Conflict Waiver Application

Information About Your Firm

Law Firm Requesting Waiver:

Full Mailing Address of Law Firm:

Correspondence Email Address:

Attorney Making Request

First Name:

Last Name:

Email Address:

Dow Attorney To Whom Request Is Directed

First Name:

Last Name:

Information About The Conflict Of Interest

Legal Name of Firm's Client(s) Creating Potential Conflict:

Describe in Detail The Potential Conflict And How You Propose To Resolve It (vague request will be rejected):

Dow Matters Relating To Request:

Dow Entity On Whose Behalf Waiver Is Requested:

Is Confidential M&A Request:

Additional Information Or Comments: