PLDRC NEW MATTER INTAKE FORM



new matter intake form

( NEW CLIENT ( EXISTING CLIENT DATE:_____________

( CORPORATE / ( INDIVIDUAL CLIENT NAME:

__________________________________________________________________

[IF EXISTING CLIENT, REST OF THIS PAGE NEED NOT BE FILLED OUT]

client address:

Street Address: ____________________________________________

Suite: ___________________________________________________

City: __________________ State: ______________ Zip: __________

IF CORPORATE CLIENT, CONTACT NAME:

_____________________________________________________

BUSINESS PHONE:________________________________________

MOBILE PHONE: _________________________________________

home PHONE: _________________________________________

FAX NUMBER: ___________________________________________

EMAIL ADDRESS: _________________________________________

*****************************************************************

alternative contact PERSON:

Name: __________________________________________________

Street Address: ____________________________________________

Suite: ___________________________________________________

City: __________________ State: ______________ Zip: __________

Business Phone:________________________________________

Mobile Phone: _________________________________________

MATTER TYPE: ( Litigation

( Transactional / General Business

ENGAGEMENT LETTER TYPE:

( Standard Contingency – 40%

( Standard Contingency – ____ %

( Litigation Hourly

( General Business Hourly

( Three Party Hourly [Third party name:____________________]

( Other

DEPOSIT REQUIRED? ( Yes ( No Amount: $_________________

RESPONSIBLE ATTORNEY (Circle one): NP DEH TAM

********************************************************************

LAWSUIT NAME (if applicable): _________________________________

COURTHOUSE (if applicable): ___________________________________

CASE NUMBER (if applicable): ___________________________________

NATURE OF ENGAGEMENT: ___________________________________

_______________________________________________________________

_______________________________________________________________

**************************************************************

DEVELOPING ATTORNEY: ____________ NP approval (

**************************************************************

REFERRAL FROM (if applicable): _______________________________

REFERRAL FEE? ( Yes ( No REFERRAL PERCENTAGE: ____ %

REFERRAL ATTORNEY ADDRESS:

Firm Name: ______________________________________________

Street Address: ____________________________________________

Suite: ___________________________________________________

City: __________________ State: ______________ Zip: __________

IMPORTANT case information

ANY STATUTE OF LIMITATIONS OR OTHER CRITICAL DATES?

Statute of limitations: _______________________

Trial date set: _____________________________

Other critical dates:_________________________

BRIEF DESCRIPTION OF STATUS:

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

PLDRC INTERNAL INTAKE CHECKLIST:

Engagement Letter

( Engagement letter prepared ___

( Engagement letter sent to client ___

( Engagement letter signed by client and returned to PLDRC ___

( Engagement letter signed by NP and fully executed agreement transmitted to client ___

Fee Sharing Letter (applicable? ( Yes ( No)

( Fee sharing letter prepared ___

( Fee sharing letter sent to client ___

( Referral thank you note to referring person (with executed fee sharing letter) ___

( Fee sharing letter signed by client and returned to PLDRC ___

( Fully executed fee sharing letter sent to referring attorney ___

Client number creation and distribution

( Client number issued by JJP [Quickbooks and Timeslips] ___

( Client number added to master client number list ___

( Client number input into printer/scanner ___

Files, documents, internal records

( All files and documents received from client or prior counsel ___

( PLDRC files created ___

( Client and referral attorney contact information input into Contacts ___

( Electronic folders set up in Active Clients on network ___

( Matter added to Master To Do list ___

( Conflict check performed ___

Substitution of Attorney (applicable? ( Yes ( No)

( Substitution of attorney form created ___

( Substitution of attorney form to client for signature ___

( Substitution of attorney form returned by client to PLDRC ___

( Substitution of attorney form signed by prior counsel ___

( Substitution of attorney form filed ___

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download