Due Diligence Request:
Company Information
Company Name
/State of Inc.
Address
Signatory on behalf of Company
Title
/Phone
Issue Information
Are the Shares DWAC or DRS Eligible?
/Yes
/No
Has the Company ever been deemed a Shell?
/Yes
/No
Is there currently a “Chill” on the Stock?
/Yes
/No
Is the Company an SEC Reporting?
/Yes
/No
Common Stock
Classes of Common Stock Authorized
/A
/B
/C
/D
/E
A Shares Authorized
A Shares Outstanding
Preferred Stock
Classes of Preferred Stock Authorized
/A
/B
/C
/D
/E
A Preferred Shares Authorized
A Preferred Shares Outstanding
Officers and DirectorsIs the Company or any of its officers or directors currently involved in any litigation, dispute, or other claim or currently under investigation? / Yes / No
Has the Company or any of its officers or directors ever been under investigation by an administrative authority or subject to any order restraining the Company from issuing shares? / Yes / No
Are any current or former officers, directors or affiliates been the subject of an administrative enforcement order finding fraud or deceit in connection with the purchase or sale of a security? / Yes / No
Are any current or former officers, directors or affiliates currently under investigation with any regulatory agency or been under investigation or convicted of a felony or filed for bankruptcy in the past 5 years? / Yes / No
What is the company’s monthly negative cash flow? (Cash spent per month before generating positive cash flow from operations)
Transfer Agent:______Email:______
Information to be provided by your Transfer Agent: (This will be requested as a part of the document package)
- Total number of shares of each class of stock issued and outstanding certified on Transfer Agent letterhead before and after transaction.
- Total amount of public float before and after transaction.
Note Information
Original Date of Note
Was the Note Ever Assigned in Whole or in Part? / Yes / No
What is the Current Balance of the Note (Principal plus Interest less any Conversions, Sales or Assignments?
Where in Your Filings is this Note disclosed? / Form / Page / Section Title
IF THIS IS A SALE OF A PROMISSORY NOTE, PROOF OF PAYMENT AND/OR RECEIPT OF FUNDS BY THE BORROWER MUST BE PROVIDED. (This can be a copy of the wire advise or a copy of the bank statement)
Note Holder InformationName / State of Inc.
Address
Email / Phone
Number of Shares the Current Note Holder Owns
Is or has the Current Note Holder ever been an affiliate, employee, officer, director or married to an Officer or director? / Yes / No
Please Note that Before Funding Occurs
For all promissory note transactions:
- Investor will require your transfer agent to reserve 2x the number of shares the note is convertible into and this must be acknowledged by your transfer agent in a document to be provided.
For all types of transactions:
- Original documents must be received by investor’s attorney.
The undersigned consent to allow Knightsbridge Law Co LTD to perform background and credit checks on themselves.
For Company
By:______
Name:______
Title:______
For Holder
By:______
Name:______
Title:______
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