1 (877) 272-4653

42 West Allendale Ave
Allendale, NJ 07401

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Are engagement letters or retainer agreements, that establish the scope of your firm’s representation, required to be sent to all new clients?

Have you ever sued a client (past or present) for uncollected fees?
 Yes No

Has any member of your firm handled class action or mass tort litigation in the past 5 years?
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Has any member of your firm been disbarred or been the subject of a disciplinary proceeding?
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Designations: O=Owner, P=Partner, A=Associate, IC=Independent Contractor, OC=Of Counsel, PA=Patent Agent

Name Hire Date Designation

AREA OF PRACTICE (Total must equal 100%)


Does your firm currently have professional liability insurance?
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If currently insured, please complete the following:

Who is your Insurer?

What are your expiring limits of liability?

What is the deductible?

What is the annual premium?

What is the Retroactive Date (if applicable)?

Current policy expires

CLAIMS HISTORY (if applicable)

Date of Claim or Incident Reported Amount Paid (incl. Expenses) Claim Status
Claim #1  Open Closed
Claim #2  Open Closed
Claim #3  Open Closed