Legal PC Report

LEGAL PC REPORT

This Legal PC Report (the "Report") is made as of Day Month Year by and between Reporting Party: , Entity Type: , Principal Office: ; and Recipient: , Recipient Address: .

RECITALS

WHEREAS, the Reporting Party is organized as a professional corporation and provides professional legal services through licensed individuals and maintains corporate records, licenses, and compliance systems as required by applicable professional regulation; and

WHEREAS, Recipient is the individual or entity designated to receive and review the Reporting Party's corporate, regulatory, conflict and compliance disclosures for the purpose stated herein; and

WHEREAS, the parties desire to document the Reporting Party's corporate status, licenses, conflicts, material proceedings, remedial steps and certifications in a form suitable for internal, regulatory or transactional review.

NOW THEREFORE, in consideration of the mutual covenants contained in this Report, the parties agree as follows:

1. Definitions

For purposes of this Report, the following terms have the meanings set forth below: "Reporting Party" means the entity identified above; "Recipient" means the entity identified above; "Material Proceeding" means any litigation, arbitration, administrative or disciplinary matter that could reasonably be expected to result in material liability or impairment of professional license.

2. Entity Information

Day Month Year

3. Licensed Professionals and Ownership

4. Compliance Checklist

The Reporting Party represents and warrants the following:

Corporate formalities and minute records are maintained in accordance with applicable law.

All required professional licenses and registrations for practicing professionals are current.

Malpractice insurance coverage in place as described in attached documentation.

5. Conflicts of Interest and Disclosures

The Reporting Party discloses the following actual or potential conflicts of interest. For each disclosed matter, identify the affected client, nature of the conflict, steps taken to obtain informed consent or to implement screening measures and any waivers obtained.

Checklist:

No actual conflicts known at the date of this Report.

Conflicts disclosed to affected clients and written consents obtained where required.

6. Material Actions, Proceedings and Liabilities

Provide a concise statement of any Material Proceedings, claims, judgments, settlements, disciplinary investigations or other matters that could reasonably be expected to result in material liability or adversely affect the ability to practice.

7. Attachments and Exhibits

The Reporting Party has provided the following documents as exhibits to this Report. Each listed exhibit is a true and complete copy of the document described.

Attachments listed above are included with this Report.

8. Representations, Warranties and Certification

The Reporting Party represents and warrants to the Recipient that, to the best of the Reporting Party's knowledge after reasonable inquiry: (a) the information contained in this Report and in the attached exhibits is true, correct and complete in all material respects as of the date hereof; (b) no material event or omission has occurred that would render such information materially misleading; and (c) there are no undisclosed facts that could reasonably be expected to impair the professional licenses or corporate standing of the Reporting Party.

The Reporting Party further certifies that it has authority to provide this Report and the attachments, and that any consents or authorizations required for disclosure to the Recipient have been obtained.

9. Notices

All notices, requests, consents and other communications required or permitted under this Report shall be in writing and delivered to the parties at the addresses set forth below or such other address as either party designates by notice in accordance with this section.

10. General Provisions

Governing Law: This Report shall be governed by and construed in accordance with the substantive laws of the jurisdiction identified as the Reporting Party's principal jurisdiction of practice, without regard to conflicts of law principles. The parties submit to the exclusive jurisdiction of the courts of that jurisdiction for disputes arising under this Report.

Entire Agreement: This Report, together with its exhibits and attachments, constitutes the entire understanding between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations and understandings, whether written or oral.

Severability: If any provision of this Report is found to be invalid, illegal or unenforceable, the remainder of this Report shall remain in full force and effect and such provision shall be reformed only to the extent necessary to make it enforceable.

Amendments; Waiver: Any amendment or waiver of any provision of this Report must be in writing signed by both parties. No failure or delay by either party in exercising any right will operate as a waiver of that right.

Counterparts: This Report may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. A scanned or electronically transmitted signature shall be treated as an original signature for all purposes.

11. Acknowledgment and Signature

The undersigned persons certify that they are authorized representatives of their respective parties and that the information contained in this Report is true and complete to the best of their knowledge as of the date signed below.

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