KANSAS LAWYERS' FUND FOR CLIENT PROTECTION Kansas ...
KANSAS LAWYERS' FUND FOR CLIENT PROTECTION Kansas ...
KANSAS LAWYERS' FUND FOR CLIENT PROTECTION Kansas ...
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21. How did you learn about the Lawyers’ Fund for Client Protection?<br />
_____<br />
_____<br />
_____<br />
_____<br />
_____<br />
_____<br />
Disciplinary Administrator<br />
County or District Attorney<br />
Private Attorney<br />
Local Bar Association<br />
Brochure<br />
Other -- Specify _________________________<br />
22. Are you presently being represented by a lawyer concerning this claim?<br />
NOTE: You do not have to have a lawyer to file this claim. If a lawyer does assist<br />
you in filing the claim, please note that Rule 19 of the rules relating to this<br />
Commission states that it is intended law yers w ill "provide assistance as a public<br />
service."<br />
Yes _____ No _____ If "yes," please provide the following information regarding<br />
the lawyer:<br />
NAME:<br />
ADDRESS:<br />
__________________________________________ (____)__________<br />
Telephone<br />
___________________________________________________________<br />
Street City State Zip<br />
23. Have you ap plied or do you intend to ap ply to a Client Protection Fund from<br />
another state or any other state agency for reimbursement of this loss?<br />
Yes _____ No _____<br />
If "yes," please provide the name and address of the fund and a copy of your<br />
application.<br />
Name of Fund<br />
State<br />
Address of Fund<br />
____________________________________________________<br />
____________________________________________________<br />
____________________________________________________<br />
ATTACH ANY DOCUMENTS WHICH YOU BELIEVE<br />
SUPPORT YOUR CLAIM.<br />
9 Rev. 11/ 03
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