Authority to Represent-Contingency


I, the undersigned client, do hereby employ , Attorneys, hereafter

“Attorney” to represent

in the matter of


and to institute legal proceedings


or any other person, corporation or partnership who may be liable for damages I may have received, and to seek recovery of said damages. For the services rendered by Attorney, I agree to

pay to said attorney percent of any recovery received from any settlement or award.

All court costs and other out of pocket expenses shall be paid by me and deducted from my share of any of said proceeds of settlement.

I agree not to settle this case without consulting with Attorney and likewise no settlement shall be made by my attorney without my prior consent.

Dated this the day of , 20 .






Attorney Specific Forms

–For Attorney Specific Forms you can download in Word format, go to

Inside Authority to Represent-Contingency