ALN Capital Services

Get Started

Complete and submit an application and disclosure to apply for lawsuit funding. Our team responds to most applications within 48 hours. If you have any questions regarding our process, please feel free to contact us at (866)734-1035.

*Please complete the entire form. Applications with missing information will not be processed.

Personal Information

*Full Name:

Date of Birth (MM/DD/YYYY):

Address:

Address 2:

City:

State:

Zip Code:

*E-Mail Address:

Home Phone:

Work Phone:

Cell Phone:

Attorney Information

Attorney's Full Name:

Name of Law Firm:

Phone Number:

Fax Number:

Address:

City:

State:

Zip Code:

Law Firm Contact (paralegal/legal assistant):

Funding Information

Amount of Funding Requested:

By submitting this form, I agree that all the information listed is accurate and correct. In order to obtain information about your case, we need your authorization to release your case records and information to us. We cannot proceed without it.

Enter your ATTORNEY'S NAME here:

I request and authorize my attorney to provide ALN Capital Services, LLC with whatever information (whether oral or in writing) needed to evaluate my funding request. I specifically waive any privilege that I may have regarding such information.

I hereby request and authorize your firm to cooperate with and release to ALN Capital Services, LLC any and all information and documents pertaining to my case. Please share your candid opinion regarding this action with ALN Capital Services, LLC, so that ALN Capital Services, LLC can evaluate my funding request.

I acknowledge that I understand the benefits and risks of non-recourse funding. I further acknowledge that I understand the effects of disclosing the contents of my file, including waiver of the attorney-client and work product privileges.

Thank you in advance for your cooperation.

Name:

Date:

By clicking here, you indicate that you have read and agree to the Records Release Authorization. You must check this box for your application to be processed. This authorization gives us permission to contact your attorney and discuss your case with your attorney.

By submitting this form, I agree that all the information listed is accurate to the best of my knowledge.