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Legal Funding Group Application - Attorney Questionnaire

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Please Note That This Information Is For Case Evaluation Purposes Only, and Will Not Be Shared With Your Client.

In order for this case to be considered for funding, we require answers to the questions below. Please forward any documents requested to our office at fax (310) 878-0592 or via US Mail after completing this on-line application.

Attorney Information
Attorney's First Name: Date:
Last Name:
Firm Name:
Address:
City: Email:
State: Phone:
Zip: Fax:

Case Information
Clients's First Name: Type of Case:
Last Name: Property Damage 
(if applicable):
 Under $4,000
 Over $4,000
Incident Occurred In City:
State:
Suit Filed:
Yes No
Mediation Date:
Settlement Offer 
(verbal or written), if any:		 Settlement Demand, if any:
Liability Been Admitted:
Yes No
Settlement Prospects:
Good Fair Poor
Please note this information will not be revealed to anyone including your client and we understand you are not offering a guarantee or opinion as it pertains to the viability of this case.
Your Estimated Value 
of This Case: $
Insurance Company: Policy Limits:
Details of Case 
(Theory/Basis):
Extent of Injuries 
(Physical/Financial):

Medical Treatment Information
MRI:
Yes No
Emergency Room:
Yes No
Surgery:
Yes No
Length of Hospital Stay:
Fractures:
Yes No
Still In Treatment:
Yes No

Case Summary
Case on Contingency 
Fee Basis:
Yes %: No
Medical Costs 
(to date):		 Lost Client Income 
(to date):
Leins and Amounts
Filed to Date
Professional, Personal Loans/Serviecs:
Estimated Date 
of Settlement:

Fees
A word about our fees and the industry. At Legal Funding Group (LFG) we work diligently to educate the client that even at the lowest rate possible, a non-recourse cash advance is expensive and should only be used as a last resort. Be aware that the Lawsuit Financing industry is full of part timers and very expensive advance operations. Some companies charge an automatic 100% of the advance amount; some charge 15% per month etc. Some even demand a portion of the settlement in addition to the advance amount and fees!
The ones that advertise low rates are simply adding larger front loaded one-time fees. For example, in place of a 10% origination fee - they will charge a 20% origination fee and knock off a ½ point on the monthly fees, hardly a bargain. In other cases they are doubling up on application fees.
Make sure that the funding company you select is experienced and actually capable of delivery of Lawsuit Financing. Many times less experienced companies will bog the attorney down with request and never deliver. Some even take the case information in and then go looking for funding.
Approximately 70% of our funding requests are attorney referrals and we fund 100+ cases monthly. For more information on our service visit. www.legalfundinggroup.com
Our fee structure includes a flat one-time application fee that ranges from $250.00 - $350.00. A one-time origination fee of 10% of the gross funding amount. Our monthly compounding fees range from 3.0 to as high as 8.9%. The client is never required to pay any upfront out of pocket expense. And of course all of our advances are non-recourse. If your client is seeking a larger advance, we encourage monthly drawdowns to save on monthly fees. We find that everyone's needs are different. Please feel free to call us toll free at (877) 457-7771 - 9:00 A.M. - 5:00 P.M. CST should you have questions.
Thank you for submitting your application for our review. The submittal of your application is not a guarantee of funding. By submitting your application you agree that the Legal Funding Group (LFG) automation process will capture and store your IP address 38.103.63.17 for security purposes only. LFG in no way offers your information for sale or exchange. Should you have any questions, please feel free to call us toll free at: (877) 457-7771. Monday through Friday 9:00 AM - 5:00 PM CST. Our office is closed on all governmental holidays.

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