Intake Forms

Litigation

*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Are you known by any other names?
Yes No

If yes, list other names you have used:

What is your marital status?

Does this matter involve a business you own or run?
Yes No

If yes, provide the business name, address, and phone:

Are you employed?
Yes No

If yes, please provide your job title and employer's name and address.

Can you be contacted at work?
Yes No

Are you being sued?
Yes No

If yes, please provide the following:

Name of the party suing you

Name, address, and telephone number of the attorney for the party suing you, if any

Name and location of the court you are being sued in

Date you were served with court papers

What area of law does your situation involve (if known)?

Are any other people involved?
Yes No

If yes, provide names, addresses (if known), and their relationship to you, if any:

Where did you hear about this website?

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