Client Interview Info Form (Businesses)

CLIENT INTERVIEW INFO FORM (BUSINESSES) 1. Name of business Headquarters address State and date of incorporation Licensed to do business in California? Fictitious business name(s) Corporate affiliates (parent and or subsidiary companies) 2. General counsel's name Business address Home telephone number Work telephone number Telecopier or Fax number Telex number 3. Officer in charge of litigation Title Business address Home telephone number Work telephone number Telecopier or Fax number Telex number Car telephone number 4. Where and to whom should attorney's billings be sent? 5. Insurance information Officer in charge of risk/insurance Outside broker CGL carrier(s) and date(s) Auto carrier(s) and date(s) Workers' comp carrier(s) and date(s) Employer's liability carrier(s) and date(s) 6. Have you consulted another (outside) counsel about this case? If so, name 7. Have you been served with any papers concerning this case? Describe briefly 8. Have you conducted any internal investigation concerning this case? Who/when 9. Have you made any statements to anyone outside the company concerning this case? To whom/when/what