LSR – 2 

 
 

Notice of Limited Scope Representation 
(Not for Family Law Cases) 

Rev. 3/12 

Case Number:  
 

In the (check one):  (cid:134) Circuit  (cid:134) District Court of  

Plaintiff’s Name 

Defendant’s Name  

 

  v. 

 

 County, Alabama 

 

1  Lawyer’s Information  
 

 
name 

 

   
address  

(           ) 
phone #    

 

city 

e-mail 

state 

zip code 

(           ) 
fax # 

2  I am the lawyer listed in 1. I agree to provide limited scope representation to the (check one):   

My representation will include only the following services (check all that apply): 
a.  (cid:134)  at the hearing (date):  
  (cid:134)  and at any continuance of that hearing 
  (cid:134)  until the court’s order after that hearing 

 
 
 

 
 

b.  (cid:134)  at the trial (date):  

(cid:134)  and at any continuance of that trial 
(cid:134)  until the judgment 

(cid:134) Plaintiff  
(cid:134) Defendant 

c.  (cid:134)  Other (explain and give dates):  

 

 

 
party’s name 

 

   
address  

(           ) 
phone #    

3  The contact information for service for the party I will represent is: 
 

city 

 

(           ) 
  fax # 

state 

zip code 

4  The party must read and sign below: 

I agree to the limited scope representation checked above. I understand that I may be asked to agree to 
other terms not mentioned on this form in order for this lawyer to represent me. I also understand that 
when the services checked above have been completed, I must get a new lawyer or represent myself. 

Party signs here:  

Lawyer signs here:  

5  After signing above, the lawyer must: 
1.  Fill out the box to the right, then   

2.  Mail or deliver a copy of this form to the 

other party or his/her lawyer. 

3.  File the original of this Notice with the court 

clerk. 

 

 

Rev. 3/12 

 Date:  

 Date:  

Certificate of Service — I certify that a true copy of this 
Notice was delivered or mailed to the other parties or their 
lawyer(s) on (date):  

. 

Sign here:  

 

© 2012 Alabama State Bar