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Tell Us About Your West Palm Beach Criminal Case (Questionnaire)
Tell Us About Your West Palm Beach Criminal Case (Questionnaire)
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Personal Information:
Personal Information:
Name:*
Address:
City:
State:
ZIP:
Home Phone:
Work Phone:
Cell Phone:
Other Phone:
Email:
Height:
Weight:
Age:
Date of Birth:
U.S. Citizen
Yes
No
Military
Yes
No
Education:
Occupation:
Marital Status:
What was the date of your DUI arrest?
What was the time of your DUI arrest?
What city were you arrested in?
Which of the Following Crimes Were You Arrested for?
Which of the Following Crimes Were You Arrested for?
Please check all that apply:
Posession of Drugs
Trafficking of Drugs
Sale of Drugs
Manufacture of Drugs
Delivery of Drugs
Possession of Drug Paraphernalia
Disorderly Conduct
Disorderly Intoxication
Obstructing Justice
Resisting Without Violence
Trespass
Driving Under the Influence (DUI)
Boating Under the Influence (BUI)
Reckless Driving
Driver License Offenses
Possession of a Fraudulent or Stolen Driver License
Driving with a Suspended License (DWLS)
Fleeing and Eluding
Grand Theft
Dealing in Stolen Property
Petit Theft
Shoplifting
Indecent Exposure / Lewd and Lascivious Conduct
Probation Violations / Community Control Violations
Seal and Expunge Records
Fraud Offenses
Credit Card Fraud
Insurance Fraud
RICO
Homicide / Murder
Mortgage Fraud
Wire Fraud
Phone and Telemarketing Fraud
Bankruptcy Fraud
Healthcare Fraud
Organized Fraud
Stalking / Aggravated Stalking
Assault and Battery / Domestic Violence
Aggravated Battery / Aggravated Assault
Weapons Offenses / Concealed Firearm / Deadly Missile
Forgery and Counterfeiting Offenses
Uttering a Forged Instrument
Check Offenses (Worthless Check)
Burglary of a Dwelling / Conveyance / Structure
Possession of Burglary Tools
Robbery_/_Armed_Robbery
Prostitution Offenses / Soliciting
Battery on a Law Enforcement Officer
Resisting With Violence
Tampering / Witness / Evidence
I want information about Sealing or Expunging A Criminal Records
Other
Prior Criminal History:
Prior Criminal History:
Have You Ever Been Arrested Before?
Yes
No
If You Have Been Arrested, Please List All Arrests Below, Including The Dates Of Arrests, Whether You Were Convicted And Dates Of Conviction, If Applicable.
Were You On Probation At The Time Of This Most Recent Arrest?
Do You Have Any Other Cases Pending?
Yes
No
If So, What Case In What County?
Was Anyone Else Arrested With You At The Time Of This Most Recent Arrest?
If So, Name All Persons Arrested:
Did You Make Any Statements To The Police Regarding This Most Recent Crime?
If So, What Did You Tell Them?
Describe All Of The Events Leading Up To The Arrest:
Have You Talked About This Recent Arrest With Anyone?
If So, What Did You Discuss With Them?
Brief Summary Of The Events Leading Up To Your Arrest:
Brief Summary Of The Events Leading Up To Your Arrest:
Did Any Police Officer On The Scene Use Excessive Force At Any Time?
Was This Observed By Any Other Officers?
Was This Observed By Other Civilians?
Do You Have Any Witnesses That Will Testify On Your Behalf?
Do You Have Any Witnesses That Will Testify On Your Behalf?
Please List All Witnesses That Will Testify On Your Behalf With A Brief Summary Of What Each Individual Will Testify To:
Witness #1:
Witness #2:
Witness #3:
Witness #4:
Witness #5:
What Was Your Bond Amount For This Most Recent Arrest?
Are You Being Monitored By Pre-Trial Release?
Special Instructions - Questions Or Comments Not Covered Above.
Special Instructions - Questions Or Comments Not Covered Above.
Please List Any Additional Comments or Special Instructions That Are Not Covered Above:
