LLC Member Due Diligence Questionnaire
General Information
Name
Address
Phone Number
Email
Date of Birth
Identification
Type of Identification (e.g., Driver's License, Passport)
Identification Number
Issued By
Expiration Date
Ownership Interest
Percentage of Interest in LLC
Capital Contribution Amount
Background Information
Have you ever been convicted of a felony?
No
Yes
If yes, please provide details
Are you a party to any pending litigation?
No
Yes
If yes, please provide details
Certification
Signature
Date