Legal Client Questionnaire

LEGAL CLIENT QUESTIONNAIRE

This Legal Client Questionnaire is entered into by and between Client Name: and Firm Name: . Effective Date: .

RECITALS

WHEREAS, the Client desires to retain counsel to evaluate and potentially represent the Client in the matter described in Section 3 below and to provide related legal services; and

WHEREAS, the Firm has requested certain factual, organizational and documentary information to perform conflicts checks, determine scope, and assess fees; and

WHEREAS, the Client will provide the information requested in this Questionnaire and understands that the responses will be relied upon by the Firm in evaluating representation and forming the attorney-client relationship.

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

1. SCOPE OF QUESTIONNAIRE

This Questionnaire is intended to gather information necessary for the Firm to (a) perform conflicts and background checks, (b) evaluate the nature and scope of the proposed representation, and (c) prepare an engagement letter if representation proceeds. Completion of this Questionnaire does not by itself create an engagement for legal services, and any representation will be governed by a separate engagement agreement.

2. CLIENT IDENTIFICATION

Individual Corporation Limited Liability Company Partnership Other:

3. DESCRIPTION OF MATTER

Anticipated primary legal objective(s):

4. CONFLICTS, PRIOR REPRESENTATION, AND INTERESTS

Has the Client previously consulted or been represented by any other attorney or firm regarding this matter? Yes No

List all persons, entities or parties you believe may have interests adverse to the Client in this matter (include names and relationships):

5. DOCUMENTS AND EVIDENCE

Please indicate which documents you have or will provide to the Firm (select all that apply):

Contracts/Agreements Emails/Communications Financial Records Corporate Formation Documents

6. FEES, BILLING, AND RETAINER

Does the Client currently have a budget or ceiling for fees in this matter? Yes No

Preferred billing method: Hourly Flat Fee Contingency Other:

7. CONFIDENTIALITY AND PRIVILEGE

The Client acknowledges that communications and information provided to the Firm may be protected by the attorney-client privilege and work product doctrine to the extent applicable. The Client represents that disclosure of any privileged material to the Firm is intentional and waives no privilege as to third parties without separate written waiver. The Firm will take customary measures to preserve confidentiality consistent with professional obligations.

8. REPRESENTATIONS

The Client represents and warrants that the information provided in this Questionnaire is true, complete and correct to the best of the Client's knowledge and belief as of the Effective Date. The Client agrees to promptly notify the Firm in writing of any material change to the information provided.

9. NOTICES

All formal notices required under any subsequent engagement agreement or arising from this Questionnaire shall be delivered to the addresses below unless otherwise agreed in writing.

10. AMENDMENTS; WAIVER

This Questionnaire may be amended or supplemented only by a written instrument signed by both parties. No failure or delay by either party in exercising any right shall operate as a waiver of that right unless a written waiver is executed by the waiving party.

11. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

Governing Law: This Questionnaire shall be governed by and construed in accordance with the internal laws of the state governing the Firm's principal office, without regard to its conflict of law principles.

Entire Agreement: This Questionnaire, together with any written engagement letter signed by the parties, constitutes the entire understanding between the parties with respect to the subject matter hereof and supersedes all prior communications and representations, whether oral or written.

Severability: If any provision of this Questionnaire is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect and the offending provision shall be reformed only to the minimum extent necessary to make it valid and enforceable.

12. CERTIFICATION

By signing below, the Client certifies under penalty of perjury that the information provided in this Questionnaire is true, correct and complete to the best of the Client's knowledge and that the Client has the authority to provide such information. The Firm acknowledges receipt of this Questionnaire and agrees to rely upon the information herein for initial conflicts and intake purposes.

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