DUI Email Request
Western Washington
Today's Date:
Court Date:
Charges:
Blood Alcohol Content (BAC) Reading:
Personal Information:
Name:
Address:
E-Mail Address:
Telephone:
Message Number:
Name of person at message number:
Where Do You Work?:
How Long at Job?:
Type of Work?:
Incident Information:
Date of Incident:
Type of Case:
Charges Filed:
Jailed/Arraigned:
Arraignment Date:
County in Which Incident Occurred:
Court:
Superior
District
Municipal
Ticket/Citation Issued?:
Ticket
Citation
Sheriff/City Police/State Patrol:
Sheriff
City Police
State Patrol
Did You Take a Breath Test?:
Yes
No
Do You Have a Commercial Driver's License?:
Yes
No
Do You Have Prior Convictions for Alcohol Related Offenses?:
Yes
No
If So, When, Where?:
Do You Have Any Other Pending Traffic Tickets or Charges in
This or Other Counties in This or Any Other State?:
Yes
No
Any Other Pertinent Facts:
DISCLAIMER:
Please complete this form if you wish to have an attorney review your inquiry.
Please understand that emailing this information to a firm attorney and receiving
a response does not create an attorney-client relationship. This means an attorney
of this firm does not represent you until you have met in person with that attorney
and you and the attorney have signed a written retainer agreement. Questions and
answers alone do not create an attorney-client relationship.
