Consultation Request

* Indicates required field

 

First Name*  Middle Initial
Last Name*
   
Address1
Address2
City       
State Zip

 

Home ph.* Work phone 
Cell phone Pager
Other Email*

  

Seeking representation for:* Self  Family Member  Friend

 

Please fill out the following information pertaining to the individual needing representation:

 

First Name*  Middle Initial
Last Name*
Name on arrest form   Click here if same as above

 

Case No. Jail Name
Date of Birth Jail No.
Driver Lic. Judge
SSN    

 

Charges*
   
Describe what happened*
   
Bond No Yes   Amount

 

Is the arrested individual still in custody? Yes  No
Did he/she make statements to police? Yes  No
     If "Yes", choose one:  taped  court reporter  
  written  oral  
Are we the first attorneys you have consulted regarding this matter? Yes  No
Have you ever been represented by an attorney before? Yes  No
     If "Yes", please state the circumstances:  
   
Have you ever been arrested before? Yes  No
     If "Yes", please explain what charges:  
   
Have you ever been convicted of a crime before? Yes  No
     If "Yes", please explain what charges:  
   
   
Are you known by any other names ? Yes  No
     If "Yes", please list names (fictitious, maiden, former, or nickname):  
   
   
   
How did you learn about our firm?  
Friend Name    
Client Name    
Lawyer Name    
Florida Bar      
Yellow Pages      
Website Name    
Other Explain  
       

How will you pay for your attorney’s fee in this matter ?

 
Cash  Check  Credit Card  
       

 

PLEASE READ CAREFULLY & SIGN BELOW:

The above information is submitted for the purposes of requesting a consultation. Following your initial interview, if you agree to hire the Attorney, and the Attorney agrees to represent you, you will both sign an Agreement for Representation.  The Agreement for Representation will set forth the terms and conditions of representation.

 

NOTICE: This office does not represent you with regard to the matters set forth by you herein in this information sheet or discussed during your consultation, unless and until, both of you and the Attorney execute a written Agreement for Representation.

 

Indicate your acknowledgement and acceptance of the above by clicking the "I AGREE" checkbox AND typing your full name in the area provided. Your acknowledgment means only that you submitted the above completed information and does not mean you have hired the Attorney.

 

I have accurately submitted the above information to the best of my knowledge. I agree to the terms as described above and consent to be contacted by a representative of Marrero & Bozorgi, LLP.

 

I AGREE*

 

Signature

Type your full name and then click the "Submit" button.*

 

 

 
 
Know your Rights
Do not get caught in a situation unaware of your legal rights.  Click here to learn about your rights.

Understanding the legal system
This web site exists to answer all your questions.  Click here for answers to the criminal process step by step.
 

Case Evaluations
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CRIMINAL DEFENSE TRIAL LAWYERS

 

 

Being charged with a crime is devastating.
 

Our law firm has the experience you need to protect your rights.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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MARRERO BOZORGI LLP
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