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False Arrest Case Intake Form

  • Step1
  • Step2
  • Step3
  • Step4
  • Step5

Section1

The date of this incident was:

The location of the incident was:

I want to file a claim against a:

Please Explain:

I was the victim of:

Please Explain:

Section2

I was charged with a crime:

The area of the incident had video cameras:

I have, or can get the name of, a witness to the incident:

Section3

After the incident, I sought medical or hospital care:

I injured my:

Please Explain:

Section4

The injuries have caused me to:

Please Explain:

Additional Information:

My name is:

My email address is:

My telephone number is:

I understand that the transmission of this information does not create an attorney client relationship but is, instead, a request for a free consultation with an attorney about the details of my potential case.

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