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Contingent Fee Retainer Contract

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The undersigned (“Client”) hereby retains the services of Law Offices of Matthew D. Dubin, PLLC (“Attorney”) to represent the Client in the matter of the Client’s claims for damages arising out of an accident which occurred on or about

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For such services rendered, it is agreed that Client will pay to Attorney a contingent fee of one third (33 1/3%) of any amounts recovered prior to filing a lawsuit or demanding arbitration. In the event a lawsuit is filed or a demand for arbitration made, Attorney’s fee shall be forty percent (40%).

There will be no attorneys’ fees in the event there is no recovery.

By my signature, I authorize my attorneys to take such steps as they deem necessary to protect and establish my claim, and I agree to pay all costs and expenses incurred in the handling of my case and to reimburse all itemized expenses advanced on my behalf. Case expenses shall include all court costs, carrying fees, investigation costs, and litigation expenses, including reasonable finance charges incurred.

Client has been advised and consents to the file being created and stored solely in an electronic format, both during the case and after the matter is completed. Client also consents to receive periodic updates and information via email, fax, text messages, and regular mail. Client hereby provides authority for Law Offices of Matthew D. Dubin, PLLC and its attorneys to sign necessary authorizations (medical, employment, etc.), settlement documents, settlement checks, and deposit settlement checks into the client trust account.


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