Excess Funds Claim – Third‑Party Company Intake Questionnaire

Excess Funds Claim – Third‑Party Company Intake Questionnaire

For third‑party asset recovery companies seeking to submit an excess/surplus funds claim through E. Albert Law, LLC
Instructions: Complete all sections fully. Attach supporting documents where required. This questionnaire is for case evaluation only and does not establish attorney‑client representation until an engagement agreement is signed.
Company & Contact Information

If your company already has open claims with our office, you do not need to complete this section again unless there are updates to your information.
Company Name*
Entity Type*

LLCCorporationPartnershipSole ProprietorOther
EIN (last 4)*
State of Incorporation/Registration*
Principal Office Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Website (if any)
Primary Contact Person*

First NameLast Name
Title/Role*
Phone (call/text)*
Please enter a valid phone number.
Email*
example@example.com
Preferred Communication Method

CallTextEmail
Upload/Provide: Business registration (Articles of Organization/Incorporation), Operating Agreement, or equivalent authority documents.

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Property & Sale Information
Property Address (foreclosed/tax sold)*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
County & Parcel/Tax ID (if known)
Date of Sale (if known)
Type of Sale*
If Other, please specify
Upload/Provide: Notice of sale, foreclosure deed, etc.

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Authority & Assignment
Do you have a signed assignment/contingency agreement with the homeowner/claimant?*

YesNo
Date of Agreement
Homeowner(s) covered
Type of agreement*

Assignment of RightsContingency Recovery AgreementOther
Upload/Provide: Signed assignment/contingency agreements, POA if applicable.

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Homeowner/Claimant Information
Homeowner/Claimant Full Name*

First NameLast Name
Other Names/Aliases (if known)
Property Address (foreclosed/tax sold)*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
County & Parcel/Tax ID (if known)
Date of Sale (if known)
Type of Sale*

Mortgage foreclosureHOA/COA lien saleTax saleOther
Upload/Provide: Deed showing ownership, foreclosure/tax sale notices, trustee/court letters, probate documents (if applicable).

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Ownership & Authority
How did claimant hold title at the time of sale?

Sole ownerJoint ownersLLC/CorpEstate/Heirs’ propertyTrust
If yes, who and when?
Name(s) exactly as on the deed
Acquisition method

PurchaseInheritanceGiftDivorce decreeOther
Was the claimant the owner of record on the date of sale?

YesNo
If no, explain
Name of decedent
Date of death

MonthDayYear
Date
Has an estate been opened?

YesNoUnsure
County/State of probate
Status/Personal Representative/Administrator appointed?

YesNo
Do Letters Testamentary/Administration exist?

YesNo
Upload Letters Testamentary/Administration

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Entity/trust name
EIN (last 4)
Authorized signer & title
Upload operating agreement/trust docs/POA

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Upload/Provide: Most recent deed, probate Letters (if any), POA/trust/LLC authority documents

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Liens, Mortgages, and Claims Against Funds
At the time of sale, did any of the following exist?**

Mortgages/Deeds to Secure DebtHELOC/Second mortgageHOA/COA liens or dues owedTax liens (county/state/federal/IRS)Judgments/fi fa’s/child support liensUCC filings or mechanic’s liens
Have any creditors asserted a claim to the excess funds?

YesNo
If yes, who and when?
Upload/Provide: Payoff letters, lien releases, judgment orders, HOA ledgers, tax payoff/estoppel, IRS notices, bankruptcy orders (if applicable)

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Bankruptcy / Divorce / Litigation
Has claimant ever filed bankruptcy?

NeverChapter 7Chapter 13Other
Case #/District/Judge (if known)
Filing date

MonthDayYear
Date
Discharge/dismissal date

MonthDayYear
Date
Is/was the property or proceeds part of the bankruptcy estate?

YesNoUnsure
Divorce or domestic relations orders affecting the property/funds?

YesNo
If yes, upload divorce decree/QDRO/property settlement

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Any pending lawsuits/judgments involving the claimant or the property?

YesNo
If yes, explain & upload orders
File Upload

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Probate / Estate Issues
Is the original homeowner deceased?*

YesNoUnsure
Name of decedent
Date of death
Has an estate been opened?*

YesNoUnsure
County/State of probate
Personal Representative/Administrator appointed?*

YesNo
If yes, provide the appointed administrator's name
Upload/Provide: Death certificate, Letters Testamentary/Administration, will (if available).

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Prior Recovery Efforts
Has the homeowner/claimant previously filed any claim for these funds?*

YesNoUnsure
HOA/COA liens or dues owed*

YesNo
Has another attorney or recovery company worked on this case before you?*

YesNoUnsure
Upload/Provide: Any prior claim filings, attorney letters, or company agreements.
Tax liens (county/state/federal/IRS)*

YesNo
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Notices & Documentation
Do you or the claimant have any of the following (check all that apply):

Notice of foreclosure/tax saleTrustee/court/tax commissioner letter about excess fundsInterpleader or court order filingBankruptcy filings impacting propertyDivorce decree affecting ownership
Date interpleader served

MonthDayYear
Date
Case number
Has an answer been filed?

YesNo
Upload copies of all notices.

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Fees
Have you explained your fee agreement to the homeowner?*

YesNo
Fee percentage or structure*
Do you understand that attorney’s fees, court costs, and lien payouts may reduce net funds?*

YesNo
Do you understand that, unless otherwise agreed, E. Albert Law, LLC’s fees will usually be deducted from your company’s portion of recovery (the TPA’s portion)?*

YesNo
Do you agree to share necessary information with E. Albert Law, LLC for claim compliance?*

YesNo
Upload/Provide: Payoff letters, lien releases, judgment orders, HOA ledgers, tax payoff/estoppel, IRS notices, bankruptcy orders (if applicable)

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Compliance & Verification
Please confirm each statement*

I affirm that my company has a valid written agreement with the homeowner/claimant.I have provided true and complete information to the best of my knowledge.I understand that submission of this questionnaire does not guarantee case acceptance.I authorize E. Albert Law, LLC to contact the claimant directly for verification and compliance purposes.I acknowledge that only an engagement agreement executed with E. Albert Law, LLC creates an attorney‑client relationship for the claimant.
Authorized Company Rep Initials*
Date*
Should be Empty:

Excess Funds Claim – Third‑Party Company Intake Questionnaire

Company & Contact Information

Property & Sale Information

Authority & Assignment

Homeowner/Claimant Information

Ownership & Authority

Liens, Mortgages, and Claims Against Funds

Bankruptcy / Divorce / Litigation

Probate / Estate Issues

Prior Recovery Efforts

Notices & Documentation

Fees

Compliance & Verification