Name *

First Name

Last Name

Phone *

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DISCLOSURE / DISCLAIMER OF REPRESENTATION *

I HEREBY REPRESENT, ACKNOWLEDGE, AND AGREE THAT (I) THE ABOVE FORM DOES NOT INCLUDE ANY CONFIDENTIAL INFORMATION, (II) NO ATTORNEY-CLIENT RELATIONSHIP IS CREATED WITH TWM LEGAL BY SUBMITTING THIS FORM, (III) NOTHING STATED HEREIN THIS FORM IS CONFIDENTIAL IN NATURE, AND (IV) NOTHING STATED HEREIN THIS FORM WILL NOT BE KEPT CONFIDENTIAL BY THE FIRM.

Accept