Legal Questionnaire Document

Legal Questionnaire Document

This Legal Questionnaire Document (the "Questionnaire") is made effective as of by and between Party A: with principal address and Party B: with principal address .

Recitals

WHEREAS, Party A seeks to provide information regarding a potential or existing legal matter and requires Party B to collect, review and rely on factual and documentary information supplied herein;

WHEREAS, Party B requires a standardized statement of facts, disclosures and supporting documentation to evaluate conflicts, counsel availability, compliance obligations and potential litigation or transactional risk;

WHEREAS, the parties wish to set forth the terms governing the submission, handling and reliance upon the information supplied in this Questionnaire.

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

1. Definitions

1.1. "Confidential Information" means all non-public information provided by a party in connection with this Questionnaire, whether factual, documentary or electronic, including but not limited to business, financial, contractual, regulatory and litigation-related materials.

1.2. "Respondent" means the party completing the Questionnaire or any authorized representative completing portions on the party's behalf.

2. Questionnaire Responses

2.1. The Respondent shall complete each item below fully and accurately. Responses will be relied upon by the recipient for conflict checks, scope definition and preliminary legal assessment. Material omissions or inaccuracies may result in withdrawal of services or indemnification obligations as set forth in Section 5.

Corporation    Limited Liability Company    Partnership    Individual    Other:

Earliest relevant date:   Contract/Deadline date:

Has the entity been a party to litigation, arbitration or regulatory enforcement in the last 5 years?    Yes    No

Are there material regulatory, licensing or compliance matters relevant to this inquiry?    Yes    No

3. Attachments and Supporting Documents

3.1. Respondent shall attach or otherwise deliver copies of all material documents identified in responses above, including but not limited to contracts, relevant correspondence, financial statements and regulatory filings. List attached documents below.

4. Representations, Warranties and Reliance

4.1. The Respondent represents and warrants that the information provided in this Questionnaire and any attachments is true, complete and accurate to the best of the Respondent's knowledge as of the effective date. Respondent acknowledges that the recipient will rely upon these representations in conducting conflict checks, making engagement determinations and providing initial advice or guidance.

4.2. Respondent agrees to promptly amend or supplement any response that becomes materially inaccurate or incomplete. Failure to disclose material facts or the existence of conflicts may result in termination of services and, where permitted by law, indemnification for damages arising from such failure.

5. Confidentiality and Use of Information

5.1. All Confidential Information provided in connection with this Questionnaire shall be treated in accordance with the parties' existing confidentiality obligations, if any, or otherwise shall be held in confidence by the recipient and used solely for the purposes of evaluating the matter and determining whether to accept representation. Nothing in this Paragraph shall prevent disclosure as required by applicable law or court order, provided the recipient uses reasonable efforts to notify the disclosing party where permitted.

5.2. Completion of this Questionnaire does not, by itself, create an attorney-client relationship between the parties. Any attorney-client relationship shall be established only by a separate written engagement letter signed by both parties.

6. Notices

Notices under this Questionnaire shall be in writing and delivered to the addresses set forth below or to such other address as a party may designate by written notice to the other party.

7. Amendments; Waiver; Counterparts

7.1. No amendment, modification or waiver of any provision of this Questionnaire shall be effective unless in writing and signed by both parties.

7.2. The failure of either party to enforce any provision of this Questionnaire shall not constitute a waiver of future enforcement of that or any other provision.

7.3. This Questionnaire may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

8. Governing Law; Entire Agreement; Severability

8.1. Governing Law. This Questionnaire shall be governed by and construed in accordance with the laws of the jurisdiction specified below without regard to conflict of laws principles. Choice of law:

8.2. Entire Agreement. This Questionnaire constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous understandings, whether written or oral, relating to such subject matter.

8.3. Severability. If any provision of this Questionnaire is held to be invalid, illegal or unenforceable in any respect, the remaining provisions shall remain in full force and effect and the invalid provision shall be reformed only to the extent necessary to make it enforceable.

9. Certification

The undersigned certify that they are authorized representatives of the parties identified above and that the information provided in this Questionnaire and any attachments is true, correct and complete to the best of their knowledge. The undersigned further acknowledge that the recipient will rely upon these statements in performing conflict checks and other pre-engagement activities.

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