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LOWMH In-House Financing Application

At the Law Office of Will M. Helixon, we understand that access to experienced legal counsel is critical, and that financial concerns should not stand in the way of securing quality representation. This Financing Application is designed to help us better understand your circumstances and needs so we can provide you with tailored options for financing your legal services.

Please complete all sections of the form below. The information you provide will remain strictly confidential and is necessary for us to assess your eligibility for financing, payment plans, and any special arrangements that may assist you during this process. If you have questions about any part of the form or need assistance, our team is ready to help you every step of the way.

Basic Information

Full Name(Required)
Address(Required)
MM slash DD slash YYYY

Legal Financing Request

Number of Payments Desired(Required)
Frequency of Payments(Required)
List Dates You Would Like to Make Payments

Financial Information

Do You Own a House?(Required)
Do You Own a Car?(Required)
Do You Own Other Property?(Required)
Are You Willing to Set Up an Auto-Draft via LawPay (Credit, Debit, or Bank Account)?(Required)
Are You Willing to Set Up a Discretionary Allotment Through the Service (Army, Air Force)?(Required)
Are There Co-Sponsors or Co-Signers Willing to Guarantee Your Loan?
Name
E-Mail
 

Debt Information (Monthly)

Other Expenses
Expenses
Amount
 

Documentation

Have you signed the Engagement Agreement (Contract)?(Required)
Have you signed the Financing Addendum?(Required)
Have you received the Terms and Conditions of Representation?(Required)
Have you signed the Payment Plan Addendum?(Required)
Max. file size: 10 GB.

*I hereby affirm that all the information I have provided on this application form is true, complete, and accurate to the best of my knowledge and belief. I understand that any misrepresentation, omission, or false statement may result in the denial or termination of financing and could have legal consequences. I further acknowledge that the information provided may be used to evaluate my eligibility for financing, and I authorize the verification of any or all aspects of the information contained herein.

Clear Signature