Sample Fee Agreement Form (Page 2 of 2) in pdf

Sample Fee Agreement Form Page 2

SAMPLE

LOMAS Administrative Form

Form No. 096128, page 2 of 2

( )

Estimate for costs and expenses (not including attorney's fees):

( )

Expected to range between $_____ and $_____ .

( )

Not expected to exceed $________.

( )

No expenses expected.

NOTE: This is an estimate for your convenience; it is not a guarantee.

If the above properly sets forth our agreement, please sign below and keep one copy. Return the

original together with your check in the amount of $ ________________.

We will draw $ ________________ towards attorney fees and apply $ ________ towards out-of-

pocket expenses as outlined above. If we do not receive the signed original of this agreement

(you retain the copy), and your check within ___ days, we shall assume that you have obtained

other counsel and shall mark our file "CLOSED" and do nothing further. Thank you.

Dated:_________________

By: ______________________________________

Attorney at Law

The above is understood and agreed to by me.

Dated: ________________

By: ______________________________________

Client

Sample Fee Agreement Form Page 2