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Confidential Attorney-Client Communication
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Date:

PERSONAL BACKGROUND

Self

Spouse

* Title:

* Client Name:

* Address:

* Phone (Home):

(Work):

Fax:

* E-mail:

Date of Birth:

Place of Birth:

U.S. Citizen:

Drivers Lic:

Soc. Sec. #:

Occupation:

Employer:

Address:

Years in Position:

Prior Occupation :

Years in Position:

Education Highest Yr:

Degrees Held :

Children:

Licenses:

Patents/trademarks:

Health:

SUITABILITY

1. Investment related courses/seminars, etc:

2. Subscriptions to magazines,
newspapers, etc:

3. Securities books read?

4. Do you keep ledgers regarding your accounts?

5. Ever work in a brokerage firm?

6. Have you ever been or are you now a Trustee of a Trust or Pension Plan?
(if so, when created; who are participants?)

7. What other, if any, sources of income do you have?

8. Do you use coupons?

9. Do you own your home?

If so, how long?

10. If so, what is estimated equity?

11. Cars:

12. Other investments or real estate:

13. Did you rely on the account for profit/loss?

14. Have you ever been involved in any other lawsuits, either as plaintiff or defendant which involve business matters? (This does not include divorce or personal injury).

Yes
No

If yes, describe each such prior experience.

15. Have you ever been a general partner or corporate officer or director in a prior investment enterprise which included passive investors?

Yes
No

If yes, describe each such prior experience.

PRIOR INVESTMENT EXPERIENCE

1. Prior to the transactions which are the subject of this lawsuit have you ever invested in any of the following:

Raw Land:

Yes No

Residential Real Estate:

Yes No

Commercial Real Estate:

Yes No

Stock Market:

Yes No

Commodities Market:

Yes No

Limited Partnership:

Yes No

Oil & Gas Ventures:

Yes No

Precious Metals:

Yes No

Stamps or Coins:

Yes No

Bonds, Debnetures:

Yes No

Money Market Funds:

Yes No

2. If your answer to any of these questions is Yes, briefly relate your prior investment experience, other than with persons involved in this case.

3. Do you consider yourself to be a sophisticated
investor generally?

Yes
No

Why?

4. Other than the broker(s) in this lawsuit, have you relied on anyone for investment advice or counseling during the past 5 years? If so, state for each such person.

Name of Advisor:

Address of Advisor:

Telephone Number:

Advisor's Occupation:

Type of Advice:

FORMING ACQUAINTANCE WITH BROKER(S)

The following questions seek the circumstances under which you became aware of or acquainted with the broker(s). Feel free to give lengthy details and elaborate. Attach as many extra pages as you need to fully explain. Your goal should be to fully advise us, as your attorney, of the totality of the facts.

1. When did your first become acquainted with the broker(s)?

2. Who introduced you?

3. Who initiated contact?

4. What were the circumstances of
your first meeting?

5. Relate what was said
by each participant with particular emphasis on representations and promises of future events

6. Did you invest immediately?

Yes
No

If no, briefly describe all subsequent conversation.

OPENING OF ACCOUNT

1. Date:

2. Brokerage House:

3. Broker:

4. Address:

5. Account Number:

6. Initial Investment:

7. Documents signed
upon opening account
(i.e. Margin, Power of
Attorney, etc. ):

8. Objectives your expressed to Broker:
(be explicit)

9. Representations by Broker to you: (be explicit)

10. Witnesses (if any):

11. Describe any correspondence between Broker and yourself:

12. Any additional documents:

13. Summary of
account activity:

13 (a). Describe the "stories" associated with the broker selecting the particular securities in your account.

14. Primary Complaint:

15. Estimate of Losses: $

16. Any other damages:

17. When did you first discover there was a problem?

18. How did you first discover there was a problem?

19. Current Goal:

20. Additional Comments or Notes:

21. Who made the decisions regarding the transaction?

22. (Did broker have carte blanche? If so, why?)

23. Did you listen to your broker's advice more often than not?

24. Did you ever expressly give the broker discretion to trade the account as he saw fit?

25. Did broker encourage you to let him trade as he saw fit?

26. Was the broker aware of your financial situation?

27. Did broker ask about your financial situation?

28. Why did you enter the stock market in the first place?

29. Who suggested that you do so? (What did they tell you)

30. Were they knowledgeable in stocks/securities, etc. ?

31. Did they refer you to a specific broker/firm?