What date were you arrested?
What county did the arrest happen in?
What charges were made against you?
What department/agency was the arresting officer from?
Where were you when you first encountered the police?
BRIEFLY, what were you doing when the police encountered you?
Please describe BRIEFLY how the police encounter took place:
Was there a search of: Your person Your belongings Your car Your home Other (please identify) –
Was anyone else present with you at the time of the police encounter? yes no If so, were those persons also arrested? yes no
Where were you taken after the arrest?
Were you read your Miranda rights (“You have the right to remain silent . . .”)? yes no
Were you questioned by the police? yes no If yes, when and where did the questioning occur?
Did you make any statements to the police at any time? yes no If yes, was this before or after your Miranda rights? before after
Did you admit to any criminal activity? yes no If yes, BRIEFLY describe that admission –
Did you make any phone calls after being arrested? yes no If yes, to whom?
Did you spend any time in jail after the arrest? yes no
Are you currently on bond? yes no
Have you requested a court appointed lawyer? yes no
Please provide us your name (Required):
Phone number (Required):
Email:
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