Contact Name


Are you known by any other names?

 Yes No


If yes, please list any other names you have used


Telephone Number



Alternate Number







Does this matter involve a business that you own or run?

 Yes No


If yes, provide the business name, address, and phone


Are you being sued?

 Yes No


Name of the party suing you


Name, address, and telephone number of the attorney for the party suing you, if any


Date you were served with court papers

/ /


Name and location of the court you are being sued in


Are you suing someone or planning on suing them

 Yes No


Please provide their name


How much are you suing for/ how much are you being sued for?



Please provide us with a brief description of what your matter is about


Is there any other information that we should be aware of?

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