Legal Application Form

Legal Application Form

This Legal Application Form (the "Application") is made and entered into as of , by and between Applicant Name: (the "Applicant") and Legal Service Provider: (the "Provider").

RECITALS

WHEREAS, Applicant seeks legal advice and representation concerning the matter described as:

WHEREAS, Provider represents that it is duly authorized and competent to provide legal services in the jurisdiction(s) implicated by the matter and that it will comply with applicable professional conduct rules and laws in providing such services.

WHEREAS, the parties wish to set forth the terms under which Provider will consider and, if accepted, represent the Applicant and the information the Applicant must provide in connection with such consideration and potential engagement.

NOW, THEREFORE, in consideration of the mutual promises set forth herein, the parties agree as follows:

1. Definitions

For purposes of this Application, the following terms have the meanings set forth below: "Confidential Information" means non-public information provided by Applicant to Provider in connection with the matter; "Engagement" means any subsequent written agreement executed by the parties pursuant to which Provider provides legal services.

2. Scope of Application

This Application constitutes Applicant's formal request for Provider to evaluate and potentially undertake representation related to the matter described above. Submission of this Application does not by itself create an attorney-client relationship. Provider may accept or decline representation in its sole discretion. If Provider accepts representation, the parties shall execute a separate engagement letter that will govern the scope, fees, and other terms of representation.

3. Applicant Information and Representations

Individual Corporation Partnership Other:

Applicant represents and warrants that all information submitted in this Application is true, complete, and accurate to the best of Applicant's knowledge, and that Applicant has the authority to disclose the Confidential Information provided herein.

4. Documents and Attachments

Applicant shall provide the documents identified below in connection with Provider's evaluation. Provider may request additional documents as necessary to assess conflicts and merits.

5. Fees, Retainer and Billing

Submission of this Application does not obligate Applicant to pay fees unless and until the parties agree in a separate engagement letter. Applicant acknowledges that Provider will provide an initial estimate of fees and may require a retainer. Applicant agrees to disclose any fee arrangements previously agreed with other counsel that relate to the same matter.

6. Confidentiality

All Confidential Information disclosed by Applicant to Provider for the purpose of evaluating the matter shall be held in confidence by Provider in accordance with applicable professional obligations. Provider's obligations of confidentiality do not extend to information that is or becomes publicly available other than through Provider's breach, is independently developed without use of Applicant's Confidential Information, or is required to be disclosed by law or court order, in which case Provider shall, to the extent permitted, provide Applicant prior notice.

7. Conflicts and Compliance

Applicant agrees to disclose promptly any existing or potential conflicts of interest, including the identity of other parties or counsel previously engaged. Provider reserves the right to conduct a conflicts check and to decline representation where a conflict exists that cannot be resolved.

8. Notices

All notices required or permitted under this Application shall be in writing and delivered by hand, certified mail, or nationally recognized courier service to the addresses set forth above, and shall be deemed given upon receipt.

9. Governing Law

This Application and any dispute arising out of or related to it shall be governed by and construed in accordance with the substantive laws of the jurisdiction identified by Applicant's primary address above, without regard to conflict of laws principles. Applicant may specify a different governing jurisdiction below:

10. Entire Agreement; Amendments; Severability; Waiver; Counterparts

This Application constitutes the entire agreement between the parties concerning Applicant's request for representation and supersedes all prior discussions and understandings with respect thereto. No amendment, modification or waiver of any provision of this Application shall be effective unless in writing and signed by both parties. If any provision of this Application is held invalid or unenforceable, the remainder of the Application shall remain in full force and effect. The failure of either party to enforce any right or provision under this Application shall not constitute a waiver of such right or provision. This Application may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

11. Applicant Certifications

Applicant certifies under penalty of perjury that the information provided in this Application is true and correct, and that Applicant understands that submission of false information may be grounds for immediate rejection of the Application and for other remedies available to the Provider.

Applicant consents to receiving documents and communications electronically and acknowledges that such consent will apply to this Application and any subsequent engagement.

12. Acknowledgement

By signing below, Applicant acknowledges that Applicant has read and understands this Application, including the Confidentiality and Governing Law provisions, and that Applicant has authority to submit this Application on behalf of the entity or individual identified as Applicant.

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