Apply Today – Funded Tomorrow Your Application For Lawsuit Settlement Loans Starts Here! Loans For Lawsuits Are Easy To Apply For! NameThis field is for validation purposes and should be left unchanged.YOUR INFORMATIONFirst Name:*Last Name:*Best Phone #:*Email Address:* State:*StateAlabamaAlaskaArizonaCaliforniaConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMichiganMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificYOUR CASE INFORMATIONType of Case:*Amount Requested:*Amount Requested$1000$2,000$3,000$4,000$5,000$6,000$7,000$8,000$9,000$10,000$15,000$20,000$25,000$30,000$35,000$40,000$45,000$50,000$55,000$60,000$65,000$70,000$75,000$80,000$85,000$90,000$95,000$100,000$150,000$200,000$250,000$300,000$400,000$500,000$750,000$1,000,000Very brief description of accident/incident:*Law Firm And Case Manager InformationLawyer/Law Firm:*State of Law Firm:*State of Law FirmAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCase Manager Name:Case Manager Email: - To expedite your approval please provide your case manager and email address. -The case manager is the person responsible for handling all your documents. This could be your paralegal or your lawyer. -By entering your information and your law firms information, you authorize Legal-Bay, LLC to send a document request to your law firm to expedite your funding request.This field is hidden when viewing the formsequenceThis field is hidden when viewing the formDate of Accident/IncidentThis field is hidden when viewing the formEmail Address of Lawyer: This field is hidden when viewing the formLaw Firm Phone:This field is hidden when viewing the formPrior Lawsuit Funding?Prior Lawsuit Funding?YesNoThis field is hidden when viewing the formCity:By entering my mobile number, I agree to receive reminders and marketing texts from Legal Bay, LLC at (973) 834-5840. Message + data rates may apply. Reply STOP to unsubscribe. Please view our terms and conditions and privacy policy.
