Lawyer Referral Service of Marin County Bar Association

Attorney Application and Agreement

**Please Note: There are two signature lines on this form.
Full Membership Year 05/15/2010 - 05/14/2011
Half Membership Year 11/15/2010 - 05/14/2011
 
* Fields Required
Name *
Phone *
Fax
Cell Phone
Email *
CA State Bar Number*
Year Admitted to the Bar
Admission to practice in another state, State:
Year Admitted:
Marin Office Address: *
City:  *
Zip Code:  *
Other Office Address:
City: 
Zip Code: 
State: 
What percentage of time is spent in each office, Marin:
Other office:
Firm Name
Law School
Undergraduate School
Other language(s) spoken with sufficient fluency to conduct a consultation
Is there Wheelchair Access to your building and office?
For the HEARING IMPAIRED: Do you know American Sign Language?
Do you have TDD telephone equipment?
In addition to normal business hours, Please indicate whether your office can arrange to see clients at the following times:
After 5:30 p.m.
Saturdays
Sundays

PLEASE CHECK EACH APPROPRIATE STATEMENT BELOW:
1. I certify that I am an active member in good standing with the State Bar of California, that the majority of my professional time is devoted to the active practice of law, and I have a full-time business office for such practice in Marin County (all in accordance with Rule #1 of the LRS Rules).

2. An annual registration fee of $175 shall be required of each member of the Lawyer Referral Service, unless the applicant is not a member of the Marin County Bar, in which case the registration fee is $275. There is a $300 supplemental panel fee for participation on the Bankruptcy/Workouts panel for debtor referrals. The registration fee allows the attorney to participate on two subject matter panels (except the Bankruptcy/Workouts Panel). For each additional 2 panels there is a $50 fee. All such application, registration and supplemental panel fees are non-refundable. Your check should be made payable to LRS.

3. I certify I am familiar with and agree to abide by all of the rules of the Lawyer Referral Service.

4. In the event of a fee dispute with a client referred to me by the Lawyer Referral Service I agree to submit such dispute to binding arbitration by the Client Relations Committee of the Marin County Bar Association, if the client so elects. I agree to accept the rules, procedures and decisions of that committee.

5. I agree to maintain an Errors and Omissions insurance policy in an amount of not less than $100,000 for each occurrence and $300,000 aggregate per year and provide a copy of such policy's face sheet to the Lawyer Referral Service Office. I agree to notify the Lawyer Referral Service coordinator if I should be without Errors and Omissions insurance coverage at anytime during my membership year.

6. I agree that I will comply with California Business and Professions Code Section 6148 regarding service contracts and bills for services rendered to any client referred to me by the Lawyer Referral Service if I am retained for further services.

7. I agree to indemnify and hold harmless the Marin County Bar Association and its members, the Lawyer Referral Service Committee and its agents (including the Lawyer Referral Service staff) from any and all claims, demands, actions, liability or loss, including but not limited to costs of defense including reasonable attorneys' fees, which may arise from or be incurred as a result of any loss by referrals of clients to me from the Lawyer Referral Service.

8. I hereby apply for membership on the general panel and declare that I qualify according to the minimum standards when these apply.
  Please click the area(s) in which you agree to advise clients:
  Change of Name   Small Claims

9. I hereby apply for membership on the subject matter panel(s) as attached.

10. I agree to see clients from the following volunteer areas:
  Please click the area(s) in which you agree to advise clients:
  Home Visits   Hospital Visits

11. Legal Services for Senior Citizens: This panel serves senior citizens sixty (60) years and older, with a maximum income of $1200 per month or maximum assets of $25,000 excluding home and automobile. Participating Attorneys agree to charge a maximum fee of half the hourly rate normally charged for the work being done. The client pays the referral fee for the half-hour consultation. Thereafter, the attorney will charge the reduced hourly fee.


Lawyer Referral Service Affidavit


HAVE YOU EVER BEEN SANCTIONED OR HAVE YOU EVER BEEN DISCIPLINED BY THE STATE BAR (EXCEPTING PRIVATE REPROVAL)? Yes No

HAS THE STATE BAR OF CALIFORNIA COMMENCED DISCIPLINARY PROCEEDINGS AGAINST YOU WHICH ARE CURRENTLY PENDING? Yes No

I hereby sign under penalty of perjury, that the above is true and accurate.
(Type full name here)*
Date*

Referral Agreement

The Lawyer Referral Service (LRS) of the Marin County Bar Association makes available to the public the services of qualified attorneys who are members of the LRS. The applicant is applying for Panel membership in the LRS. In exchange for eligibility to receive LRS referrals, applicant agrees to the following conditions and covenants:

1. Applicant represents that he or she has read the LRS Rules and agrees to abide by them or by those that may be later adopted. Rules are incorporated by reference. Applicant further represents that he or she has read and is familiar with the State Bar Rules of Professional Conduct, especially Rule 3-110.

2. For each Panel referral, applicant shall personally conduct the initial half-hour consultation without charge. Unless LRS collects the referral fee from the client in advance of the consultation, the attorney will collect the referral fee, and forward the fee together with the referral form to the LRS office within 10 days. The attorney is liable for the fee if he/she fails to collect the fee. For services rendered beyond the initial half-hour consultation applicant shall establish in advance the fees to be paid.

3. Applicant shall pay the LRS forwarding fees on all attorney fees collected. The amount of the forwarding fees shall be 12.5% of the total attorneys fees received, or such other percentage as established by LRS. The applicable percentage shall be the percentage in effect at the time of the LRS referral to applicant. These fees are based on the total fees that arise out of the subject matter of the original referral. "Total attorneys fees" are fees received (exclusive of costs) by the applicant, partners, or associates, or by any attorney to whom the case has been transferred, with or without LRS consent. Applicant shall not pass the LRS forwarding fee on to any client, either directly or indirectly, through an increase in the fees that would ordinarily be charged for the matter, or in any other matter. On all contingent fee cases (where client's obligation to pay fees is dependent upon the outcome of the matter) and probate cases, payment of forwarding fees shall be accompanied by a statement of account.

(A) All forwarding fees are to be paid within 20 days of written request by the LRS. An additional interest charge at the maximum legal rate may be assessed on any fees not received by the LRS within 20 days after the attorney is paid. Upon request, applicant shall provide the LRS with copies of all fee agreements.

(B) In extraordinary cases, applicants may seek modification or waiver of forwarding fees. All such requests must be placed in writing and delivered to the LRS Coordinator within 20 days of receipt of attorney's fees. The LRS Committee shall consider all such requests and render a decision in writing, which shall be final.


4. FORWARDING FEE DISPUTE/BINDING ARBITRATION

(A) Upon administrative determination by the LRS Committee, in regular session, that a dispute exists between LRS and the panel member attorney, LRS will promptly notify the panel member in writing, setting out the amount of the forwarding fee due to LRS and the basis of the calculation of the forwarding fee. The panel member will have twenty days from the date the notice was mailed, in which to remit the full amount of the fee stated in the notice; or, if the panel member disputes all or part of the fee, to notify LRS of that fact, the amount of the fee which is disputed, and the facts in support of the disputed amount of the fee.

(B) LRS and the panel member agree to submit the matter of any such disputed forwarding fee to binding arbitration before a single arbitrator to be appointed by the Chair of the Client Relations Committee of the Marin County Bar Association, from its attorney membership panel. The procedure to be followed in any such arbitration shall be as set forth in the rules and procedures of the Client Relations Committee for the binding resolution of attorney-client fee disputes by a single arbitrator. Panel member shall pay any and all administrative fees and costs charged by the Client Relations Committee.

(C) If a member notifies LRS of the existence of a dispute as to all or any portion of a forwarding fee, as described in paragraph (A) above; the panel member shall remit, within twenty days of the notice of the forwarding fee due to LRS, the full amount of the forwarding fee, including the disputed portion, to be held by LRS pending the outcome of the binding arbitration. In the event the panel member fails to remit all or any portion of the forwarding fee, including the disputed portion, within the time stated herein, LRS shall suspend further client referrals to the panel member until such time as the forwarding fee dispute has been resolved, and any amount of the forwarding fee determined to be due to LRS has been paid in full. In the event the referral of clients to the panel member is suspended for any length of time pursuant to this provision, the panel member shall not be entitled to any refund of any portion of any application/membership or panel fees paid to LRS. During any such period of suspension of referrals, no application by the panel member for recertification shall be processed.

(D) Applicant agrees promptly to report to LRS the commencement of disciplinary proceedings against the Applicant by the State Bar of California.


I hereby sign under penalty of perjury, that the above is true and accurate.
(Type full name here)*
Date*