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Due Diligence Questionnaire
Due Diligence Questionnaire
Contact Info
Name
(Required)
Phone
(Required)
Email
(Required)
Mailing Address
(Required)
Law Firm Questions:
1. What is the name of your law firm?
(Required)
2. How many equity partners are at your law firm?
(Required)
3. How may employees does your firm have?
(Required)
4. How much funding is the law firm requesting?
(Required)
5. What is the expected use of proceeds of the proposed credit facility?
(Required)
6. How many active legal claims are currently on the docket?
(Required)
a. Estimated fees from single event litigation:
(Required)
b. Estimated fees from mass tort / mass action litigation:
(Required)
7. What is the approximate value of your contingency fee inventory, net of all co-counsel and other revenue sharing agreements?
(Required)
8. In 2020, what was the law firm’s approximate revenue, net of all payments to clients, co-counsels, etc.?
(Required)
a. Revenue for single event:
(Required)
b. Revenue for mass tort / mass action:
(Required)
c. Hourly:
(Required)
9. Do you currently owe back taxes?
(Required)
Yes
No
Partner Questions:
1. Name of Equity Partners
(Required)
2. Do you currently owe back taxes personally?
(Required)
Yes
No
3. Have you or an entity controlled by you ever filed bankruptcy?
(Required)
Yes
No
4. Has any creditor ever foreclosed on or repossessed any asset of yours and/or any entity controlled by you?
(Required)
Yes
No
5. Have you or any entity controlled by you settled a balance with any creditor for less than the full balance due?
(Required)
Yes
No
6. Have you ever been arrested or the subject of a criminal investigation?
(Required)
Yes
No
7. Have you ever been disciplined by or do you have a pending disciplinary action with a State Bar?
(Required)
Yes
No
Disclaimer
The information collected on this application will only be used to respond to you about your request. We will not share your information with anyone outside of our organization.Financing with B.E. Blank & Co. will not appear on personal credit,nor will your application for financing impact your credit score.
Consent
(Required)
I understand that I have the right to request additional disclosuresconcerning the nature and scope of B.E. Blank & Co.’s credit review, upon written request, within a reasonable timeframe.
I understand that B.E. Blank & Co. may reasonably rely upon all the information disclosed within this application and any all attachments in all respects.
I understand that written or verbal communications by the partners, employees or affiliates of B.E. Blank & Co LP do not themselves constitute offers for financing. I understand further that all offers for financing are contingent upon the approval of the investment team of B.E. Blank & Co LP after completion of due diligence by its legally designated employees, which are validated through formal financing agreements.