YAGMAN & REICHMANN

475 Washington Blvd.

Venice, CA 90292-5287

(310) 452-3200

NEW CLIENT EVALUATION SHEET

Sent

Received

   

READ THIS CAREFULLY: This sheet is designed to get all the information we need to evaluate your case. Provide complete answers to every question.

YOUR FULL NAME

YOUR COMPLETE RESIDENCE ADDRESS

YOUR HOME TELEPHONE

YOUR COMPLETE BUSINESS ADDRESS

YOUR BUSINESS TELEPHONE

YOUR SOC. SEC. NUM.

/

/

DRIVERS LIC. No.

YOUR BIRTH DATE MONTH/DAY/YEAR

NAME OF POLICE FORCE INVOLVED,  FOR EXAMPLE : LAPD,  SHERIFF,  RIVERSIDE, etc.

NAME OF OFFICERS INVOLVED (ALSO, PROVIDE BADGE NUMBERS, IF KNOWN)

INCIDENT DATE

YOUR PRESENT OR LAST JOB OR OCCUPATION

EVER BEEN CONVICTED OR PLED GUILTY OR NO CONTEST (YES OR NO)?

    

IF "YES", TO WHAT? DON'T GIVE NUMBERS, USE WORDS

   

IF "YES", GIVE DATE OF PLEA OR NO CONTEST (MO/DA/YEAR)

   

EXACTLY WHAT HAPPENED? THAT IS WHO DID WHAT TO WHOM? THIS IS A TEST OF YOUR ABILITY TO FOLLOW INSTRUCTIONS AND TO BE A GOOD WITNESS. DO NOT EXCEED THE LINES PROVIDED, DO NOT USE THE OTHER SIDE. DO NOT USE UNUSUALLY SMALL HANDWRITING.  DO NOT REFER TO OTHER MATERIALS IN TELLING WHAT HAPPENED. DO NOT SAY THINGS LIKE "SEE ATTACHED". DO ATTACH ANY MATERIALS YOU MIGHT HAVE. WE WANT YOUR STORY IN YOUR WORDS. WE CANNOT RETURN ANY MATERIALS YOU ATTACH. MAKE COPIES FOR YOURSELF TO KEEP. YOU WILL BE NOTIFIED ONLY IF WE ARE INTERESTED IN YOUR CASE.

 

 

 

 

  

WHY DO YOU THINK THIS HAPPENED?

 

 

HOW WERE YOU HARMED?

 

 

WHO GAVE YOU OUR NAME?

(PUT NAME HERE)