Intake

1. What is your name? *

First

Last

2. What is the best phone number for us to reach you?

3. What is your mailing address?

Address Line 1

Address Line 2

City

State

Zip Code

4. Are you a U.S. Citizen?

Yes
No

4.A. What is your immigration status?

4.B. Do you intend to apply for U.S. citizenship?

Yes
No
Maybe

4.C.. Are you currently working with an immigration attorney?

Yes
No

5. Do you currently serve in the military?

Yes
No

5.A. Have you previously served in the military?

Yes
No

5.B. Please upload a copy of your DD214

Click or drag a file to this area to upload.

6. Do you hold any professional licenses?

Yes
No

6.A. What professional license(s) do you hold?

7. Have you ever been convicted of a crime?

Yes
No

7.A. Please list the crime you were convicted of, the name of the state and the court where you were convicted, and the year in which you were convicted.

7.B. Are you currently on probation?

Yes
No
I don't know.

8. Please upload a copy of your ticket or complaint if you have not already provided a copy to us.

Click or drag a file to this area to upload.

Ideally your ticket copy will be in a .pdf format.

9. Please write in your own words what happened that resulted in the criminal charge. 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. Please also include in your description 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.

10. What is your goal in this case?