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PROPOSAL FORM

The proposal form should be completed by the proposer and the proposer’s solicitor and both should sign the respective declarations where indicated.

1. THE PROPOSER (CLAIMANT/APPELLANT)

Please provide details of the party or parties seeking funding. If the proposer is a liquidator, please also confirm that he/she has the authority of the creditors to bring this action.

2. THE PROPOSER’S APPOINTED REPRESENTATIVE

a) The Solicitor who will be acting for the proposer in the legal action:

b) Counsel instructed on the proposer’s behalf:

3. THE OPPONENT

Please identify the name(s) and address(es) of the opponent(s):

4. THE LEGAL ACTION (CLAIM/CASE/PROCEEDINGS)

g) What is the approximate quantum?

h) What figure might the proposer agree to settle for?

p) Please indicate in percentage terms what you consider the prospects of success are:

5. ESTIMATED COSTS AND AFTER-THE-EVENT COST INSURANCE COVER REQUIRED

Please answer all questions (whether you are on a full or partial CFA or not, and whether you require cover or not), but please note it may not prove possible to get insurance cover for Costs already incurred.

a) Opponent's costs (estimated)

b) Proposer's disbursements (excl. counsel)

c) Proposer’s counsels’ fees

d) Proposer's solicitor’s legal costs

6. ENCLOSURES

Please enclose as much relevant supporting information as possible.

7. DECLARATION BY PROPOSER AND APPOINTED REPRESENTATIVE

I confirm that the contents of this proposal form and the enclosures sent with it are complete and accurate to the best of my information and belief. I understand that Managed Legal Solutions Limited will be relying on it making it’s decision as to whether and upon what terms to fund this claim.

Additional information

When completed, please forward this proposal form together with the stated enclosures (if not already sent) to MLS (see front page for email/postal address).

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