__________________ of _____________________________ (Hereinafter CLIENT), retains A + Legal Services - Greenberg & Lieberman Law Offices of Takoma Park, M.D. for representation as pertaining 

____________________________________ This agreement refers to all related matters.

I UNDERSTAND and AGREE that my attorneys will be compensated for the time and effort required to properly perform such legal services. It is understood that any attorney’s fees shall be billed at $250.00 per hour. I further understand that any failure to pay fees and expenses as required shall give the attorney the right to withdraw from representation.

Company or Contact Name ________________________________________

Address:______________________________________________________

Phone: _______________________________________________________

Fax__________________________________________________________

Other/email:___________________________________________________

Date of Birth or Inc. date:_________________________________________

SS or EIN # ___________________________________________________

Citizenship is U.S. [ ] Other________________________________________

TOTAL PAYMENT Today $_______________________________________

Make checks payable to: A + Legal Services - Law Offices of Greenberg & Lieberman

Credit cards accepted: Visa, MasterCard, Discover, or American Express.

Please note, if using American Express or Discover, an additional 3.5% is added to your total fee.

Credit Card Type:                                                           

Expiration Date: __________________________

Name on Card:___________________________

Card Number:____________________________

SMALL PRINT - please read: All work is done on an hourly basis unless your retainer or order form specifically states otherwise; (hourly is $250 p/h unless modified in writing by Firm partner); No contracts are binding unless made by a Firm partner; Government fees not included in estimates, except for Invention Disclosure; Patent and trademark searches are not guaranteed; The Firm maintains no obligation to perform additional work once work has been completed; Additional charges may include, but are not limited to: copying, mailing, faxing, telephoning; Firm shall impose a $40 returned check charge; All clients accept Montgomery County, Maryland as the sole place for jurisdiction, venue and as the choice of law, and accept complete liability, submit to judgment thereof, and indemnify the firm for all costs, including but not limited to, all charges as expressed above, any attorney’s fees, costs, associated expenses, including work done on a clients behalf or time spent prosecuting or defending any law suit in association with, for or against the client; Liability is limited to the actual amount paid by client within three (3) months of the time client first complains to the firm in writing or the amount paid on the particular project complained of, which ever is less; All Clients specifically accept that all disputes which the parties can not settle between themselves shall be decided through binding arbitration using the American Arbitration Association Commercial rules; Clients agree to pay for any work ordered, and that all orders are irrevocable, and that failure to pay within 60 days of when promised shall be breach and accept judgment on the basis of that breach; 9.5% plus APR shall be charged on all fees over 60 days late; Should any provision of this order form not survive legal judgment, all other provisions remain in full force. No work will be done unless this document has been filled out and signed by all clients.

SIGNED on this day of _____, this month of ________________________, 200__.

CLIENT/name & signature - please Date