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Text in this example:
I hereby Appoint as my attorney to prosecute a claim for Personal Injuries against relating to injuries that occurred on . DATE I hereby agree that the compensation for my attorney for services shall be determined as follows: that out of whatever sum is secured by my attorney from the above Defendant(s) by way of settlement or verdict, my attorney shall receive % thereof if my case is settled without filing a lawsuit, or % thereof if my case is settled after a lawsuits is filed, or % thereof if my case is settled after arbitration, or % thereof if my case must go to jury verdict. The expenses, including the fees of witnesses, investigation, photographs, and other proper costs incurred in the preparation, trial, or settlement shall be deducted before payment of my attorney's fee, and all otherwise unpaid medical expenses shall be paid from the balance remaining after payment of my attorney's fee and expenses. SHOULD NO MONEY BE RECOVERED BY SUIT OR SETTLEMENT, MY ATTORNEY SHALL HAVE NO CLAIM AGAINST ME OF ANY KIND FOR SERVICES RENDERED. I hereby acknowledge acceptance of this Contingent Fee Agreement. NAME ADDRESS Contingent Fee Agreement