Submission of Information We encourage you to provide us with as much relevant information as possible to help us evaluate your potential claim. We have been very successful in obtaining outstanding results for our clients. Part of that success depends upon receiving complete information in a timely manner. We will contact you within one week of your submission of your inquiry. This initial evaluation is free. You will not be billed. THE SUBMISSION OF INFORMATION BY YOU AND OUR INITIAL INVESTIGATION OF YOUR CLAIM DOES NOT CREATE AN ATTORNEY-CLIENT RELATIONSHIP. WE WILL ONLY BECOME YOUR LEGAL REPRESENTATIVE IF WE AGREE TO WORK TOGETHER AND WE SIGN A WRITTEN AGREEMENT. To assist you in providing useful information, please copy and paste the following questions into your e-mail to us at info@friedmanrubin.com (Answer those that are applicable): Full name: Full address: Daytime phone: Evening phone: Description of your claim (Tell us what happened and why you think you have a legal claim): Names of parties and attorneys involved: Your employment and/or disability status: The date and extent of your injury: Amount of your lost wages or insurance benefits withheld: Amount of your out of pocket expenses: Additional comments that you feel are relevant to your situation: Please describe your situation in your own words. After we review your information, we may need more information. If so, we will contact you for further details. We will review your submission and respond in a timely manner. Please feel free to contact us at any time by phone at 360-782-4300.

Friedman | Rubin® Offices:   Seattle, Washington 600 University St., Suite 2701, 98101 T:  206-501-4446 F:  360-782-4358     Bremerton, Washington 1126 Highland Avenue, 98337 T:  360-782-4300 F:  360-782-4358     Anchorage, Alaska 1227 W. 9th Avenue, 99501 T:  907-258-0704 F:  907-278-6449   Material Copyright © 2002-2010 Friedman | Rubin - Legal Notice