Crim Info

Client Questionnaire for Criminal & Traffic Cases
(for Drunk Driving click HERE)

Client Personal Information

Today's Date (e.g., July 4, 1776):
Name: First, Middle, Last
Name used when arrested (if different):
Actual Date of Birth (eg: Jan 1, 1901)
Driver's License Number (use dashes):
Social Security Number (use dashes):	(optional)
Email address that we can use to contact you:
Mailing address:
Physical Address (where you live):
Do you own or rent?
Telephone Numbers:
Where are you employed:
Employer's address:
How long with current employer?	(eg: 6 months, 4 years, etc.)
Name of person filling out this form if other than person in need of legal counsel.

Charge Information

Current Status:
Type of Offense:
County in which arrested:	We only cover these counties for criminal offenses.
Your case number if known:	(eg: 04-MM-003456; 030994MMA; etc.)
What were you charged with?
Briefly describe what happened:
Next scheduled court date?	(eg: Dec. 7, 1941)
List all prior arrests and their outcomes: (If vop or early termination, list conditions of current probation also)
Who is your bondsman?
List your bondsman's address
List your bondsman's phone number
List your bond invoice number

When finished, click Submit ONCE. Print the confirmation page. Click the BACK button after printed.

Once you have submitted your information please call us to discuss your case (407) 841-5555.