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Name of Law Firm
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Law Firm Address
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Please Answer the Following Questions:
Our Law Firm is a:
Corporation
Personal Corporation
Limited Liability Company
Partnership
Limited Liability Partnership
Sole Proprietorship
Other
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How many years has the firm been in practice?
Number of Partners:
Number of Associates:
Number of Paralegals:
Controller/Bookkeeper:
Other Employees:
Description of Practice Area(s)
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Approx. Number of Cases Pending:
Approx. Amount of outstanding disbursements:
Approx. Amount of total fees due to law firm:
Does any other attorney or law firm have a financial interest in any of your cases?
Yes
No
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Does the firm have either duly executed retainer agreements or an OCA filed for each of its cases?
Yes
No
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Does the firm represent any clients in which the agreed upon contingent fee is less than one-third of the recovery after deducting disbursements?
Yes
No
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Does the Law Firm currently maintain a line of credit or other borrowing?
Yes
No
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If Yes, name of financial institution and amount outstanding
Amount of Financing Requested:
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Do you, or does the law firm maintain any Life Insurance?
Yes
No
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If Yes, amount of insurance and name of beneficiary:
Is the Law Firm Currently a Defendant in any Lawsuit?
Yes
No
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Has the Law Firm or any partner/member ever declared bankruptcy?
Yes
No
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Are all partners/members of the Law Firm in Good Standing?
Yes
No
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Primary Contact:
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