Please read the disclaimer prior to completing the form.

CONSULTATION REQUEST | COMPLETED BY JC LEGAL STAFF

First Name

Address

Last Name

Phone Number

What is the issue, problem, or concern that you believe JC Legal can assist you with?

Are there any important dates associated with this matter?

Yes

If there are important dates, please explain:

Who else (any other parties) involved?

What resolution is being sought?

ACKNOWLEDGEMENTS

This is a limited Scope Legal Service, and NO appearances IN COURT, AT HEARING, OR WITH ANY TRIBUNAL shall be made on your behalf

You will be required to pay the full $125.00 consultation fee using either Paypal or CASH APP.

No attorney or JC LEGAL RESOURCES CENTER, INC is promising any particular outcome;

No attorney or JC LEGAL RESOURCES CENTER, INC has made any independent investigation of the facts and is relying entirely on YOUR disclosure of the facts given the duration of the limited services provided; and

No attorney or JC LEGAL RESOURCES CENTER, INC has any further obligation to Client after completing the above-described limited legal services unless and until both Attorney and Client enter into another written representation agreement.

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ELECTRONIC SIGNATURE ACKNOWLEDGEMENT AND CONSENT FORM

I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. I further agree my signature on this document is as valid as if I signed the document in writing. This is to be used in conjunction with the use of electronic signatures on all forms regarding any and all future documentation with a signature requirement, should I elect to have signed electronically. Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, were signed by myself with full knowledge and consent and am legally bound to these terms and conditions.