Application | Mysite 1

Is your current attorney the original attorney on your case?

If no, who was your previous attorney?

Are you required to pay child support?

If yes, are you current or behind?

If behind, how much?

Have you currently filed for bankruptcy?

Do you intend to file for bankruptcy?

Are you involved in any other lawsuits?

Do you have any other loans on this lawsuit?

If yes, who do you have loans with?

How much do you owe other companies on this claim?

Did your attorney tell you to contact us?

Please give a brief description of your injuries and how they occurred.

Did you have any prior injuries?

If prior injuries, what were they?

What is the purpose of this loan?

If approved, where would you like to sign papers?

If approved, how would you like to recieve funds?

What type of claim is your claim?

How much money would you like to apply for?

Your Signature

Thanks for submitting!

Bob Sutton Real Estate & Loans, LLC