This Agreement is made and entered into as of [Date], by and between:

Company:
Company A
[Company Address]
[State/Country]

Shareholder:
[Shareholder Name]
[Shareholder Address]
[State/Country]

Recitals

WHEREAS, the Company intends to provide an advance payment to the Shareholder in anticipation of future dividends; and

WHEREAS, the Shareholder agrees to accept such advance payment under the terms and conditions set forth in this Agreement;

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the parties agree as follows:

1. Advance Payment

The Company agrees to advance the Shareholder the amount of [Advance Amount] (the "Advance Payment") on or before [Payment Date].

2. Repayment Terms

(a) The Advance Payment will be repaid through deductions from future dividends declared by the Company.

(b) The Shareholder acknowledges that the Advance Payment will be offset against any dividends that would otherwise be payable to the Shareholder in the future until the full amount of the Advance Payment is recovered.

3. Interest

No interest shall accrue on the Advance Payment.

4. Future Dividends

(a) The Advance Payment shall be deducted from dividends payable to the Shareholder in the future.

(b) If the total dividends declared in any period are less than the amount of the Advance Payment, the Company will continue to deduct the remaining balance of the Advance Payment from subsequent dividends until the Advance Payment is fully repaid.

5. Legal and Tax Implications

The Shareholder acknowledges that the Advance Payment may have legal and tax implications and agrees to consult with their legal and tax advisors regarding these implications.

6. Dispute Resolution

Any disputes arising under this Agreement shall be resolved through [Specify Dispute Resolution Mechanism], such as arbitration or mediation, in accordance with the rules of [Arbitration/Mediation Institution] or applicable laws.

7. Amendments and Termination

(a) This Agreement may be amended only by a written agreement signed by both parties.

(b) This Agreement may be terminated by mutual written consent of the parties.

8. Notices

Any notice required or permitted under this Agreement shall be in writing and delivered to the parties at the addresses set forth above or such other address as either party may designate by written notice.

9. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of [State/Country].

IN WITNESS WHEREOF, the parties hereto have executed this Dividend Advance Payment to Shareholder Agreement as of the day and year first above written.

Company A

By: __________________________
Name: [Authorized Signatory]
Title: [Title]

[Shareholder Name]

By: __________________________
Name: [Shareholder]

This template provides a basic framework for a Dividend Advance Payment Agreement. You may need to tailor specific terms to fit the needs of both parties and ensure compliance with applicable laws and regulations. Consulting with a legal professional is advisable to address any specific legal or regulatory considerations.