Power of Attorney and Contingent Fee Contract

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Date
MM slash DD slash YYYY
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Number Of Clients*
- One
- Two
Client's Name
First
Client's Email*
Date of Incident
MM slash DD slash YYYY
Date of Birth
MM slash DD slash YYYY
Home Telephone Number
Address
Street Address City State ZIP Code
Second Client Details
Second Client's Name
First
Date of Birth of Second Client
MM slash DD slash YYYY
Home Telephone Number of Second Client
Address of Second Client
Street Address City State ZIP Code
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Contract Generation
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How do you want the contract to be generated?*
- Send the contract to the client via email
- Generate the contract to be signed right now

Second Client Details