ClaimScout® Form | Magna Legal Services

Your Info

First Name*

Last Name*

Email*

Phone

Magna Account Representative*

Corporate/Claim Contact Information

If applicable.

Company Name

Company Address

Company Contact

Contact Title

Contact Email

Contact Phone

Billing Contact?

Yes

No

Bill delivery preference

Electronic Delivery

Standard Mail Delivery

Attorney Contact Information

If applicable.

Company Name

Company Address

Attorney Contact

Attorney Title

Attorney Email

Attorney Phone

Billing Contact?

Yes

No

Bill delivery preference

Electronic Delivery

Standard Mail Delivery

Research Information

If applicable.

Case Name*

Matter/Claim #

City, County, State

Judicial District

Incident Date

Brief Case Synopsis

Claimant Name(s)

Please fill out claimant’s first and last name and provide the following if you have it: Email, Phone, Age, Address. If there is more than one claimant, add their info on the next line.

Claimant's Information*

Plaintiff Attorney Information

If applicable.

Plaintiff Attorneys Names & Firm

Plaintiff Parties (witnesses, companies, experts, etc.)

Defense Attorney Information

If applicable.

Defense Attorneys Names & Firm

Defense Parties (witnesses, companies, experts, etc.)

Additional Names (people and companies)

Please select the following pricing and a delivery speed:*

Please upload any additional documents, filings, briefs, summaries etc

Drop files here or

Max. file size: 50 MB.

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