Client Intake English | Canyon County

Client Information Sheet

Please fill out this form completely. The information you provide is strictly confidential and is for use only in connection with legal services that may be performed for you.

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Select a Judge

Full Legal Name*

First Middle Last

Nicknames or Other Names Used

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

In case of an emergency, how may we reach you?

Court Case #*

Date of Birth*

Social Security Number*

Driver's License Number & State Issued

Your Employer & Occupation

If you are self-employed, please indicate name of business.

Your Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Alternate Contact Information

Who else may we contact

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

How are you related?

Other Information

What charges have been filed?*

Are the charges Felony or Misdemeanor?*

Felony
Misdemeanor

Are you presently on probation or parole?*

Yes
No

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