Also available in PDF | MS Word

It is critical that you seek the counsel and representation of an experienced securities lawyer to guide you through the process of launching your initial public offering. In order to do the best possible job on your behalf, your attorney needs information about you and your company. At your first substantive meeting with your securities lawyer, you should be prepared to provide, as applicable, the following information:

INFORMATION ABOUT YOU

Business Address ____________________________
____________________________
____________________________
Work Phone Number  ____________________________
Other Phone Number  ____________________________
Facsimile Number  ____________________________
E-mail Address  ____________________________
Have you ever declared bankruptcy, been accused, convicted or found liable for any violation of a federal or state securities law or regulation, or entered into a consent decree with, or had an injunction granted against you by, any federal or state enforcement agency or commerce department?
(If yes, provide details)  Yes_____    No_____

INFORMATION ABOUT YOUR BUSINESS PARTNER(S)

(Your business partners, if any, should provide the same information you have provided above)

INFORMATION ABOUT THE COMPANY

Name of Company  ____________________________
Business Address ____________________________
____________________________
____________________________
Phone Number  ____________________________
Facsimile Number  ____________________________
E-mail Address  ____________________________
Web Site Address  ____________________________
____________________________
Is the business incorporated? Yes_____    No_____
In what state is the business incorporated?  ____________________________
Is the corporation in good standing in the state of incorporation? Yes_____    No_____
List any other states in which the corporation is authorized to conduct business: ____________________________
Is the corporation presently a Subchapter S corporation? Yes_____    No_____
Has the company adopted any bylaws?
(If yes, provide a copy) Yes_____    No_____
Does the corporation presently have any stock option or stock purchase plans?
(If yes, provide copies) Yes_____    No_____
Have you maintained a corporate records book for the corporation?
(If yes, provide the book to your attorney for inspection) Yes_____    No_____

Who are the current owners of the business, in what percentages, and for what contributions?

Owner                             Percentage of Ownership            Contribution

__________________                   _______           ________________________

__________________                   _______           ________________________

__________________                   _______           ________________________

__________________                   _______           ________________________

List the officers of the company:

Title                    Name                   Address                   Phone Number

_______________    _______________    _________________    ________________

_______________    _______________    _________________    ________________

_______________    _______________    _________________    ________________

_______________    _______________    _________________    ________________

Have any of the officers ever declared bankruptcy, been accused, convicted or found liable for any violation of a federal or state securities law or regulation, or entered into a consent decree with, or had an injunction granted against them by, a federal or state enforcement agency or commerce department?
(If yes, provide details) Yes_____    No_____

List the members of the board of directors of the company:

Name                            Address                         Phone Number

_________________        __________________        _________________

_________________        __________________        _________________

_________________        __________________        _________________

_________________        __________________        _________________

_________________        __________________        _________________

Have any of the directors ever declared bankruptcy, been accused, convicted or found liable for any violation of a federal or state securities law or regulation, or entered into a consent decree with, or had an injunction granted against them by, any federal or state enforcement agency or commerce department?
(If yes, provide details) Yes_____    No_____
Who is the chairperson of the board of directors of the company? ____________________________
Are there any written or unwritten compensation arrangements or contracts between any officers or directors of the company and the company?
(If yes, provide your attorney with a copy) Yes_____    No_____
Do you have a written Business Plan?
(If yes, provide your attorney with a copy of it) Yes_____    No_____

Describe your present business operations:

---

---

---

Describe your intended business operations post-IPO:

---

---

---

How much money do you believe you need to raise to achieve your business growth objectives?   __________

Have you offered to sell or sold any interests in your business to any investors (for instance, in a private placement)?
(If yes, provide details) Yes_____    No_____
Have you retained any consultants, accountants or tax professionals?
(If yes, provide names, addresses, phone numbers, and details) Yes_____    No_____
Is the business a party or potential party to any joint venture, license or similar agreement?
(If yes, provide your attorney with a copy) Yes_____    No_____
Does the business own or lease any real estate?
(If yes, provide details) Yes_____    No_____
Does the business have any written financial statements?
(If yes, provide your attorney with copies of the statements for the past three years) Yes_____    No_____
Have the financial statements been audited? Yes_____    No_____

OTHER QUESTIONS

(Make a list of pertinent questions to ask your securities attorney)