CRIMINAL CONSULTATION APPLICATION – PARALEGAL SERVICES

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CRIMINAL CONSULTATION APPLICATION

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Parish, State *

Are there criminal charges pending against you or a loved one?? *

Myself
A loved one(s)
Both
No criminal charges

Was an arrest made? *

Yes
No

Date of arrest or summons? *

List the full name(s) and D.O.B of person(s) seeking representation. *

List all pending charges of person(s) seeking representation. *

Are you currently represented by an attorney? *

No
Yes
I was, but not anymore

Briefly describe incident. *

Name *

First

Last

Date of Birth *

Social Security Number *

Phone Number *

Email *

Primary home address *

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