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
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.Format: (000) 000-0000.
Email
example@example.com
Preferred Communication Method
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
Estimated Surplus Funds Amount
Do you have a signed assignment/contingency agreement with the homeowner/claimant?
Date of Agreement
Homeowner(s) covered
Type of agreement
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
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?
If yes, who and when?
Name(s) exactly as on the deed
Acquisition method
Was the claimant the owner of record on the date of sale?
If no, explain
Name of decedent
Date of death

MonthDayYear
Date
Has an estate been opened?
County/State of probate
Status/Personal Representative/Administrator appointed?
Do Letters Testamentary/Administration exist?
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?*
Have any creditors asserted a claim to the excess funds?
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?
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?
Divorce or domestic relations orders affecting the property/funds?
If yes, upload divorce decree/QDRO/property settlement

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Any pending lawsuits/judgments involving the claimant or the property?
If yes, explain & upload orders
File Upload

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Probate / Estate Issues
Is the original homeowner deceased?
Name of decedent
Date of death
Has an estate been opened?
County/State of probate
Personal Representative/Administrator appointed?
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?
HOA/COA liens or dues owed
Has another attorney or recovery company worked on this case before you?
Upload/Provide: Any prior claim filings, attorney letters, or company agreements.
Tax liens (county/state/federal/IRS)
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Notices & Documentation
Do you or the claimant have any of the following (check all that apply):
Date interpleader served

MonthDayYear
Date
Case number
Has an answer been filed?
Upload copies of all notices.

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Fees
Have you explained your fee agreement to the homeowner?
Fee percentage or structure
Do you understand that attorney’s fees, court costs, and lien payouts may reduce net funds?
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)?
Do you agree to share necessary information with E. Albert Law, LLC for claim compliance?
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
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