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APPLICATION FOR ATTORNEYS

For Lawyers - Get the cash you need to help win your case.

A law firm loan or lawyer funding allows your firm to accept new cases with excellent potential for successful outcomes and eliminates the need to partner with a larger legal firm on major cases.

If your legal case qualifies we will provide you the best cash advance-lawsuit funding program tailored to suit your needs.


* Attorney's Name:
Co-Counsel:
* Address:
* City:
* State/Zip:
 Zip:
* Attorney's E-mail:
Attorney's Phone:
Attorney's Fax:
Client's Name:
* Nature of Incident:
Date of Incident:
* Proof of Liability:
Yes No
Medical Specials:
Future Medical Specials:
Amount of Liens:
Lawsuit Filed?:
 Yes No
(If Yes) When?:
(If Yes) Case No.:
Where?: (County)
Lawsuit Answered?:
 Yes No
(If Yes) When?:
* Estimated Case Value:
Low:
High:
Insurance Carrier:
* Claim:
Policy Limit:
Are any of the parties or their insurance carriers in
Bankruptcy, Receivership or Liquidation?
Yes No
If Yes, Please Identify Such:
   

I promise that the information provided regarding said lawsuit is truthful and complete to the best of my knowledge.

This document authorizes the release of all legal, and medical documents, police reports and insurance records and correspondences, regarding this incident to Nationwide Lawyer Funding for the sole purpose of evaluating my application for an investment.

Date:
State Bar No:
   
 
   
The transmission or receipt of any materials from or through this website, including text, graphics and/or e-mail, is not intended to create, nor does receipt of these materials establish or constitute, a contractual relationship or attorney-client relationship between Nationwide Lawyer Funding and you or anyone else.