WE MAY NOT BE ABLE TO TIMELY COMPLETE THIS PROCESS IF WE DO NOT RECEIVE THIS INFORMATON AT LEAST TWO (2) DAYS BEFORE YOUR SCHEDULED COURT APPEARANCE.

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1 We look forward to favorably resolving your traffic ticket/criminal law matter. Simply print this form and fill in the blanks. If this involves a traffic ticket, we understand that you want three things from this representation. 1 Eliminate or minimize insurance points, 2 Minimize costs, and 3 Minimize hassles. WE MAY NOT BE ABLE TO TIMELY COMPLETE THIS PROCESS IF WE DO NOT RECEIVE THIS INFORMATON AT LEAST TWO (2 DAYS BEFORE YOUR SCHEDULED COURT APPEARANCE. WE WILL NOT BE RESPONSIBLE FOR ASSISTING YOU WITH YOUR MATTER UNTIL THIS PROCESS IS COMPLETE. THIS MAY RESULT IN A WARRANT BEING ISSUED FOR YOUR ARREST FOR FAILING TO APPEAR IN COURT. PLEASE RETURN THESE DOCUMENTS TO US WELL BEFORE THE SCHEDULED COURT APPEARANCE. If you have questions about these forms call us at and then dial 2 when you begin to hear the answering device. Or us at Or fax us at I. PROSPECTIVE CLIENT INFORMATION SHEET FULL NAME: D.O.B.: AGE: MAIDEN NAME: WORK #: CELL/PGR # HOME # ADDRESS (street, apt #, city and zip: ADDRESS: S.S. #:

2 DRIVER S LICENSE # from what state: CHARGES: COUNTY: COURT DATE: PRIORS: TAKEN DEFENSIVE DRIVING CLASS: LEGAL PLAN NAME: CLAIM OR REF. #

3 Please fill in the blanks and FOLLOW THESE INSTRUCTIONS and provide us the following items 1 7, expressed below, and then return these forms and any of the items expressed below, by faxing them to or by scanning them and ing them to or by mailing them to Monks Law Firm, PLLC, PO Box 51666, Durham, NC 27717; please do not mail certified or signature confirmation required. We need the following: 1. the front and back of the citation(s, 2. a copy of this signed contract (II. and signed waiver of appearance/entry of plea (III. (below, 3. a copy of your driver s license, 4. a copy of your insurance card, 5. a copy of the your driver s record from your home state; if not NC, 6 any proof regarding a defense you may have or remedial measures to correct issues which resulted in your receiving the ticket, and 7. payment. Payment may be made by check or credit card. Make your check payable to the Monks Law Firm, PLLC (We can receive payment if you fax or scan and a copy of the check. Or, by credit card; I authorize the Monks Law Firm, PLLC to secure $ from my (circle one Visa M/C AMEX Discover. The card number is:. Expiration date:. Security Code: Zip code where you receive the bill for this card:. A copy of the card and the name exactly as it appears on the card:. If Client is a member of an affiliated legal insurance plan that pays the Client s attorneys fees, the Firm will accept the fees ordinarily paid by said plan to satisfy Client s obligation to the Firm for the services provided to the Client by the Firm. THIS MEANS YOU DON T PAY UNLESS THE INSURANCE COMPANY DOES NOT PAY.

4 II. CONTRACT I/We, hereinafter called Client, hereby engage the Monks Law Firm, PLLC, hereinafter called the Firm, to provide legal services on Client s behalf pertaining to a criminal case/traffic ticket. The Firm shall give legal counsel to Client, prepare and file pleadings, appear on Client s behalf in all legal proceedings pertaining to the Client s interests exclusively regarding: Ticket/Case(s #. Type of Case(s Infraction/Charge ; if speeding MPH in a MPH zone. Court date and location (County or city:. Client understands that another agreement will be required for the Firm to handle other matters. Client acknowledges that the Firm may associate with other attorneys in order to satisfy its obligations herein. All services rendered by the Firm shall be performed in a professional manner within the bounds of the law and the Code of Professional Responsibility of the State Bar of North Carolina. Responsibility to provide legal services will be accepted and work will begin when the Firm receives: $ as a non-refundable fee; There will be no additional attorney s fees payable if the case is resolved without the necessity of setting a case for trial or evidentiary hearing. Client acknowledges that the following fees may also be due and payable as a result of representation in this case. $ for setting a case for trial or a dispositive evidentiary hearing; this fee is payable 30 days before the trial or evidentiary hearing. YOU DO NOT HAVE TO PAY THIS FEE UNLESS YOU REQUEST A TRIAL. If this box is not filled in, Client agrees to pay attorney a reasonable fee for said evidentiary hearing or trial and $ for appeal to Superior Court, payable prior to the appeal. YOU DO NOT HAVE TO PAY THIS FEE UNLESS YOU REQUEST AN APPEAL.

5 If Client is a member of an affiliated legal insurance plan that pays for the Client s attorneys fees, the Firm agrees to secure payment for the above fees from said plan and will accept the fees ordinarily paid by said plan for the services provided to the Client by the Firm. If the plan denies the claim for said services above, Client will be responsible for paying same and Client shall pay said fees to the Firm within 30 days of receipt of notice of denial of said claim. The Firm shall process the claim for the Client. COURT APPEARANCES: Client is responsible for knowing when and if they must appear in court and for securing from the Firm what happened with their case. The Firm shall attempt to provide this information to the Client and may use any means in its discretion, mail, phone call, , etc., to notify the Client of upcoming court appearances, if any, or of the disposition of the Client s case. Client acknowledges that there may be fines, court costs which are the sole responsibility of the Client to pay. If the Firm pays for Client s fines and or court costs, Client shall reimburse the Firm in accordance with their obligation to pay attorneys fees as provided below. OR Client expressly authorizes the Firm to pay their traffic ticket fines and enclosed herein is $ to pay for any associated fines or fees of this representation. Any unused portion shall be returned to Client upon completion of said representation. If this box is left blank, client acknowledges that Client will be responsible for paying any fines or fees due to the court as a result of representation herein. Client agrees that attorney may withdraw from further representation should they not pay their attorneys fees as agreed. Client agrees to pay the Firm at the Firm s office in Durham, North Carolina. Client will pay a $25 fee for any returned or insufficient checks paid to the Firm. Client s signature below authorizes the Firm to secure payment from the credit cards provided above. Client agrees and understands that the fees which Client agrees to pay under this contract do not apply to any further litigation after the case is dismissed or a judgment is signed, such as appeal or other litigation in any trial court or appellate court. Client understands that the Firm makes no promises or guarantees as to the outcome of the case or if the Client may be able to avoid going to Court. Client agrees that the Firm may, in its sole discretion, discard the contents of Client s file after 30 days of the final disposition of Client s case.

6 CLIENT: Print name (x signature Print name: Authorized signatory on the credit card (x Signature Monks Law Firm, PLLC: By: print name (x signature

7 III. WAIVER OF APPEARANCE/ENTRY OF PLEA STATE OF NORTH CAROLINA COUNTY OF STATE OF NORTH CAROLINA, Plaintiff vs., Defendant. IN THE GENERAL COURT OF JUSTICE DISTRICT COURT DIVISION FILE NO: WAIVER OF APPEARANCE ENTRY OF PLEA Pursuant to N.C.G.S. 15A-1011 (d, the undersigned Defendant does hereby waive Defendant's appearance in the above-captioned case and thereby waives the right to testify, to face Defendant's accusers and agrees to be bound by the decision of the Court; further that the Defendant is unable to appear at this time of setting of the case and does hereby request that the State of North Carolina proceed under the Section herein above cited; that the undersigned Defendant does further designate the Monks Law Firm, PLLC or its designee to appear on Defendant's behalf and to enter a plea to the offense charged or such other offense as may be charged in a plea bargain arrangement with the State. This the day of, 20 (x Client signature (x Attorney

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