Law Office of Tara Selver

LAWYERS FOR CRIMINAL JUSTICE
- Los Angeles based Criminal Defense and Immigration Law Firm

PLEASE COMPLETE THIS FORM ON BEHALF OF THE DEFENDANT
To ensure your privacy this form is on a secure page and the information will only be used by
Lawyers for Criminal Justice

U.S. CITIZEN CLIENT INTAKE INFORMATION
Name of defendant:
Defendant’s prison number:
Incarceration address:
Contact person for defendant
Name:
Address:
Phone number:
E-mail:
What is your relationship to the defendant?
Do you and/or defendant speak English?	Yes No
If not, what language?
Did defendant have a jury trial?	Yes No
Where and when?
What was the defendant convicted of?
If there were mutiple counts please list them, and the verdict for each:
When was defendant sentenced?
What was the sentence?
Was a notice of appeal filed?	Yes No
When?
Who was defendant’s trial attorney?
Are there any other legal matters currently pending against the defendant?	Yes No
Please list them:
Has defendant ever appealed his/her conviction before?	Yes No
What was the last court the case was in?
What legal issues would the defendant, or you, like to see raised in his/her appeal?
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