Due Diligence Request:

Company Information

Company Name

/

State of Inc.

Address

Signatory on behalf of Company

Title

/

Email

/

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 Directors
Is 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 Information
Name / 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:

  1. 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:

  1. 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:______

1