ATTORNEY FEE CALCULATION WORKSHEET (CONTINGENCY FEE)

CASE INFORMATION

Case Caption: [________________________________]

Client Name: [________________________________]

Case Number: [________________________________]

Date of Incident: [__/__/____]

Date Fee Agreement Signed: [__/__/____]

Settlement/Judgment Date: [__/__/____]

Attorney Name: [________________________________]

Firm Name: [________________________________]

Prepared By: [________________________________]

Date Prepared: [__/__/____]

PART I: FEE AGREEMENT TERMS

A. Fee Agreement Basics

Type of Fee Arrangement:
☐ Standard Contingency (Fixed Percentage)
☐ Sliding Scale Contingency
☐ Graduated Contingency (Stage-Based)
☐ Hybrid (Reduced Hourly + Contingency)
☐ Statutory Fee (Workers' Comp, SSDI, etc.)
☐ Court-Approved Fee (Minor, Incapacitated)

Fee Agreement Date: [__/__/____]

Fee Agreement Attached: ☐ Yes ☐ No

B. Standard Contingency Terms

Fixed Percentage Fee: [____]%

OR

Graduated/Stage-Based Fee:

Current Stage Reached: [________________________________]

Applicable Percentage: [____]%

C. Sliding Scale Terms (if applicable)

D. Fee Calculation Basis

Fee Calculated On:
☐ Gross Recovery (before any deductions)
☐ Net Recovery (after costs only)
☐ Net Recovery (after costs and liens)
☐ Net Recovery (after costs, liens, and medical bills)
☐ Other: [________________________________]

Per Fee Agreement Language:
"[________________________________]"

PART II: RECOVERY DETAILS

A. Settlement/Judgment Amount

B. Structured Settlement (if applicable)

Lump Sum Component: $[____]

Present Value of Periodic Payments: $[____]

Cost of Annuity: $[____]

Fee Calculated On:
☐ Total Present Value
☐ Cost of Annuity
☐ Lump Sum Only
☐ Per Agreement: [________________________________]

PART III: FEE CALCULATION

Method A: Fee on Gross Recovery

Gross Recovery: $[________________________________]

Applicable Fee Percentage: [____]%

Calculation: $[____] x [____]% = $[________________________________]

Method B: Fee on Net Recovery (After Costs)

Gross Recovery: $[____]

Less: Litigation Costs: ($[____])

Net Recovery (After Costs): $[________________________________]

Applicable Fee Percentage: [____]%

Calculation: $[____] x [____]% = $[________________________________]

Method C: Fee on Net Recovery (After Costs and Liens)

Gross Recovery: $[____]

Less: Litigation Costs: ($[____])

Less: Liens/Subrogation: ($[____])

Net Recovery (After Costs and Liens): $[________________________________]

Applicable Fee Percentage: [____]%

Calculation: $[____] x [____]% = $[________________________________]

Method D: Sliding Scale Calculation

Method E: Hybrid Fee Calculation

Reduced Hourly Component:

Contingency Component:

Recovery: $[____] x [____]% = $[____]

Combined Fee: $[____] + $[____] = $[________________________________]

PART IV: STATUTORY FEE CAPS AND SPECIAL RULES

A. Statutory Caps by Case Type

Case Type: [________________________________]

Statutory Cap Applies: ☐ Yes ☐ No

B. Fee Cap Calculation

Uncapped Fee (per agreement): $[____]

Statutory Cap Amount: $[____]

Fee Limited By Cap: ☐ Yes ☐ No

ADJUSTED FEE (if cap applies): $[________________________________]

C. Court Approval Required

Court Approval Required: ☐ Yes ☐ No

Reason:
☐ Minor plaintiff
☐ Incapacitated plaintiff
☐ Class action
☐ Wrongful death distribution
☐ Other: [________________________________]

Court Approval Date: [__/__/____]

Court-Approved Fee: $[________________________________]

PART V: REFERRAL FEE ALLOCATION

A. Referral Agreement

Referral Fee Arrangement: ☐ Yes ☐ No

Referring Attorney: [________________________________]

Firm: [________________________________]

Referral Agreement Date: [__/__/____]

Client Consent Obtained: ☐ Yes (Required in most jurisdictions)

B. Referral Fee Terms

Referral Fee Type:
☐ Percentage of Fee (not additional charge to client)
☐ Flat Amount
☐ Division of Responsibility (joint representation)

Referral Fee Percentage: [____]% of attorney fee

OR Flat Amount: $[____]

C. Referral Fee Calculation

Total Attorney Fee: $[____]

Referral Fee Percentage: [____]%

Referral Fee: $[________________________________]

Handling Attorney Fee (after referral): $[________________________________]

PART VI: COST RECOVERY

A. Litigation Costs Advanced

B. Cost Recovery Terms

Per Fee Agreement, Costs Are:
☐ Client's responsibility regardless of outcome
☐ Reimbursed only if recovery
☐ Deducted before fee calculation
☐ Deducted after fee calculation

Costs to Be Reimbursed: $[________________________________]

PART VII: FEE REASONABLENESS ANALYSIS

A. Model Rule 1.5 Factors

Evaluate fee reasonableness per Model Rule 1.5(a):

B. Lodestar Cross-Check (if applicable)

Contingency Fee: $[____]

Multiplier (Fee ÷ Lodestar): [____]x

Multiplier Reasonable: ☐ Yes ☐ No (typical range 1-3x)

PART VIII: FEE SUMMARY

A. Fee Calculation Summary

B. Fee Distribution

PART IX: COMPLETE DISTRIBUTION SUMMARY

A. Settlement Distribution

B. Client Recovery as Percentage

Gross Recovery: $[____]

Net to Client: $[____]

Client Percentage of Gross: [____]%

PART X: FEE AGREEMENT COMPLIANCE CHECKLIST

☐ Written fee agreement on file
☐ Fee agreement signed by client
☐ Fee percentage clearly stated
☐ Calculation method clearly explained
☐ Cost responsibility clearly explained
☐ Client received copy of agreement
☐ Referral fee disclosed to client (if applicable)
☐ Statutory caps verified
☐ Court approval obtained (if required)
☐ Fee is reasonable under Rule 1.5

CLIENT ACKNOWLEDGMENT

I, [________________________________], acknowledge that I have reviewed the fee calculation for my case. I understand:

☐ The fee percentage in my agreement
☐ How the fee was calculated
☐ The costs being deducted
☐ The liens being paid
☐ My net recovery amount

I confirm that this fee calculation is consistent with my understanding of our fee agreement.

Client Signature: _________________________________ Date: [__/__/____]

Client Printed Name: [________________________________]

ATTORNEY CERTIFICATION

I certify that this fee calculation is accurate and complies with:
☐ The written fee agreement
☐ Applicable Rules of Professional Conduct
☐ Applicable statutory fee caps
☐ Court approval (if required)

Attorney Signature: _________________________________ Date: [__/__/____]

Attorney Name: [________________________________]

Bar Number: [________________________________]

STATE-SPECIFIC FEE RULES REFERENCE

Common State Fee Caps

Verify current state rules - caps may change

SOURCES AND REFERENCES

• Model Rules of Professional Conduct Rule 1.5
• State Rules of Professional Conduct
• State-specific fee cap statutes
• Court rules regarding fee approval
• Fee agreement (case-specific)

This worksheet is for attorney fee calculation purposes. All fees must comply with the written fee agreement, applicable professional responsibility rules, and statutory requirements. When in doubt, consult with ethics counsel.