Your
strategic partner
for legal funding
888-822-7844
PARTNERS
Request for
Plaintiff
Funding
Please complete the form below by providing your client's information for their funding application.
Partner Client Application
First Name
*
Last Name
*
State of Residence
*
-
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone Number
Date of Incident
*
Email
*
Approved Funding Amount
*
$
Accident Type
*
Motor Vehicle Accident
Premises Liability
General Negligence
Labor Law
Medical Malpractice
Civil Rights
Settled Case
Sexual Assault
Wrongful Death
Wrongful Termination
Victims Compensation Fund
Other
Cartiga does not provide funding in this state
If you are human, leave this field blank.
Next
back to Cartiga