L.E.K. Consulting LLC

New Client Registration Form

As part of ongoing compliance efforts, L.E.K. Consulting LLC collects certain key business information related to each of its new clients. As such, L.E.K. Consulting requests that you complete the information below regarding your company.

L.E.K. Consulting collects and maintains this information to help verify the company's identity and ensure that the company is not sanctioned or otherwise ineligible to conduct lawful business with L.E.K. Consulting.

Fields marked with an asterisk are required. Please do not submit personal information that is not requested by this form.

Company Information

Date

Please enter a date.

Full Company Name

Please enter the full company name.

Company Registered Mailing Address

Please enter the registered mailing address.

Company Contact Name and Title

Please enter the contact name and title.

Company Contact Email Address

Please enter a valid email address.

State of Incorporation

Please enter the state of incorporation, or N/A.

Country of Incorporation

Please enter the country of incorporation.

Company Entity Type

Please select an entity type.

Tax ID / ISIN / Government Registration Number

Provide the applicable registration identifier for your jurisdiction.

Company Website Address

Please enter a valid website address.

Ownership and Governance

Is Company Publicly Traded?

Yes No

Please select an option.

Company Directors

Please list company directors.

Company Executive Officers - names and titles

Please list executive officers and titles.

Individuals and Investors with Greater Than 25% Ownership Interest

Please list owners/investors or enter N/A.

Company Organization Structure

Please describe the organization structure.