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1. Name

2. List financial documents obtained (A)

3. List names and relationship of others having business relationships who were contacted for reference:

All references were favorable; OR Refer to attached memo.

4. Regarding predecessor auditors: Not applicable; OR refer to memo.

5. Briefly describe the intended use of the financial statements.

6. Circumstances requiring special attention of presenting unusual risks (check each one which applies and comment in attached


publicly held anticipated annual fees greater than $40,000

high risk industry changes in nature or scope of engagement

industry especially sensitive to economic conditions development stage

in financial difficulty (or potentially)

Has had significant recent changes in management directors ownership

legal counsel financial condition

litigation status nature of business scope of auditors work

other significant problems strategic focus or composition of company

7. We are independent, and accepting this engagement would not result in a violation of regulatory agencies or professional ethics

( NO - attach memo)

8. [Firm Name] has the technical ability and resources to serve this firm with high quality and timely professional services (

NO - attach memo)

9. Fees have been candidly discussed with the appropriate principals of this firm, and no fee problems are anticipated. Will

interest be charged on past due accounts receivable? Yes No

Accounts receivable contact:

10. Proposed staffing: Partner in Charge Accountant in Charge Tax Staff in Charge

Partner Contact Responsible Biller # Tax Return Signer

11. Tax Entity Level of Service [Firm Name] Industry Code

Individual Tax Class Client Contact (Individuals)

12. I/we recommend that [Firm Name] accept this firm as a client, or proceed to

attempt to obtain them as a client ( NO - attach memo) (Initials & Date )

13. Partner approvals (B) (Initials & Date )

14. Engagement letter sent (date ); Signed response received

(date ); if firm does not become a client, check here and comment in

attached memo.

Future engagement letters: Signature required No signature required

15. Origination Origination Allocation %

Does account qualify for business development bonus? (circle one) YES NO

16. Add to Bulletin mailing list (Yes) (No).

17. Add to PFP Newsletter mailing list (Yes) (No).

should include most recent registration statement and 10-K. 7 or 8 exceptions are applicable.NOTES: A = If publicly held. B = One partner. except two partners must approve if 5. . 6.