts are personal. Do not share or transfer one. Astrologers may not let another person practise under their profile.
5. Plans, prices and payment
5.1 The plans. AstroDexa offers a free tier, an Elara Subscriber subscription for clients, and an Astrologer subscription for practitioners. Each is a superset of the one before it. Charts of other people can also be bought outright as one-time purchases.
5.2 Prices. The current prices for every plan and purchase are shown on the pricing page and again at checkout, before you commit. The price shown to you at that moment is the price that applies. Prices are in US dollars unless the checkout says otherwise.
5.3 Tax. Prices are shown inclusive of the taxes applicable to you where the law requires it. Lemon Squeezy handles VAT and sales tax as merchant of record.
5.4 The booking fee. Booking a consultation costs a flat $10 booking fee on top of the astrologer's price, paid by the client. Elara subscribers do not pay it. The fee is always shown together with the astrologer's price as a single total before you commit — never added at a later step.
5.5 Who takes your money.
- Subscriptions and one-time purchases go through Lemon Squeezy, which acts as merchant of record. Lemon Squeezy is the seller of record for those transactions and its own buyer terms apply alongside these. Where Lemon Squeezy's terms give you more than ours do — including any withdrawal or refund right — those terms win. We will not apply a refund policy more restrictive than the one you were offered at their checkout.
- Consultations are paid to the astrologer through Stripe Connect. Stripe is a payment processor, not a seller. The astrologer is the seller; our booking fee is our own separate charge for the booking service.
5.6 Failed payments. If a payment fails we may retry it and may suspend paid features until it clears. We will tell you before we do.
5.7 Price changes. We may change prices for future billing periods. We will tell you at least 30 days before a change affects you, and you can cancel before it takes effect. A price change never applies to a period you have already paid for, and never to a one-time purchase already made.
6. Subscriptions
6.1 Billing. Subscriptions are billed monthly or yearly in advance, as you chose, and renew automatically at the same interval until you cancel.
6.2 Cancelling. You can cancel at any time from your account settings. Cancellation takes effect at the end of the period you have already paid for. Until then you keep everything the plan gives you. Nothing renews after that.
6.3 How easy cancelling has to be. There is a clearly labelled cancel control in your account settings. It takes no more than a few clicks, we do not put a retention flow in front of the final click, and we do not require anything beyond your normal sign-in.
- (Germany) German consumers also get a cancellation button labelled "Verträge hier kündigen", reachable from the website without signing in, leading to a confirmation form that completes the cancellation in one further click.
- (France) French consumers get an equivalent electronic cancellation path of no more than three clicks.
6.4 Renewal reminders. Before any annual renewal we email you at least 30 days in advance, telling you the renewal date, the price, and how to cancel. (France) For French consumers this notice is sent between one and three months before the cancellation deadline; if we fail to send it, you may cancel free of charge at any time from the renewal date.
6.5 No refunds for the unused part of a period. Once a billing period has started we do not refund it, in whole or in part, and cancelling does not produce a credit. You keep access to the end of the period instead. This is subject to the withdrawal right in section 8 and the conformity rights in section 9, which we do not and cannot displace.
6.6 Astrologer subscriptions are business purchases. The Astrologer subscription is sold for professional use. At signup you confirm that you are subscribing for the purposes of your trade or profession. (EU) That means the consumer withdrawal right in section 8.2 does not apply to it. Your protections as a business user of the platform are in section 13.
7. One-time chart purchases
7.1 Charts of other people can be bought individually or in packs. A one-time purchase is permanent on your account. It is not affected by starting, changing, cancelling or losing a subscription.
7.2 These purchases are digital content, generated and delivered to your account immediately.
7.3 Refunds. Because delivery is immediate and permanent, one-time purchases are not refundable, subject to sections 8.1 and 9.
8. Right of withdrawal — EU and EEA consumers
If you are a consumer in the EU or EEA, you normally have 14 days to withdraw from a distance contract without giving a reason. How that works depends on what you bought, and the three cases below are genuinely different.
8.1 One-time chart purchases — the waiver applies.
Charts are digital content delivered immediately. Before you pay, you tick a box (never pre-ticked) that says:
"I want AstroDexa to generate and deliver this chart to me immediately, and I understand that I lose my 14-day right of withdrawal once it is delivered."
We then email you a confirmation recording that consent, as Article 8(7) of the Consumer Rights Directive requires. Once the chart is delivered, the withdrawal right is gone and section 7.3 applies. If we ever fail to obtain that tick or send that confirmation, you keep the full 14-day right and we will refund you.
8.2 Subscriptions — 14 days, and no waiver.
Elara is a digital service, not digital content: it changes over time, it is personalised, and it keeps working for you throughout the term. Following the Court of Justice's ruling in Sky Österreich Fernsehen (C-234/25, 9 July 2026), a service like that cannot be waived out of the withdrawal right by consent.
So: you have 14 days from the day you first subscribe to withdraw, whether or not you have used the app. Tell us at [email protected] or use the withdrawal form in your account.
If you withdraw after starting to use the service, we may keep an amount proportionate to what you actually received before you withdrew, based on the days elapsed and the paid features you actually used. We refund the rest within 14 days, by the same payment method you used. We will show you the calculation. We will not keep the whole payment.
8.3 Renewals. The 14-day right attaches to the contract when you first sign up. A monthly renewal at the same price is continued performance of the same contract, not a new one, so it does not start a new 14-day window. We treat annual renewals the same way, and in the first 14 days after an annual renewal we will honour a withdrawal request as if the renewal were a new signup.
8.4 Consultations — no cooling-off once a slot is booked.
A booked consultation is a service for a specific date and time, in the same category as a concert ticket, a restaurant booking or a personal-training slot. Under Article 16(l) of the Consumer Rights Directive there is no 14-day withdrawal right for those, and that holds even though you book through a platform rather than direct with the provider (DM v CTS Eventim, C-96/21). What applies instead is the astrologer's cancellation policy in section 11.
For a written reading with no fixed appointment time, the digital-content mechanics in 8.1 apply instead: you consent to immediate performance at checkout and acknowledge losing the withdrawal right, and we confirm that by email.
8.5 How to withdraw. Email [email protected] with your account email and what you are withdrawing from. A statement in your own words is enough; you can use the model withdrawal form in the Annex at the end of these terms if you prefer. We acknowledge within one working day.
9. If something we sold you does not work
9.1 (EU consumers) Under Directive 2019/770 you have rights when digital content or a digital service does not conform to what we described — it is defective, it lacks features we promised, or it is not the quality you could reasonably expect. Those rights are:
- we fix it, within a reasonable time and without significant inconvenience to you;
- if we cannot fix it, or do not fix it in time, a proportionate price reduction;
- if the defect is not minor, you can end the contract and get a refund of the affected part.
9.2 These rights cannot be signed away, and nothing in sections 6.5, 7.3 or 19 limits them. Our no-refund policy is about changing your mind. It is not about us delivering something broken.
9.3 A miscalculated chart is a defect, not an interpretation. If the software applies the wrong house system, the wrong ayanamsa, the wrong time zone, or gets the mathematics wrong, that is a conformity problem and section 9.1 applies, whatever section 17 says about astrology being interpretive.
9.4 Tell us at [email protected] and we will look at it.
10. Booking a consultation: who you are buying from
10.1 Consultations are sold by individual astrologers. The astrologer is the trader and the seller. The contract for the reading is between you and them. AstroDexa provides the platform: the profile, the booking, the payment rail, the reminders, and the video room. Our booking fee pays for that, and it is a separate service from the reading.
10.2 Every booking screen, confirmation, calendar entry and receipt names the astrologer you are booking with. If you are unsure who you are contracting with, it is the person named there.
10.3 What we are responsible for. Running the platform: that booking works, that payment reaches the right person, that the session room opens, that your data is handled as the privacy policy says.
10.4 What the astrologer is responsible for. The consultation itself — its content, quality, timing and delivery — and their own professional and tax obligations. We do not supervise the content of readings, and we do not guarantee the outcome of one.
10.5 If a consultation goes wrong, raise it with the astrologer first. If that does not resolve it, contact us at [email protected]. We will look at the booking record, mediate where we can, and can refund the booking fee and, where the facts warrant it, reverse the payment.
10.6 Offerings. Astrologers publish named offerings with their own prices. Live sessions state their duration. Written readings are labelled as such and state their delivery deadline. If a written reading is not delivered by its deadline, the client is refunded in full, booking fee included.
10.7 What the astrologer sees. Booking a consultation shares your chart with that astrologer, for that booking — they need it to prepare the reading. Nothing else of yours is shared unless you choose it: your journal and notes go to them only if you tick the share box for that specific booking, and the choice never carries over to the next one. Their access ends one hour after the consultation ends. Section 13 of the privacy policy explains what the astrologer may keep afterwards and who to ask about it.
11. Changing or cancelling a booking
11.1 Each astrologer sets a cancellation policy from three presets we provide, and the one that applies to your booking is shown on the booking screen before you pay and repeated in the confirmation:
| Preset | Cancel free until | Cancel inside that window | No-show |
|---|---|---|---|
| Flexible | 24 hours before the session | 50% of the price | 100% |
| Standard | 48 hours before the session | 50% of the price | 100% |
| Strict | 72 hours before the session | 100% of the price | 100% |
Astrologers choose one of these three. They cannot write their own terms, and rescheduling never re-charges you.
11.2 A cancellation fee must reflect the real loss to the astrologer from a slot held and not filled. We do not allow punitive fees, and a fee out of proportion to that loss is not enforceable.
11.3 If the astrologer cancels, or does not show up, you get a full refund, booking fee included.
11.4 If you do not show up, or cancel too late under the policy shown to you, the astrologer keeps their fee under that policy.
11.5 These are ordinary contract terms. They are not a substitute for a statutory right, and they do not affect section 9.
12. Reviews
12.1 Who can leave one. Only a client who completed and paid for a consultation of $50 or more with that astrologer. That is how we verify every review is from a real client of that astrologer: it is tied to a completed payment we can see.
12.2 What is excluded. Reviews from unpaid or free consultations, from bookings under $50, and from anyone who did not complete a booking. We do not accept, solicit or publish reviews from any other source, and we do not write, buy or incentivise reviews.
12.3 Editing and removal. We publish reviews as written. We remove a review only if it is unlawful, abusive, reveals someone's private information, or is demonstrably not from the client it claims to be from. When we remove one we tell the author why. Astrologers cannot delete reviews of themselves.
12.4 Ranking. Review scores do not currently affect directory ranking. If that changes, this section and section 13.2 will say so first.
13. Terms for astrologers (business users)
This section applies to Astrologer subscribers. It sits alongside everything above, and it exists partly because EU Regulation 2019/1150 on platform-to-business fairness requires it.
13.1 Your status. You are an independent practitioner. You are not our employee, agent or partner. You set your own prices, availability, offerings and cancellation policy, you provide your own services, and you handle your own taxes and any professional registration your country requires.
13.2 How ranking works. The default "Recommended" order on directory and search pages is decided by these parameters, in order of importance:
- Whether your profile is claimed. Profiles that an astrologer has claimed, including identity-verified ones, are always placed above profiles nobody has claimed, whatever the rest of this section says. A claim we are still reviewing does not count as claimed until it is approved.
-
Your quality band. We score how substantial a profile is, and group profiles into bands by that score. Among profiles on the same side of the claim line, a profile in a higher band is always placed above a profile in a lower band. The score is built from:
- How complete your profile is — your bio first, then the traditions and focus areas you list, your languages, your location, your website link, and whether you have built out a profile page. This is the heaviest of the profile signals.
- Whether your profile has a photo.
- Your claim and verification status — which also counts towards the score, so a claim under review already lifts a profile among the unclaimed ones, and a verified profile scores above a merely claimed one.
- Whether you have an active Boost. An active Boost lifts your profile one band, and within that band it makes your profile more likely to be drawn near the top. It cannot lift you above the highest band, it never places you above a profile that sits in a band higher than the one it has lifted you into, and it never places an unclaimed profile above a claimed one. Boost is described in 13.3.
- The rotation. The order inside a band is not fixed. It is drawn again for each visitor and changes through the day, so that profiles of comparable quality take turns near the top of their band instead of one of them holding the position permanently.
Typing a search narrows the list to the profiles that match the words. It does not order them: what is left is ordered by the four parameters above.
Visitors can also switch the order to alphabetical by name or to newest, which overrides all of the above entirely, Boost included.
If we change the main parameters materially, section 13.6 notice applies.
13.3 Boost. Boost is optional paid placement in slots labelled "Featured", cycled among participating astrologers. An active Boost also lifts your profile in the ordinary "Recommended" order, in the way 13.2 describes. It does not affect verification or trust signals. The fee is 30% of a new client's first booking, with a $30 minimum and a $100 maximum, charged only when the client reached you through a boosted placement and books within 30 days of that click, and only for a client you have never worked with before. Nothing is ever charged on repeat bookings. Where a first booking is too small to carry the minimum fee on the transaction, the fee draws from a prepaid Boost balance, and a positive balance is required for such bookings to be boost-eligible. Boost fees are refunded when the underlying booking is refunded.
13.4 Fees and payouts. Your subscription is a flat fee. We take no commission on your consultations and charge you no per-booking fee. The $10 booking fee is charged to the client, not to you. Payouts run through Stripe Connect on Stripe's schedule, and you must complete Stripe's identity verification before you can be paid.
13.5 Your clients' data. When you keep client charts, notes or portals in AstroDexa, you are the data controller for that data and we process it on your behalf. You accept our Data Processing Agreement, available at [email protected] on request, when you use those features. You are responsible for having a lawful basis to hold your clients' data and for giving them your own privacy notice. Section 13 of our privacy policy explains the split.
13.6 Changes to these terms for you. We give you at least 15 days' notice, by email, of any change to these terms that materially affects you, and longer where the change requires you to make technical or commercial adjustments. If you do not accept the change, you can terminate your subscription before it takes effect. Continuing to use the platform after the notice period means you accept it. This notice period does not apply where a change is required by law or is needed to address an immediate security or legal risk.
13.7 Suspension and termination of your account. If we restrict, suspend or terminate your account or a listing, we give you a written statement of the reasons, on a durable medium, before it takes effect where we can, and at the latest when it does. You can respond and ask us to reconsider at [email protected]. Where the reason is illegality, fraud, a repeated breach, or a legal obligation, we may act immediately.
13.8 Data you can access. You can access and export your own profile data, your bookings, your client records, your reviews and your payout history at any time from your account. We do not give any astrologer access to another astrologer's data, and we do not sell astrologer or client data to anyone.
13.9 Differentiated treatment. We do not sell consultations ourselves and we do not operate a house astrologer. The only favourable treatment any astrologer receives from us is Boost, and it reaches exactly two places: the labelled "Featured" placements described in 13.3, and the band lift and draw advantage in the "Recommended" order described in 13.2. It reaches nothing else. Paying us never affects how your reviews are displayed, how we moderate content, or the outcome of a verification or credential check. If any of that ever changes, we will disclose it here first.
13.10 Complaints. Write to [email protected]. We acknowledge within 3 working days and aim to resolve within 14 days.
14. Reporting content, and moderation
14.1 Anyone can report a profile, an offering, a review or any other content on AstroDexa that they believe is illegal or breaks these terms. Use the removal and report page at astrodexa.com/legal/remove or write to [email protected]. Tell us what the content is, where it is, and why. We confirm receipt, review it, and tell you what we decided.
14.2 When we remove, demote or restrict content, we give the person who posted it a statement of reasons: what we did, what facts we relied on, whether the decision was made or assisted by automated tools, which term or law it rests on, and how to challenge it.
14.3 You can challenge any moderation decision by replying to that statement.
15. What you may not do
Do not:
- use AstroDexa for anything unlawful, or to harass, defraud or impersonate anyone;
- enter another person's data without a lawful reason to do so (see section 8 of the privacy policy);
- try to break into any part of the service, or into anyone else's account;
- scrape, bulk-download or systematically copy the directory, profiles or chart data;
- disrupt the service, overload it, or interfere with anyone else's use of it;
- resell or redistribute the service, or share your account;
- take bookings or payments off-platform after meeting a client through AstroDexa in order to avoid platform fees;
- present AI-generated or third-party readings as your own work when selling consultations;
- misrepresent your qualifications, accreditation or verification status.
16. Content and intellectual property
16.1 Yours. You own your birth data, your charts, your notes and your journal. You own the profile content and offerings you write. You give us the limited licence we need to store, process and display it in order to run the service — including showing your profile publicly, if you are an astrologer who has published one. That licence ends when the content is deleted, except for copies still in backups on the rotation described in the privacy policy.
16.2 Ours. The software, the design, the chart rendering, the databases and the brand are ours. Do not copy, resell, decompile or reverse-engineer them.
16.3 Astrologers' work. A written reading delivered to a client belongs to the client to keep and read. The astrologer keeps copyright in it. Neither we nor the client may republish it commercially without the astrologer's permission.
16.4 We never use your personal data to improve the product. Improvement runs only on aggregated, de-identified data that can no longer be tied to you, inside our organization only. We do not use your journal, notes, chart interpretations or messages to train or tune anything, and there is no opt-in for it, because we do not do it. Section 4 of the privacy policy spells this out.
17. What astrology is, in our hands
17.1 AstroDexa calculates astronomical positions accurately and presents them in astrological form. The calculations are precise. The interpretations are interpretations.
17.2 Astrology is a reflective and interpretive framework. We offer it as a way to think about timing, character and relationship — not as a source of factual predictions about what will happen to you.
17.3 Nothing on AstroDexa, and nothing in a consultation booked through it, is medical, psychological, legal or financial advice. For decisions about your health, your money, your legal position or your safety, consult a qualified professional in that field. If you are in crisis, contact a doctor or an emergency service.
17.4 We do not say "for entertainment purposes only", because that would contradict what we actually build and how we describe it. We say what is true instead: the mathematics is exact, the meaning is interpretive, and the responsibility for your decisions is yours.
18. Availability
18.1 We aim to keep AstroDexa available and working. We do not promise it will never be interrupted, and we may take it down for maintenance, ideally with notice.
18.2 Outside the statutory rights in section 9, the service is provided as it is. That is a statement about scheduled downtime and the ordinary imperfection of software, not a disclaimer of the rights described elsewhere in these terms.
19. Liability
19.1 What we do not limit. Nothing in these terms excludes or limits our liability for:
- death or personal injury caused by our negligence;
- fraud or fraudulent misrepresentation;
- gross negligence or intentional misconduct;
- (EU consumers) your conformity rights under section 9, or any other liability that cannot be excluded under the law of your country of residence.
19.2 What we do limit. Subject to 19.1, we are not liable for indirect or consequential loss, lost profits, lost business, lost goodwill, or loss caused by decisions you made on the basis of an astrological interpretation.
19.3 Cap. Subject to 19.1, our total liability arising out of your use of AstroDexa in any 12-month period is limited to the greater of the amount you paid us in that period and $100.
19.4 Consultations. We are not liable for the content, quality or conduct of a consultation, which the astrologer provides and is responsible for under section 10. We remain liable for the platform, the booking and the payment.
19.5 Astrologers. If you are an astrologer, you indemnify us against claims arising from your consultations, your professional conduct, and your handling of your clients' data. This does not apply to consumers.
20. Suspension and termination
20.1 By you. Close your account at any time from your settings. Section 6.2 governs what happens to a paid period. Section 12 of the privacy policy explains what happens to your data.
20.2 By us. We may suspend or terminate an account where you have breached these terms, used the service unlawfully or fraudulently, failed to pay, or where we are legally required to. We tell you the reason and, unless the breach is serious or immediate action is legally required, give you notice and a chance to fix it first. Astrologers additionally get the reasoned-statement protections in section 13.7.
20.3 We do not terminate accounts at our sole discretion for no reason. If we ever need to withdraw the service generally, we will give at least 30 days' notice, let you export your data, and refund the unused part of any paid period.
21. Changes to these terms
21.1 We may change these terms where there is a valid reason: a change in the law, a change in the service, a new feature, a security or fraud problem, or a change in our costs or payment providers.
21.2 For consumers, we give at least 30 days' notice by email and in the app before a material change takes effect, telling you what changed and why. If you do not accept it, you can cancel before it takes effect and we refund the unused part of any paid period. For astrologers, section 13.6 applies.
21.3 Minor changes — corrections, clarifications, new contact details — take effect on posting.
21.4 Previous versions stay available on request at [email protected], and the version these terms replace stays archived on the site.
22. Law, courts and complaints
22.1 Governing law. These terms are governed by the law of the State of Maryland, United States. (EU consumers) That choice does not deprive you of the protection of the mandatory consumer-law rules of the country where you live. Where those rules give you more than this contract does, they apply.
22.2 Courts. (EU consumers) You may bring proceedings against us in the courts of the country where you live, and we may only bring proceedings against you there. There is no arbitration clause in these terms, and no clause requiring you to litigate away from home.
22.3 Complaints first. Write to [email protected]. We acknowledge quickly and aim to resolve within 14 days. Most problems end there.
22.4 Alternative dispute resolution. (EU consumers) If we cannot resolve your complaint, you can take it to an alternative dispute resolution body in your own country. Consumer authorities in each Member State maintain lists of the competent bodies for online services. We have not committed to a specific ADR body. The EU's central Online Dispute Resolution platform stopped taking cases in March 2025 and no longer exists, so there is no EU-wide link to give you.
22.5 If any part of these terms is found unenforceable, the rest stays in force.
23. Privacy
Your data is covered by the AstroDexa Privacy Policy, linked in the footer of every page, which forms part of your agreement with us.
24. Version
Version: 2.0. Effective: 6 September 2026. Replaces: the AstroDexa Terms of Service dated December 2024.
Annex — Model withdrawal form
(Complete and return this form only if you wish to withdraw from the contract.)
To Dexa LLC, [email protected]:
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*),
Ordered on (*)/received on (*): ______________________
Name of consumer(s): ______________________
Address of consumer(s): ______________________
Signature of consumer(s) (only if this form is notified on paper): ______________________
Date: ______________________
(*) Delete as appropriate.