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Traffic New Client Intake
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Full Name (First Middle Last)
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Date of Birth
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Present Street Address (Street, City, State, and Zip)
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Telephone Number
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Email Address
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Current Employer Name
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Employer's Address (Street, City, State, and Zip
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Employer's Phone Number
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Jurisdiction of Charge (City, County, State)
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Case Number (If Known)
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Next Scheduled Court Date
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DD
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YYYY
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