I hereby authorize the designated
representatives or any of their successors, assigns, designees,
agents or administrators to disclose, make available and
furnish to Legal Funds Now any and all information pertaining
to the settlement of my case as set forth. I specifically
direct that the attorney representing me in my case or any
of the successors, assigns, designees, agents or administrators
cooperate with Legal Funds Now regarding disclosure of information
related to the settlement of my case. I also authorize Legal
Funds Now to pull consumer credit reports and any information
concerning liens and judgments against me. Please provide
copies via fax or otherwise of any and all documents requested
by Legal Funds Now. I also request that my attorney share
his candid opinion of my case with Legal Funds Now. By submitting
this form, I/we certify that all of the information provided
above is true and correct. I/we understand that any intentional
misrepresentation on my/our part will result in the immediate
cancellation of any assignment or purchase made in connection
with this application.
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