ÿþ<title>Uninsured, Underinsured and No-Fault Insurance - Forms Included</title>

<p style="margin-top: 6px; margin-bottom: 6px">

<font face="Arial" color="#CC6633" size="4">Forms Included</font><b><font face="Arial" color="#CC6633" size="3"> </font></b></p>

<table border="0" width="100%" cellspacing="0" cellpadding="0" id="table1">

	<tr>

		<td align="left" valign="top">

		<ul>

			<li>

			<p style="margin-top: 12px; margin-bottom: 6px">

			<font face="Arial" size="2"><b>2010 No-Fault Arbitrator 

			Recertification Form </b>(Section 4)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Affidavit of No Insurance </b>

			(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Authorization for Release of 

			Information </b>(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Consent to Release </b>(Section 3)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Contingent Fee Agreement </b>(Section 

			7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Income or Wage Loss Benefits for 

			Medical Treatment </b>(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Initial Interview Checklist </b>

			(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Medical Disability Statement </b>

			(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Petition for No-Fault Arbitration </b>

			(Section 4)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Power of Attorney </b>(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Preliminary Investigation Report </b>

			(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Proof of Representation </b>(Section 

			3)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Replacement Services and Disability 

			Statement </b>(Section 7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Replacement Services Log </b>(Section 

			7)</font></p>

			</li>

			<li>

			<p style="margin-top: 0; margin-bottom: 6px">

			<font face="Arial" size="2"><b>Wage Loss Verification </b>(Section 

			7)</font></p>

			</li>

		</ul>

		</td>

	</tr>

	<tr>

		<td align="left" valign="top">&nbsp;</td>

	</tr>

</table>