StandardizedInvestmentManagerQuestionnaire-IMCA.docVIP

IMCA Standardized Investment Manager Questionnaire Please read the following instructions before completing this questionnaire: 1. All questions must be completed. 2. Type or select answers to each question. The tab key will take you to the next field. 3. If any questions are not applicable or the answer is not available, please answer as N/A. 4. If any answer is larger than the space available, please include it in an attachment that references the page and section number. Answer only the question asked. Any additional information required will be requested. This form is for your use as a model. This document can serve as a sample questionnaire that you or your clients may use in the search and selection process. DO NOT return a completed form to IMCA. Thank you. 5619 DTC Parkway, Suite 500 ? Greenwood Village, CO 80111 ? 303.770.3377 ? ? 2007, Investment Management Consultants Association, Inc. All rights reserved. This questionnaire is in compliance with IMCA Performance Reporting Standards. BACKGROUND INFORMATION A. Firm Name Address Firm Name Address City, State ZIP Telephone Number Fax Number Email address B. Contacts Questionnaire completed by: Your name Title: Your title Primary client contact: Client contact name Title: Primary client contact title Backup client contact: Backup client contact name Title: Backup client contact title C. Ownership Affiliates Your firm is organized as a: List ALL owners of your firm: Explain owners’ relationship to firm: List ALL related companies: Explain related companies’ relationship to firm: D. Other offices List the locations where the firm has other offices. E. History List names, positions held, and dates of all professional-level personnel hires in the past five years. List names, positions held, and dates of all professional-level personnel departures in the past five years. Provide information pertaining to any organizational changes that have occurred during the past 10 years