Lawyer Questionnaire Form (NZL1)

Lawyer Application Form

Thank you for your applying with JustFund. Please complete the below form to commence your client's application.
Your First Name*
Your Last Name*
Your Law Firm's Name*
Your Contact Number *
Your email address*
Are you the lawyer with day to day responsibility for the matter?*

YesNo
What’s the name of the lawyer with day to day responsibility for this matter?

First NameLast Name
What’s their email address?
Do you confirm that you have obtained your client's instructions to submit this application for funding on their behalf?*

YesNo

Matter Overview
Your client's first name *
Your client's middle name *
Your client's last name *
What's their email address?*
What's their contact number?*
What's their date of birth?*

DayMonthYear
Date
What's the name of your client's former partner?*

First NameMiddle NameLast Name
What's their date of birth?

DayMonthYear
Date

Funding & Costs
Approximately how much has your client already paid in legal fees and costs associated with their matter?*
How much in outstanding invoices or WIP (if any) does your client have with your firm? *
What is your estimate for the amount of funding required to seek to resolve your client’s matter?*

Lawyer Application Form