Underwood Law Offices Intake Form - Traffic
Please answer the following questions. Our office will review your information and contact you.
Title
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Citation Number on Ticket (Usual format AB123456 or 123456AB)
Your answer
Cited for (Violation Code (VC) and description)
Your answer
What is your court date? This will be the due date on your ticket or courtesy notice.
MM
/
DD
/
YYYY
Interaction with Officer (check all that apply)
Please use this section to further explain your answers above, if necessary.
Your answer
Have you received any other traffic tickets in the last three years? If so, when, and what is the status of those tickets (how did you resolve them)?
Your answer
Have you taken Traffic School in the last 18 months?
Additional Information - Please add any additional information you feel would assist us in helping you with your case.
Your answer
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