I understand that it may be necessary to act promptly to protect my rights and that commencement of a civil action may be required to preserve my rights. I acknowledge my understanding that the completion of this form does not constitute commencement of a civil action and that The Mississippi Bar will not commence any such action. I acknowledge it is my responsibility to seek and obtain any necessary legal advice with respect to this matter.
NOTICE: I UNDERSTAND THAT INFORMATION I SEND MAY BE USED TO ASSIST ME BUT MAY NOT BE CONFIDENTIAL
1: If you are submitting this Request for Assistance on behalf of or for another person, please give that person's name, address and daytime telephone number and explain why you are acting for that person.
2: If not, please tell us why not. If yes, please provide the facts in 6 & 7 above