Attorney Advance Form

Your Name:
Your Email:

Date:
Advance Amount:
Attorney Name:
Firm Name:
Type of Practice:
Address:
City:
State:
Zip:
Attorney Phone
Attorney Fax

Outstanding Firm or Individual loans and their amounts due:

Lines of credit and their amounts due:

Number of cases pending on a contingency basis:

Number of cases offered as collateral of non-recourse advance:

Quality of cases – Please provide the attorney questionnaire and supporting documents for each casethat will be used as collateral for the advance via mail, email, or fax us at (248) 948-1802.

One of our Financial Representatives will be in contact with you once you have submitted this form.
If you have any questions, please contact Litigation Funding at 1-866-LIT-FUND.

1.866.LIT.FUND

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Attorney Advance Form

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