Legal Suitability Form

LEGAL SUITABILITY FORM

This Legal Suitability Form is executed on Date: by and between Applicant Name: and Recipient Name: . The parties hereby acknowledge and agree to the statements, representations, disclosures, and certifications set forth in this Form.

RECITALS

WHEREAS, Applicant seeks to be deemed suitable, eligible, and compliant for engagement by Recipient to provide legal services or to participate in a specified legal matter; and

WHEREAS, Recipient requires contemporaneous and accurate disclosures regarding Applicant’s credentials, disciplinary history, regulatory status, financial insolvency, conflicts of interest, and relevant insurance coverage in order to determine suitability for engagement; and

WHEREAS, the parties desire to record certain certifications, representations, and procedures concerning such suitability determinations.

NOW, THEREFORE, in consideration of the mutual covenants set forth below, the parties agree as follows:

1. DEFINITIONS

For purposes of this Form the following terms shall have the meanings assigned: "Applicant" means the party identified as Applicant Name above; "Recipient" means the party identified as Recipient Name above; "Engagement" means any present or future contract, matter, transaction or representation for which Applicant seeks acceptance by Recipient; "Material Adverse Event" means any event, fact or circumstance reasonably likely to impair Applicant’s ability to perform professional services or to create material reputational or regulatory risk to Recipient.

2. SUITABILITY CRITERIA

Applicant shall provide truthful, complete and accurate responses to the items below. Recipient’s determination of suitability shall be based upon, among other things, the following criteria:

a) Licensure and Good Standing: Applicant attests to current admission, licensure or registration in the following jurisdictions:

b) Professional Liability Insurance: Applicant certifies it maintains liability insurance in the minimum amount of $ per occurrence and $ aggregate with an insurer authorized to do business in applicable jurisdictions.

c) Conflicts and Impartiality: Applicant has conducted reasonable conflicts checks for the proposed Engagement and discloses any actual, potential or perceived conflicts in the Disclosures section below.

3. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants to Recipient that, as of the date of this Form: (a) Applicant is duly organized and in good standing in the jurisdictions of its formation and the jurisdictions where it practices; (b) there are no pending criminal charges or convictions for Applicant or any of its principals that would materially affect Applicant’s fitness to perform legal services; (c) Applicant is not presently suspended or disbarred and is not subject to any unresolved disciplinary proceeding that would reasonably be expected to result in suspension or disbarment; and (d) Applicant is not subject to any governmental or economic sanctions that would prohibit or materially limit performance under any Engagement.

4. DISCLOSURES AND BACKGROUND

Applicant shall fully disclose below all matters that could reasonably be considered Material Adverse Events, including disciplinary proceedings, regulatory actions, criminal matters, judgments, insolvency, sanctions, or pending litigation related to professional services. If no such matters exist, state "None" in each field.

5. CERTIFICATIONS

Applicant certifies under penalty of perjury and subject to civil and professional sanctions that the information supplied in this Form and all appended documents is true, complete and correct to the best of Applicant’s knowledge. Applicant shall promptly notify Recipient in writing of any change in fact or circumstance that would render any representation or disclosure untrue or incomplete.

Applicant acknowledges that Recipient may rely on these certifications in making suitability determinations and that any material misrepresentation or omission shall constitute grounds for denial of the Engagement or termination for cause if discovered after engagement.

6. CONFIDENTIALITY

All information provided in this Form and in associated disclosures shall be treated as confidential by Recipient, except as disclosure is required by law, professional conduct rules, or court order. Recipient may share such information internally on a need-to-know basis for purposes of evaluating the Engagement or complying with regulatory obligations.

7. NOTICES

All notices required or permitted by this Form shall be in writing and delivered to the contact information below. Notice is effective upon receipt.

8. AMENDMENTS; WAIVER; COUNTERPARTS

No amendment to this Form shall be effective unless in writing and signed by both parties. No waiver of any provision shall constitute a waiver of any other provision or of the same provision on another occasion. This Form may be executed in any number of counterparts, each of which shall be an original and all of which together shall constitute one instrument.

9. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Form shall be governed by and construed in accordance with the laws of the jurisdiction specified for governing law: without regard to conflict of laws principles. This Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings. If any provision of this Form is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

10. ATTACHMENTS

Applicant has attached or will attach the following documents in support of this Form (check applicable items and provide documents as required):

Certificate of Good Standing / Licensure

Insurance Declarations / Policy Summary

Conflict-Check Report or List of Current Clients

Other Disclosure Exhibits (describe below)

11. ACKNOWLEDGMENT

By signing below, Applicant and Recipient acknowledge that they have read, understand, and agree to be bound by the terms of this Legal Suitability Form and that the representations and certifications contained herein are true and complete to the best of their knowledge and belief.

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