PEOPLE'S LEGAL FRONT
BECAUSE THESE ARE NOT THE TRADE SECRETS OF ATTORNEYS
LAW OFFICE OF _______________
PERSONAL INJURY AGREEMENT
I, Robin McDermott, retain ____________, Attorney at Law, as counsel
to take all steps, proceedings and actions, which counsel and myself, after
discussion, find necessary to obtain settlements, verdicts, compromises,
and judgments, with regard to injuries received by me on October 5, 1998.
DATED: 23 December 1998 ________________________________________
I, Robin McDermott, give my attorney, ____________, full authority to act
on my behalf in all matters concerning my claims for medical expenses,
present and future personal injuries, lost wages, lost employee benefits,
and any other losses resulting from the personal injury of myself on October
5, 1998. I give _______________ full authority to gather medical and other
evidence, enter into agreements, appear on my behalf in Court and administrative
hearings, and do any other act which in his opinion and after discussion
with me, we agree is appropriate.
In consideration of this representation, I agree to pay ______________
thirty-five percent, (35%) of any award I receive above the actual medical
expenses incurred as a result of this incident of October 5, 1998 whether
or not this matter must be resolved through lawsuit.
I, Robin McDermott, and my attorney, ______________, agree that the property
damage settlement of eight hundred and ninety-seven dollars, ($897), is
not now nor ever will be subject to this or any other agreement between
I, Robin McDermott, agree to advance to my attorney, ______________, the
sum of one hundred dollars, ($100), against any reasonable and necessary
costs and expenses he may incur on my behalf .
My attorney, ___________, agrees to provide me with a detailed statement
of said reasonable and necessary costs and expenses he may incur on my
behalf and to apply any unused portion of said amount toward the thirty-five
percent consideration agreed by the parties for his services as outlined
DATED: _______________ _________________________________________
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