Client Suitability Questionnaire

Client Suitability Questionnaire and Engagement Agreement

Parties and Recitals

This Client Suitability Questionnaire and Engagement Agreement (the Agreement) is entered into by and between:

WHEREAS, Service Provider provides advisory, consulting, or other professional services for business planning, capital formation, or operational improvements; and

WHEREAS, Client seeks to engage Service Provider to evaluate Client's suitability for the proposed services and, based on that evaluation, to enter into an engagement governed by the terms set forth below; and

NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows.

Client Identification

Corporation    LLC    Partnership    Individual

Scope of Work

Service Provider will perform the services described in this Scope of Work. The parties acknowledge that accurate knowledge of Client's financial position, business objectives, and experience is necessary to assess suitability and to define a tailored scope.

Client Suitability Questionnaire

1. Primary business activity or occupation:

2. Investment / Engagement objectives (select all that apply):

Growth of capital    Income generation    Capital preservation    Speculative / High risk

3. Risk tolerance (check one):    Conservative    Moderate    Aggressive

4. Prior experience with similar engagements (years):

Financial Profile

Annual revenue or household income: $

Estimated net worth (excluding primary residence): $

Liquid assets available for this engagement: $

Payment Terms

Client agrees to pay Service Provider the fee described below in consideration of the services. All fees are exclusive of applicable taxes unless otherwise agreed in writing.

Late payment will incur a late fee of on outstanding balances, compounded monthly, to the fullest extent permitted by law.

Term and Termination

This Agreement commences on the Start Date and continues until the End Date unless earlier terminated in accordance with this Section.

Start Date:    End Date:

Either party may terminate this Agreement upon written notice to the other party at least days prior to the intended termination date. Service Provider may terminate immediately for material breach by Client, including failure to pay fees when due.

Confidentiality

Each party shall hold in strict confidence all Confidential Information disclosed by the other party and shall not use Confidential Information except as necessary to perform its obligations under this Agreement. Confidential Information means non-public information designated as confidential or which, by its nature, ought reasonably to be treated as confidential.

The obligations of confidentiality do not apply to information that: (a) is or becomes generally available to the public other than through a breach of this Agreement; (b) is received from a third party without breach of any obligation of confidentiality; or (c) is required to be disclosed by law or regulation, provided the receiving party gives the disclosing party prompt notice and cooperates in limiting or contesting such disclosure.

Conflicts and Representations

Yes    No

Client represents and warrants that the information provided in this Questionnaire is true, complete, and accurate to the best of Client's knowledge and that Client will promptly notify Service Provider of any material changes to such information.

Governing Law and Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflicts of law principles.

This Agreement, together with any attachments and the information provided in this Questionnaire, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous agreements, understandings, and communications, whether written or oral.

Certifications

By signing below, Client certifies that the information contained in this Questionnaire is accurate and complete and acknowledges that Service Provider will rely on this information in assessing suitability and in performing the services described herein. Client further acknowledges that failure to provide truthful and complete information may result in termination of the engagement or other remedies.

Sign Now