Completing this form alone does not create an attorney/client relationship – You must take other steps outlined in the email and fee agreement you received from our office.

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1. What is your name?
3. What is your mailing address?
6. Are you a U.S. Citizen?
8. Do you currently serve in the military?
9. Do you hold any professional licenses?
10. Have you ever been convicted of a crime?
11. Are you required to drive as part of your job?
12. Do you have a commercial driver license?
14. How long have you had your current driver license?
Click or drag a file to this area to upload.
Ideally your license copy will be in a .pdf format.
Click or drag a file to this area to upload.
Ideally your ticket copy will be in a .pdf format.
Click or drag a file to this area to upload.
We would like a copy of your driving history. If you have an Arizona license, you can obtain a copy of your 39 month driver license motor vehicle record at azmvdnow.gov. If your license is from a state besides Arizona, google "(your state) driving history". More often than not, there is a .gov website where you can obtain your driving record online. If you run into problems, give us a call.
Please use the space above to write in your own words what happened. This information is for our own internal use to help us understand what happened and to have a description to refer too during your case. You can include details such as: ( A) When did you first notice the police officer (B) What were the weather and road conditions like (C) Were there other cars around you/how dense was traffic (D) The substance of any conversation you had with the police officer (E) Whether there were any other passengers in the car with you (F) Whether or not you believe you committed the alleged violation, and if not, why not. Even if you believe you committed the alleged violation, knowing that helps us with identifying possible defense strategies. (G) Any other details you believe are important.