STATE OF _________(1)________)

ss:

COUNTY OF ________(2)________)

KNOW YE ALL MEN BY THESE PRESENTS,

This Agreement is made and entered into this _(3)_ day of ________(4)________, 19_(5)_, by and between ________(6)_________, of ___________(7)____________, hereinafter called the "Attorney", and __________(8)__________, of ____________(9)______________,

hereinafter called the "Client".

WHEREAS, Client desires to initiate proceedings against ___________(10)_________, of _____________(11)___________________, Client hereby retains and employs Attorney to prosecute said action to final judgment or to any other settlement satisfactory to Client.

Client agrees to pay Attorney for his services under this Agreement a sum equal to _(12)_ percent of any monies or property obtained or received by Client as the result of voluntary

compromise or other out-of-court settlement; _(13)_ percent if received after judgment; and _(14)_ percent if received by Client after appeal.

Client further agrees to reimburse Attorney for all proper expenses incurred by Attorney pertaining to such action or settlement.

Except as provided herein, Attorney shall not be entitled to any other compensation from Client for legal services related to this Agreement.

It is agreed between the parties hereto that Attorney shall have a lien for payment of his fee on all monies or property obtained, received or recovered by compromise, settlement, judgment or any other means whatsoever.

In the event legal action is required to enforce any provision of this Agreement, the prevailing party shall be entitled to recover reasonable attorney's fees and costs.

IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the date first above written.

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