Major Criminal Defense Intake Form

Name
Address
City
State
Zip Code
E-mail Address
Home Phone
Business Phone
Cellular or Pager
Facsimile
Booking #
Court Date
Time
Court Name
Division/Room
Arresting Officer's Name and Badge
City of Arrest
What crime were you arrested for?
Any similar past convictions?
If yes, when and where?
Any other convictions?
If yes, what, when and where?
Are you on probation or parole?
For what?
Do you have any other cases pending?
Was anyone else arrested?
If so, name(s) of all persons arrested:
What statements do you remember making?
Describe events leading to your arrest:
Have you discussed the alleged crime?
If so, what was discussed and to whom?
Any witnesses to the alleged crime?
If yes, provide names and info if known:
Amount of the bond you posted?
Are there any special bond conditions?
Were you referred by somebody else?
Who?
Special Concerns or added comments:
Where did you hear about this website?