Fee Agreement Acceptance "*" indicates required fields Name* First Last Email* Enter Email Confirm Email Jurisdiction*Select JurisdictionBlandBrunswickCarolineCarrollChesterfieldDinwiddieEmporiaGoochlandGreensvilleHanoverHenricoHopewellMecklenburgMontgomeryNew KentPetersburgPrince GeorgePulaskiRichmond-John MarshallRichmond-ManchesterRoanokeSmythSouthamptonSpotsylvaniaStaffordSussexWashingtonWythePlease select the jurisdiction where your case will be heard.Case NumberThis can be found in the body of the email titled “Fee Agreement” towards the bottom, or in Paragraph 2, Subsection b “Period and Scope of Representation” of the attached Fee Agreement PDF file. If your case does not have a Case Number assigned yet, you may leave this section blank.Acknowledgement* I have read and fully understand the terms of the Fee Agreement.Acceptance of Fee Agreement* I accept the terms of the Fee Agreement.Confirmation of Authority to Accept* I am the above named person so authorized to accept the terms of the Fee Agreement.While we love helping out your loved ones, we need the actual person that we will be representing to accept the Fee Agreement. If you are a parent, spouse, or any other person that is not the actual defendant in this case, we will need to make sure that they are the person actually accepting the terms of this Agreement.Signature*You can use your mouse or finger to sign the document.Have you submitted payment? Yes No Would you like to submit payment now? Yes No Pay Online – Please follow this link to submit payment for representation with a credit or debit card. A receipt will be emailed to you upon submission.Just a reminder that we are not retained until we have received payment of the attorney’s fee. Once you submit payment, we’ll send you a receipt confirming that we have been retained.Document Upload Drop files here or Select files Max. file size: 32 MB. If you have any documents you would like to submit for your case, you can do so here. If there are documents you plan to submit but don’t have them readily available at this time, you can submit them later. Instructions for how to do that later are listed in the Fee Agreement email.What are you uploading? Driving Record(s) Driving School Certificate Community Service Document(s) Speedometer Calibration Copy of the Summons / Charging Document Other Select AllPlease select all that apply.If "Other" please explain.We typically do not need you to submit a copy of the receipt for the Attorney’s Fee payment.
