Name
Email Address
Phone Number
Business Phone
Cellular or Pager
Address
City
State
Zip
Does this matter involve your employer Yes No
If yes, please provide the following:
Employer
Webpage
Main Phone
Job title and description (including areas of responsibility)
Were you arrested Yes No
If yes, please provide the following information:
Booking #
Court Date
Time
Court Name
Division/Room
Arresting Officer's Name and Badge
City of Arrest
What were you arrested for (include Code section if known)
Have you been convicted of a similar crime before Yes No
If yes, when
Have you been convicted of other offenses Yes No
If yes, what and when
Are you on probation or parole Yes No
For what
Do you have any other cases pending
Was anyone else arrested Yes No
If so, name all persons arrested
What statements do you remember making to the police about the alleged crime
Describe the order of events leading up to the arrest or your need for advice
Have you discussed the alleged crime with anybody else Yes No
If so, who did you discuss it with and what did you tell them?
Were there any witnesses to the alleged crime Yes No
If yes, provide names and contact information if known
Were there any other individuals involved in the alleged crime Yes No
What is the amount of the bond you posted
Are there any special bond conditions Yes No
Were you referred by somebody else Yes No
Who
Special concerns
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Exclusively Criminal Defense for Over 25 Years
Rothman & Associates, located in Miami, Florida, represents clients throughout the Middle and Southern federal districts of Florida, including the communities of Miami, Ft. Lauderdale, Miami Beach, West Palm Beach, and Hollywood, as well as in Broward County, Miami-Dade County, Palm Beach County, FL and throughout the United States.