Please complete this form to submit a request for your personal reinstatement requirements. The following information is required to accurately identify your record and respond to you.
Please print out this new client questionnaire form and fill it out in great detail. This form will provide us with needed information to allow us to give you the best defense. Fill this form out before you read any of the police reports because your memory is the best source. Police can make mistakes when at a later time they fill out their reports. Select the form and click print from your browser. When you have completed this new client questionnaire, please return it to our office by mail, email or fax. Dan Shipp will review your completed questionnaire once you have retained his services.