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*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Please provide the address of the property involved:

What type of issue does your matter involve?

Are you the present owner of the property?
YesNo

If no, please provide the owner's name and address.

Describe your situation, including any relevant dates:

How would you rate your legal needs described here?

Are any other people or businesses involved in this matter?
YesNo

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

Do you have any documents that could help explain your situation?
YesNo

If yes, list those documents and their dates:

Are there other documents that you do not have access to that could be of assistance?
YesNo

If yes, list those documents and their dates and locations (if known):

Describe how this situation has impacted you:
Describe what you would like to happen to resolve your issue (your preferred outcome):
Have other attorneys worked on this matter? YesNo
If yes, provide names, addresses, and a brief description of their involvement:
Special concerns:
Where did you hear about this website?

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