PLEASE READ CAREFULLY:

I am submitting this questionnaire and attachments for review by Daley, DeBofsky & Bryant. I understand the following:

1. That the submission of information is for review only and that there will be no charge for this review.

2. Daley, DeBofsky & Bryant and I have not entered into an attorney-client relationship and are not acting as my attorney unless and until a formal, written Retainer Agreement has been signed both by me and by a representative of Daley, DeBofsky & Bryant. No decision has yet been made on whether Daley, DeBofsky & Bryant will take my case and there is no guarantee that the firm will accept my case.

3. Further information may be requested in order for Daley, DeBofsky & Bryant to reach a decision.

4. It takes time to review the material submitted and to make any reply or decision. Because no attorney-client relationship has yet been established, I will be responsible until I am notified otherwise to meet all necessary deadlines and time frames applicable to my claim; and I acknowledge that I have not received any representations or legal opinions with respect to any time frames or deadlines that may be applicable to my claim.

I have read and agree to all of the above conditions.