Fill and Sign the Purchase Payment Agreement Afterpay Shop Now Enjoy Form

ACKNOWLEDGMENT OF ACCOUNT AND AGREEMENT FOR INSTALLMENT PAYMENTS Name of Client acknowledges that his/her account balance with Name of Law Firm, as of Date, equals $ __________ . Client has previously signed a retainer agreement with the Firm, which requires his/her payment of the outstanding monthly account balance in full. However, Client has not had the funds to keep current with said obligation. Client has received and reviewed the itemized billing statements and finds them to be reasonable for the services rendered. Client is aware that his/her recourse for concerns regarding the contents of said statements is to bring such matters to the Firm's attention, and that further rec ourse is available, as necessary, through consultation with counsel from outside the Firm. Consequently, Client makes this acknowledgment under no duress. Client requests the Firm to continue its representation of his/her recognizing that the services rendered to this point have been necessary, and that further services are also necessary. Client and the Firm hereby agree that Client's account balance shall be paid in installments of $_______ per month, with interest continuing to accrue as set out in the retainer agreement. Client's insta llment payments will be due on the __________ day of each month, commencing Date. Client recognizes that the continuation of services while an account balance remains outstanding constitutes a credit transaction, and Client makes this acknowledgment as an as surance of the fact that, while Client cannot fully pay the balance at present, Client has the ability a nd the intention ultimately to meet his/her obligations under the retainer agreement. Dated: ___________________ _________________________________ Dated: ___________________ _________________________________ Name of Law Firm