I, the undersigned client, do hereby retain and employ Justin Ziegler, P.L. as my attorney(s) to represent me in my claim for damages against______________________ or any other party, firm or corporation liable therefore, resulting from an accident that occurred on or about ________________. I HEREBY AGREE to pay for the costs incurred by Justin Ziegler in prosecuting this claim and authorize them to undertake and/or incur such costs as they may deem necessary from time to time. These costs include, but are not limited to, such items as police reports, hospital and medical records, photographs, research, filing fee, costs of serving summonses and subpoenas, court reporters fees, jury list, exhibits, state records, investigation expenses, expert witness fees, including fees for medical testimony and fees for medical conferences. They will make every effort to keep these costs at an absolute minimum consistent with the requirements of the case. At the time the case is closed, an accounting will be made for all disbursements made in my case. As compensation for their services, I agree to pay my said attorneys from the proceeds of recovery the following fee: a. Before the filing of an answer or the demand for appointment of arbitrators or, if no answer if filed or no demand for appointment of arbitrators is made, the expiration of the time period provided for such action: b. After the filing of an answer or the demand for appointment of arbitrators or, if no answer is filed or no demand for appointment of arbitrators is made, the expiration of the time period provided for such action, through the entry of judgment: c. If all defendants admit liability at the time of filing their answers and request a trial only on damages: d. An additional 5% of any recovery after notice of appeal is filed or post judgment relief or action is required for recovery on the judgment. After the attorney takes his contingency out of the gross proceeds of recovery, costs will then be subtracted and the client will net the balance. IT IS AGREED and UNDERSTOOD that this employment is upon a contingent fee basis, and if no recovery is made, I will not be indebted to my attorneys for any sum whatsoever as attorneys fees. Any costs or expenses incurred on behalf of the client will still be owed. I hereby expressly grant power to the attorney to endorse and deposit in Trust any checks in my name, and authorize the attorney to deduct fees, costs, and expenses, and to pay all appraisal expenses from my share of the recovery. Any unpaid bills for services shall remain the client’s obligation. THE UNDERSIGNED CLIENT HAS, BEFORE SIGNING THIS CONTRACT, RECEIVED AND READ THE STATEMENT OF CLIENT’S RIGHTS, AND UNDERSTANDS EACH OF THE RIGHTS SET FORTH THEREIN. THE UNDERSIGNED CLIENT HAS SIGNED THE STATEMENT AND RECEIVED A SIGNED COPY TO KEEP TO REFER TO WHILE BEING REPRESENTED BY THE UNDERSIGNED ATTORNEY(S). THIS CONTRACT MAY BE CANCELLED BY WRITTEN NOTIFICATION TO THE ATTORNEY AT ANY TIME WITHIN 3 BUSINESS DAYS OF THE DATE THE CONTRACT WAS SIGNED, AS SHOWN BELOW, AND IF CANCELLED THE CLIENT SHALL NOT BE OBLIGATED TO PAY ANY FEES TO THE ATTORNEY(S) FOR THE WORK PERFORMED DURING THAT TIME. IF THE ATTORNEY(S) HAVE ADVANCED FUNDS TO OTHERS IN REPRESENTATION OF THE CLIENT, THE ATTORNEY(S) ARE ENTITLED TO BE REIMBURSED FOR SUCH AMOUNTS AS THEY HAVE REASONABLY ADVANCED ON BEHALF OF THE CLIENT. DATED THIS ______ day of ____________________, 2007. ________________________________________ ______________________________________ The above employment is hereby accepted upon the terms stated above. By:_____________________________________ Authority to Represent and Contingency Fee Agreement (PDF)
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AUTHORITY TO REPRESENT AND CONTINGENCY FEE AGREEMENT
