Thank you for contacting MR Business Law, PLLC. This form collects preliminary information so we can determine whether we may be able to assist and whether a conflict of interest may exist.
Submitting this form does not create an attorney-client relationship.
Do not provide highly sensitive details until the firm confirms that it is appropriate to do so.
The firm will not represent you or take action on your behalf unless a written engagement agreement is signed and any required fee or retainer is paid.
Legal deadlines may apply, so do not delay seeking counsel.
Prospective Client Information
The following section asks for information regarding the Prospective Client ONLY. (Note: The Prospective Client and the Person completing this form are not necessarily the same.)
If the Prospective Client is a BUSINESS ENTITY, please only provide information for the Business Entity. (Note: The next section (also) will ask for information regarding the Primary Contact Person. That section would ask for information about the person completing this form.)
If the Prospective Client is an INDIVIDUAL, please only provide information for the Individual.
Contact information: Prospective Client Information
Prefix
First name
*
Middle name
Last name
*
Company
Emails
Email Address
*
Type
Upon submission, a copy of this form will be sent to the primary email.
Work
Home
Other
Primary
Default email false
Add email
Addresses
Street address
Country
Australia
Canada
United Kingdom
United States
---------------
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
City
State/Region
Alaska
Alabama
Arkansas
American Samoa
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Northern Mariana Islands
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Virginia
Virgin Islands, U.S.
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Province/Region
Zip/Postal code
Address type
Work
Billing
Home
Other
Primary
Default address false
Add address
Phone numbers
Phone number
Type
Work
Home
Mobile
Fax
Pager
Skype
Other
Primary
Default number false
Add phone number
Is the Prospective Client:
Select an option
Individual
Corporation (Inc, Corp)
Limited Liability Company (LLC)
(General) Partnership (GP)
Limited Partnership (LP)
Limited Liability Partnership (LLP)
Professional Corporation (PC)
Professional Limited Liability Company (PLLC)
Nonprofit
Trust
Estate
Other
If "Other," please describe:
Business/entity legal name, if applicable:
Any trade names, DBAs, assumed names, former names, or related names:
State/country of formation, if applicable:
Principal business address, if different from above:
Mailing address, if different from above:
Website, if applicable:
Primary Contact Person
This section asks for information regarding the Primary Contact Person for the Prospective Client. This may (or may not) be the same as above.
Please identify the Primary Contact Person (if any) for the Prospective Client/Business by providing his/her Name, Address, Telephone/Fax Number(s), and Email Address (If different from above):
Title/Role for the Prospective (Business) Client:
Relationship to the Prospective Client:
Check all that apply
Owner
Officer
Director
Manager
Partner
Employee
Agent
Spouse/Family Member
Other
If "Other," please describe:
Do you have authority to retain counsel on behalf of the Prospective Client
Yes
No
If no, please provide the contact information for the person(s) with authority to retain counsel on behalf of the Prospective Client
Preferred method of contact
Select an option
Email
Phone
Text Message
Video Conference
Mail
Preferred days/times for contact:
May we leave voicemail at the number provided?
Yes
No
May we send email to the email address provided?
Yes
No
Are there any confidentiality concerns about contacting you?
Yes
If yes, please explain:
No
Type of Legal Matter
Type of Legal Matter
Please check all that apply
Outside general counsel / ongoing business counsel
Business formation
LLC operating agreement, bylaws, shareholder agreement, or partnership agreement
Contract drafting
Contract review
Contract negotiation
Business purchase or sale
Asset purchase / sale
Equity purchase / sale
Joint venture
Commercial real estate purchase or sale
Commercial lease
Title, lien, easement, or property issue
Loan, financing, or personal guaranty
Business dispute
Owner, member, shareholder, or partner dispute
Vendor, customer, or supplier issue
Employment-related business issue
Compliance / risk management
Demand letter or threatened claim
Litigation, arbitration, mediation, or administrative proceeding
Other
If "Other," please explain:
Brief Matter Summary
Please provide a brief, general description of the matter. DO NOT include highly sensitive details at this stage.
What is your primary objective?
What outcome are you hoping to achieve?
What outcome(s) could you accept if your preferred outcome is not available?
Deadlines and Urgency
Is there any deadline, hearing, closing date, response date, cure period, notice deadline, statute of limitations, or other urgent date?
Yes
If yes, please provide the date and describe the deadline:
No
Have you received any legal papers, notices, demand letters, default notices, termination notices, title objections, contract deadlines, or court documents
Yes
If yes, please describe generally:
No
Parties and Conflict Check Information
Please identify
ALL
people, companies, entities, and organizations involved in this matter, even if they are not adverse to you. Please include each (1) Person's Name, (2) Business's or Firm's Name (if represented by counsel), (3) Address, (4) Telephone Number, (5) Fax Number, (6) Email Address, (7) Website, and (8) Role in the matter.
ALL
of this information is necessary for the Firm to perform a property Conflicts Check before deciding whether to proceed further.
Please include any and all counterparties, owners, affiliates, lenders, brokers, landlords, tenants, buyers, sellers, investors, guarantors, title companies, agents, attorneys, accountants, and any other important parties. Twelve (12) spaces are provided. If you require additional spaces to identify additional parties, please indicate so in the last space.
Thank you.
Party/Attorney 1
Party/Attorney 2
Party/Attorney 4
Party/Attorney 3
Party/Attorney 5
Party/Attorney 6
Party/Attorney 7
Party/Attorney 8
Party/Attorney 9
Party/Attorney 10
Party/Attorney 11
Party/Attorney 12
Are you currently represented by an attorney for this matter?
Yes
If yes, please identify the attorney or firm and briefly explain the status
No
Have you consulted another attorney about this matter?
Yes
If yes, please identify the attorney or firm and briefly explain the status
No
Prior or Pending Legal Proceedings
Is there any lawsuit, arbitration, mediation, administrative proceeding, foreclosure, eviction, bankruptcy, receivership, lien claim, or government investigation related to this matter?
Yes
If yes, provide the case name, court/agency, case number, and current status, if known:
No
Has any party threatened legal action?
Yes
If yes, describe generally:
No
Documents
Please do not send documents until the firm confirms how they should be submitted
Do you have documents related to this matter
Yes
No
If yes, please check any documents you have
Check all that apply
Contract
Draft agreement
Signed agreement
Emails or letters
Demand letter
Notice of default
Corporate records
Operating agreement / bylaws / shareholder agreement
Purchase agreement
Lease
Loan documents
Personal guaranty
Deed / title documents
Survey
Court papers
Other
If "Other," please describe:
Referral Source and Consultation Preference
How did you hear about MR Business Law, PLLC
Select an option
Referral from a person
Referral from an attorney
Referral from an accountant/CPA
Referral from broker/advisor
Google search
Website
Social media
Referral from a Bar Association
Referral from a former client
Other
Name of referral source, if any:
May we thank the person who referred you?
Yes
No
Consultation Preference
Preferred consultation format
Select an option
Telephone
Video Conference
In Person
No Preference
Are you seeking:
Select an option
One-time consultation
Representation in a legal matter
Ongoing outside general counsel
Unsure
Billing preference, if any:
Select an option
Hourly
Flat fee
Monthly retainer
Subscription / outside counsel
Unsure
Acknowledgement
By submitting this form, you acknowledge and agree that:
this form does not create an attorney-client relationship;
MR Business Law has not agreed to represent you or any entity unless and until a written engagement agreement is signed by both the client and the firm;
MR Business Law will not take action on your behalf unless representation is confirmed in writing and any required fee or retainer is paid in advance;
legal deadlines may apply and you should seek other counsel promptly if the firm does not agree to represent you.
The information provided is accurate and complete to the best of your knowledge; and
you consent to being contacted by MR Business Law for purposes of scheduling, consultation, and conflict review.