Insurance Network of America • Professional Services Group

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Do you have other office locations: yes no Please make a selection. If yes, list other locations in the space provided below

Other locations:

Areas of Practice: Please provide percentages of time devoted during the previous year in each area of practice (MUST TOTAL 100%)
%		%		%
	Admiralty & Marine		Employment Law – Union Rep.		Plaintiff Lit. – Medical Malpractice
	Agent Practice /Entertainment Law		Environmental Regulatory		Plaintiff Lit. – Personal or Bodily Injury
	Business Formation		Estate & Probate – General		Plaintiff Lit. – Social Security, Workers Comp.
	Business Transactions – General		Estate Planning & Trust Admin.		Public Utilities (not finance)
	Civil Lit. – General		Family Law / Juvenile Rights		Real Estate – Finance
	Com. & Corp. General Lit. – Defense		Immigration		Real Estate Residential & Basic Commercial
	Com. & Corp. General Lit. – Plaintiff		Intellectual Property		Schools & Education (not finance)
	Corporate Finance;		Investment Advice		Securities/Private Placements/Public Regist.
	Creditor/Debtor Rights and Collections		Mediation, Arbitration		# of investors
	Criminal Defense		Mergers & Acquisitions		Tax Preparation – Individual
	Defense Lit. - Insurance Carrier Rep.		Municipal – General (not finance)		Taxation (ex. estate tax & ind. tax prep.)
	Elder Law		Municipal – Finance or Bonds		Other (if more than 5%, explain):
	Employee Benefit Plans, ERISA		Oil & Gas, Mineral Rights
	Employment Law – Employee Rep.		Plaintiff Lit. – Class Actions
	Employment Law – Management Rep.		Plaintiff Lit. – Legal Malpractice

Currently insured? yes no Please make a selection. If Yes, who is the Carrier?

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