U-LPQ Module 9

U-LPQ Module 9

Non-client Potential Conflicts, Ethics, Risk Management & Additional Info:

List all organizations, entities or individuals (including, but not limited to, any private, public, or governmental organizations or entities) where you serve, or have served as an officer, director, partner, trustee, executor, commission member, task force member, department member, conservator, guardian or any other member- either in a fiduciary capacity, attorney capacity or a non-attorney capacity- in the last seven years

Organization, Entity or Individual #1

Organization, Entity or Individual #2

Organization, Entity or Individual #3

Organization, Entity or Individual #4

Organization, Entity or Individual #5

Organization, Entity or Individual #6

Organization, Entity or Individual #7

Organization, Entity or Individual #8

Organization, Entity or Individual #9

Organization, Entity or Individual #10

Do you have any investment authority for any organizations, entities, or individuals?
Do you engage, or have you engaged, in the past seven years, in any business transactions with a client?
Do you have any ownership interest in any client in the past seven years?
%
Do you, or have you ever in the past seven years, provided non-legal or business professional services to any clients?
Are you related, in any way, to a judge, judge’s spouse or court personnel?
Are any of your family members associated with, or related to, any of your clients?
Do you have any non-clients that may present a conflict for you joining our firm?
Have you ever been a party in any past or pending administrative proceeding, arbitration, civil or criminal court action exclusive of routine and minor non-substance use related motor vehicle offenses?
Have you ever been the subject of a legal malpractice claim, breach of trust claim, employment discrimination claim, employee discrimination grievance, employee discrimination investigation (including harassment or retaliation) or do you know any circumstances that may give rise to such all such malpractice or employment discrimination claims?
Have you ever had to file a claim or incident report with any firm’s liability insurance carrier for any reason at all regardless of if resulted in a claim against the firm?
Have you ever been the subject of an investigation, grievance, or complaint with any state or federal bar or otherwise subjected to any discipline by a state or federal bar?
Have you ever been the subject of court-ordered sanctions or similar court ordered action?
Have you ever been investigated by any state or federal government or agency?
Have you filed complete and accurate federal, state, and local tax returns for all prior years?
Are you currently engaged in a bankruptcy proceeding?
Do you have any significant personal indebtedness that might affect your professional obligations to your clients or in your fiduciary duties to your partners?
Are you being represented by a search firm?
If there is mutual interest in your candidacy and at the appropriate time, can you provide references from your top clients as well as references from your current firm and any prior firms?
Is there anything not covered by this form that could potentially embarrass our firm if it were made public or negatively affect your candidacy in any way- including any social media or online postings or other publicly available information about you?
Is there anything not covered by this form that could reasonably be expected to affect our partners’ views on your candidacy for admission to our partnership?
Is there anything else you would like to share that could otherwise be relevant to the process of considering you to become a lawyer at our firm not otherwise disclosed in this form?

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