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INTAKE FORM: ASU Indian Legal Clinic Rights Restoration & Criminal Records
Please take 5-10 minutes to give us some information that will allow our Student Attorneys to research your case and advise you of your options.

Please contact the Indian Legal Clinic at IndianLegalClinic@asu.edu or 480-727-0420, if you have any questions or concerns.

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Email *
Client Name *
Tribal Affiliation *
Please list any other names you have used (pre-marriage, aliases, etc.) *
Date of Birth *
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DD
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Mailing Address *
Phone Number *
Name of Person Assisting (interpreter, etc.)
Contact for Person Assisting (interpreter, etc.)
Have you ever received a Prison Sentence?  *
Have you ever been convicted of a felony by a state court in Arizona?  *
Please select all the counties where you have felony convictions (it's okay to leave this blank if you are not sure or do not remember).
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Have you ever been convicted of a felony by a state court in another state?  *
Have you ever been convicted of a felony by a federal court (in any state)?  *
Please list all states, other than Arizona, where you have felony convictions (including federal).
Have you completed Probation on all charges? *
Do you owe Victim Restitution in any case?  *
If there were any victim(s) in any of your cases, please list their names, to the best of your knowledge. *
Do you have any Marijuana Convictions in Arizona? *
Do you know of Open Cases or Active Warrants against you?  *
Any questions or comments?
I agree to allow a Student Attorney to research my cases(s) and to prepare court documents to be reviewed with me and filed on my behalf, for restoration of rights, set aside, expungement, and/or sealing of records, as I may be eligible.

I understand that completing this form does not create an attorney-client relationship.  I understand that the Indian Legal Clinic (ILC) will review my case to determine if it can represent me, and if the ILC agrees to represent me, the ILC will prepare a representation agreement.   
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A copy of your responses will be emailed to the address you provided.
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