Kevin Chaffin Law Offices in Ventura
   
 

Select your type of case and confidentially submit information for immediate attorney review and response.

Bankruptcy
Probate
Guardianship
Wrongful Death
Wrongful Termination
Sexual Harassment
Hostile Work Environment
Failure to Pay Wages
Overtime and Salary Claims
Retaliation and Whistleblower
Discrimination
Medical Malpractice
Elder Abuse & Nursing Homes
Train Accidents
Car & Motorcycle Accidents
Criminal Defense
Family Law
Personal Injury

Home | 674 County Square Dr. - Suite 310, Ventura CA 93003 - Ph 805-650-8200 - info@chaffinlaw.com

Criminal Law Questionare

PLEASE NOTE:
This questionnaire is meant solely for the use of the consulting attorney for purposes of analyzing and evaluating the prospective client's case. The contents of this document are therefore protected by the attorney-client privilege and the attorney work product doctrine. It is very important that you be completely truthful, accurate and complete in answering the following questions. The defendant in this case will likely obtain all relevant records about you. Therefore, it is crucial that we are aware of all information, including information you may believe will damage your case, in order to best represent you. If we decline to take your case, it does not mean you do not have a case. Therefore, if we decline your case you should contact another attorney. Most of our clients are employees or injured persons. If you are an employer, or you are concerned you might be sued by someone else, do not complete a questionnaire. Instead, you must first contact our office by telephone.

GENERAL BACKGROUND INFORMATION
1 What is your name?

2 What is your age?

3 What is your mobile cell phone number?

4 What is your home phone number?

5 What is your e-mail address?

6 What is your street address?

City

State

Zip Code

7 What is your Social Security Number?

8 What is your California Drivers License Number?

9 What is your Date of Birth?

10 What is your inmate booking number?

11 What is your case number?


12 What is your next court date?

GENERAL CASE INFORMATION
13 What type of criminal law charges are you facing?
(DUI, Domestic Violence, Drugs, Alcohol, Theft, Assault, White Collar, etc.)

14 Which law enforcement agency was involved in your investigation/arrest?
(City Police, County Sheriff, CHP, DOJ, DEA, FBI, County District Attorney, State Attorney General, US Attorney General, etc.)

PRIOR CIVIL OR CRIMINAL LITIGATION OR CLAIMS
15 Have you ever filed a lawsuit before or have you ever been sued before?

If so, please explain:

16 Have you ever filed for bankruptcy before, or are you considering filing bankruptcy in the near future?

If so, please state the date you filed and the result, (or state the date you are planning on filing bankruptcy. (****Note if you are planning on filing bankruptcy anytime soon do not sign or file any bankruptcy documents without consulting with this office first, as filing a bankruptcy action could result in the termination of your lawsuit****)

17 Have you ever been arrested?

If so, please state the date, the charge/s and whether you were convicted.

18 Have you ever filed a workers compensation claim for any injuries sustained at work?

If so, state the date of complaint and the result?

 
Chaffin Law Office - 674 County Square Dr. - Suite 310, Ventura CA 93003 - Phone 805-650-8200 - email: info@chaffinlaw.com