Vol. 71, No. 11,
November 1998
Sample Pro Bono Representation Agreement
I hereby request and authorize [insert name] to evaluate, and if merit exists, to provide legal services regarding [insert].
Legal services may include appropriate advice and counsel, referral, and direct representation in legal proceedings but does not include appeals unless otherwise agreed.
I have provided complete financial information and will update this information should my circumstances change. I understand that my lawyer has decided that I am eligible for free legal services. I
further understand that I am responsible for costs incurred in my case and court costs and may be required to advance these costs.
When I ask, I will be told what is happening in my case. Further, I understand that before my lawyer takes any action that may significantly affect my claims, (s)he will consult with me for direction and
my agreement to take a course of action.
I have the responsibility to cooperate fully with my lawyer and his/her staff; to provide all information about my legal problems; to promptly notify the lawyer or law firm of any change in my
address, telephone number, other material circumstance and my financial circumstances; to appear in court when required to do so; and to contact the lawyer or the law firm office when I am asked to
do so. I understand that the lawyer may stop handling my case and seek a court order to withdraw as my lawyer if I do not cooperate.
I understand that all information I have provided is confidential and will not be released without my express consent except as necessary during the course of representation or as required by the Rules of
Professional Conduct.
Date: [insert] [insert name of attorney] agrees to provide legal services to this client on the terms set forth above.
Date: [insert [insert name of client]
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