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Pre Application Form
                                                                                                                 
Person charged with offense   Examples Below
Date of birth 10/17/1968
Sex
Current address
Primary phone number 555-555-5555
Secondary phone number
Date of arrest 10/17/2007
Alleged Charges
City / County arrested in
Arresting Agency Gwinnett Police, State Patrol, City of LawrencevillePolice
Court Date if known
Is Defendant in jail
How much is their Bond $ 50,000
Prior criminal history ?
Name of person filling out form
Primary contact phone number
Relationship with Defendant
Please provide your email address hhhhh@yahoo.com
How did you hear about our Firm

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