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{{company_name}}

{{company_address}}

Phone: {{phone}} | Email: {{email}} | Web: {{website}}

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{{company_name}} {{company_address}} Phone: {{phone}} Email: {{email}} Website: {{website}}

Introduction and Purpose

This Due Diligence Questionnaire (the 'Questionnaire') is provided to {{Target_Company_Name}} (the 'Target Company') by {{Requesting_Party_Name}} (the 'Requesting Party') for the purpose of gathering information deemed necessary for the Requesting Party's evaluation of a potential {{transaction_type}} involving the Target Company. The information provided in response to this Questionnaire will be treated with strict confidentiality, subject to the terms of any non-disclosure agreement in force between the parties.

General Company Information

1. Legal Name of Company: {{Target_Company_Name}}

2. Registration Number: {{Registration_Number}}

3. Date and Place of Incorporation: {{Date_of_Incorporation}}, {{Place_of_Incorporation}}

4. Registered Address: {{Registered_Address}}

5. Business Address (if different): {{Business_Address}}

6. Details of current directors and key management personnel (names, roles, and brief biographies): {{Directors_and_Management_Details}}

7. Organizational structure and any subsidiaries or affiliated entities: {{Organizational_Structure}}

8. Details of share capital and ownership structure, including any shareholders’ agreements: {{Share_Capital_and_Ownership}}

Financial Information

1. Provide audited financial statements for the past three (3) fiscal years: {{Financial_Statements_Years}}

2. Provide management accounts for the current fiscal year to date: {{Management_Accounts_Date}}

3. Details of all outstanding loans, credit facilities, and other debt obligations, including terms, security, and repayment schedules: {{Debt_Obligations_Details}}

4. List of major assets (e.g., property, plant, equipment) and their current market value: {{Major_Assets_List}}

5. Details of any off-balance sheet liabilities or contingent liabilities: {{Off_Balance_Sheet_Liabilities}}

6. Information on significant past and current legal disputes or litigation, and their financial implications: {{Litigation_Financial_Implications}}

Legal and Regulatory Compliance

1. Copies of all material contracts, including customer agreements, supplier agreements, and lease agreements: {{Material_Contracts_List}}

2. Details of any past or pending litigation, arbitration, or regulatory investigations involving the Target Company: {{Legal_and_Regulatory_Actions}}

3. List of all licenses, permits, and regulatory approvals necessary for the Target Company's operations and their current status: {{Licenses_and_Permits}}

4. Confirmation of compliance with all applicable data protection laws (e.g., POPIA in South Africa, GDPR if applicable): {{Data_Protection_Compliance_Status}}

5. Details of any intellectual property owned or licensed by the Target Company (e.g., patents, trademarks, copyrights): {{Intellectual_Property_Details}}

Operational Information

1. Description of core business activities and key products/services: {{Core_Business_Activities}}

2. Details of key suppliers and customer relationships, including contract terms and revenue contribution: {{Key_Suppliers_and_Customers}}

3. Information regarding the Target Company's operational facilities, including locations, ownership/lease details, and capacity: {{Operational_Facilities_Details}}

4. Overview of IT systems, infrastructure, and data security measures: {{IT_Systems_and_Security}}

5. Details of human resources, including employee numbers, key personnel, employment contracts, and any employee benefit schemes: {{Human_Resources_Details}}

Market and Commercial Information

1. Overview of the market in which the Target Company operates, including market size, trends, and competitive landscape: {{Market_Overview}}

2. Sales and marketing strategies and channels: {{Sales_and_Marketing_Strategies}}

3. Customer segmentation and analysis of customer churn rates, if any: {{Customer_Segmentation_and_Churn}}

4. Pricing strategies for key products/services: {{Pricing_Strategies}}

5. Details of any significant contracts or pipeline opportunities: {{Significant_Contracts_and_Pipeline}}

Environmental, Social, and Governance (ESG)

1. Information on the Target Company’s environmental policies and practices, including any environmental permits and compliance history: {{Environmental_Policies_and_Compliance}}

2. Details of social impact initiatives, community engagement, and employee welfare programs: {{Social_Impact_and_Welfare}}

3. Overview of corporate governance structures, including board composition, ethics policies, and risk management framework: {{Corporate_Governance_and_Risk}}

Declaration and Acknowledgment

I, the undersigned, duly authorized representative of {{Target_Company_Name}}, hereby certify that the information provided in response to this Due Diligence Questionnaire is, to the best of my knowledge and belief, true, accurate, and complete. I further acknowledge that the Requesting Party will rely on this information in its evaluation of the potential transaction.

Signature Block

_____________________________

Name: {{Signatory_Name}}

Title: {{Signatory_Title}}

Date: {{Date}}

For and on behalf of: {{Target_Company_Name}}