Legal Pre-filing Form

LEGAL PRE-FILING FORM

This Legal Pre-filing Form is executed as of Effective Date: by Client Name: with Client Address: and Counsel Name: of Firm: with Counsel Address:

RECITALS

WHEREAS, Client believes that certain actionable claims exist arising from the events and transactions described in the factual summary below and wishes to pursue formal legal relief against the identified adverse party(ies);

WHEREAS, Counsel has reviewed the preliminary facts and legal theories and has agreed to evaluate and, if appropriate, prepare documentation necessary to initiate litigation, administrative proceedings, or other dispute resolution mechanisms consistent with the scope of authorization set forth herein;

WHEREAS, Client and Counsel desire to set forth in writing the scope of pre-filing authorization, the claims to be asserted, the relief sought, and the respective certifications and acknowledgments required prior to filing;

NOW, THEREFORE

In consideration of the mutual promises contained in this Legal Pre-filing Form and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, Client and Counsel agree as follows:

1. AUTHORIZATION TO PREPARE AND FILE

Client hereby expressly authorizes Counsel to: (a) conduct necessary factual and legal investigation; (b) prepare pleadings, petitions, motions, and other papers as reasonably necessary to initiate and prosecute the identified claim(s); and (c) file such documents with the proposed tribunal: . Such authorization is limited to the claims, causes of action, and parties described in Section 2 unless otherwise amended in writing.

2. DESCRIPTION OF CLAIMS AND FACTS

3. RELIEF REQUESTED

Counsel is authorized to seek the following forms of relief on behalf of Client (select all that apply) and any additional relief the tribunal deems appropriate:

Injunctive relief (temporary restraining order / preliminary injunction)   Temporary restraining order   Declaratory judgment   Monetary damages

4. FILING DEADLINES AND STATUTE OF LIMITATIONS

Client represents that, to the best of Client's knowledge, the last actionable date for filing is: . Client must promptly notify Counsel of any facts affecting timeliness. Counsel will exercise reasonable diligence to file within applicable limitations but is not liable for forfeiture of claims caused by Client's failure to provide timely information or execute necessary filings.

5. EXHIBITS AND SUPPORTING DOCUMENTS

6. FEES, COSTS AND RETAINER

Client agrees to the fee arrangement specified below and to promptly provide any retainer or advance required for filing and other costs. Selection (check one or more as applicable):

Contingency fee arrangement   Hourly billing   Flat fee

7. CERTIFICATION OF GOOD-FAITH

Client certifies, under penalty of perjury, that the factual statements and evidence provided to Counsel supporting the claims are true and presented in good faith and that the claims are not frivolous. Client acknowledges that Counsel will rely upon these certifications when preparing and filing documents and that knowingly false statements may expose Client to sanctions.

Client acknowledges receipt of this certification and makes the following acknowledgment: I acknowledge the foregoing.

8. CONFIDENTIALITY AND PRIVILEGE

All communications and materials provided to Counsel are subject to attorney-client privilege and work-product protection where applicable. Client authorizes Counsel to disclose privileged information only to the extent necessary for filing, court practice, or as required by law. Any limited waiver of privilege made in connection with pre-filing disclosures shall be no broader than necessary.

9. NOTICES

Notices given in accordance with the addresses above shall be effective upon delivery by hand, certified mail, or nationally recognized overnight courier.

10. GOVERNING LAW

This Pre-filing Form shall be governed by and construed in accordance with the laws of the State of , without regard to choice-of-law principles that would apply the law of another jurisdiction.

11. ENTIRE AGREEMENT; SEVERABILITY; AMENDMENT; WAIVER; COUNTERPARTS

This Pre-filing Form constitutes the entire agreement between the parties concerning the subject matter herein and supersedes all prior understandings and agreements. If any provision is held invalid or unenforceable, the remaining provisions remain in full force and effect. This Form may be amended only by a written instrument signed by both Client and Counsel. No waiver of any provision is effective unless in writing and signed by the waiving party. This Form may be executed in counterparts, each of which is an original and together constitute one instrument.

12. VERIFICATION

By signing below, Client and Counsel each verify under penalty of perjury under the laws of the governing jurisdiction that the statements contained in this Pre-filing Form are true and correct to the best of their knowledge and belief and that they are authorized to execute this document on behalf of the respective signatory.

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