Attorney Representation Notice

Attorney Representation Notice
Please complete this form to formally notify all parties of attorney representation in your legal matter.
Client Full Name
First NameLast Name
Client Email Address
example@example.com
Client Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Client Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Attorney Full Name
First NameLast Name
Law Firm Name
Attorney Email Address
example@example.com
Attorney Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Case Reference or Matter Description
Relevant Court or Authority
Date Representation Begins
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Client Signature
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Should be Empty: