Pesantes Law

310 Comal St 2nd Floor
Austin TX , TX 78702

New Client Intake Form

Criminal Defense

Thank you so much for contacting our law office. Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation.

Privacy Policy

All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your Social Security number and other personal information will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.

Social Security numbers are most often used to positively identify parties. Most courts require Social Security numbers of all parties in a case. Some other examples of how this information may be used include:

Initial service
In court orders
In required reports or other documents filed with the State

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you.

Client Information

INSTRUCTIONS:

Please ensure that you include the following details when providing us with your contact information:

Your full legal name as it appears on your ID
Address
- Your residential address
- Any alternate address(es) - Business, Mailing, etc.
Telephone numbers:
- Your preferred telephone number
- Any alternate telephone number(s) - Mobile, Work, etc.
- Your Fax number, if applicable
Email address
- Your primary email address
- Any alternate email address(es) - Personal, Work, etc.
Your date of birth

Is the person currently detained?

Yes

Personal Information

Contact information

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Social Security Number:

Driver’s License Number:

State:

Emergency Contact

Name:

Relationship:

Phone Number:

Email Address:

Employment Information

Current Employer:

Occupation:

Work Address:

City:

State:

ZIP Code:

Work Phone:

Legal Case Information

Case Name/Number:

Date of Arrest/Incident:

Loca8on/County:

Charges:

Assigned Court:

Assigned Judge:

Financial Information

Fee Agreement:

Method of Payment:

e.g., Credit Card, Check, Cash

General Information

How did you hear about our firm?

Referral

Online Search

Other

Prior Legal Representation

Have you had legal representa8on for this matter before?

Yes

Additional Comments or Information:

Consent and Authorization

E-Acknowledgment

I hereby authorize PesantesLaw to represent me in the legal matter specified above and provide the necessary informa8on to handle my case.

Disclaimer

Please note that comple8ng this form does not by itself establish an a`orney-client rela8onship.

Thank you.

When you are finished, please click the "Submit" button.