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Call 212-627-3184 For 24/7 Help, Call:212-627-3184

For 24/7 Help, Call: 212-627-3184

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Criminal Defense
Civil Rights
- False Arrest
- Police Brutality
Insights
- Videos
Contact

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Intake form

Intake Form

All information collected in this form is confidential and will not be disclosed without your consent. The more thoroughly you complete this form, the better I can determine the best strategy for your case.

Name(Required)

First Last

DOB

MM slash DD slash YYYY

Email(Required)

Phone

Name and phone number of a backup contact for you

Address

Street Address City State / Province / Region ZIP / Postal Code

How long have you lived at that address?

How long have you lived in New York City?

Occupation

Who is your employer?

What is your employer’s address?

How long have you worked there?

Annual income

Are/were you in the military?

Yes

No

When, and were you honorably discharged?

Did you graduate from high school?

Yes

No

Name of school and location

Did you attend college?

Yes

No

Name of school and location

Did you graduate?

Yes

No

When

What was your major?

Did you attend grad school?

Yes

No

Name of school and location

Did you graduate?

Yes

No

What degree did you receive?

Are you a U.S. Citizen?

Are you married?

Yes

No

For how long?

Do you have children?

Yes

No

How many children and their ages

Who do you live with?

Do you have a history of substance abuse issues?

Yes

No

Please describe, including type, amount, and frequency:

Do you have a history of mental health issues?

Yes

No

Please describe, including type, duration of issues, and medications prescribed:

Is there anything else about you that you think I should know?

Criminal History

Have you ever been convicted of a crime?

Yes

No

Please list the crimes of conviction, including dates, locations, and sentences:

Have you ever been on parole or probation?

Yes

No

For how long, and did you ever have any violations?

Are you currently on probation or parole?

Yes

No

Provide name and contact information for your P.O.:

When does your parole/probation expire?

Pending Charges

Note: Please send me any available court paperwork that you have for your case.

What are your current charges?

What is your docket or indictment number?

When were you arraigned (your first court appearance)?

In which courthouse is your case pending?

In which courtroom is your case pending?

When is your next court appearance?

What is the purpose of your next court appearance?

Are you aware of any plea offers by the prosecution?

Yes

No

What is the most recent offer?

What is your bail amount currently set at?

If you paid to bail out, when was bail paid?

Did you pay the cash amount or bond amount?

If you used a bail bondsman, which company did you use?

Provide their contact information:

Arrest

When were you stopped by the police (i.e. when did you feel as though you could not leave, either from the police grabbing you, telling you to stop, or signaling for you to pull over your vehicle)? Provide day and time.

Where were you stopped?

If you were arrested inside of a building, did the police show you a warrant?

What is your relationship to the building (home, friend’s home, office)?

What were you wearing when you were stopped (clothing type and color)?

What are the names of the officers (and shield numbers if known) who grabbed you or told you to stop?

Did the officer/s tell you why they stopped you?

Yes

No

Who were the officer/s and what did they say?

When did they tell you why they stopped you?

Did the police search you?

Yes

No

Where were you when the police searched you?

Did you consent to the search?

Did the police recover anything from their search of you?

If yes, what was recovered?

Did the police injure you? If so, describe:

If you were in a building or car, did the police search that area?

Yes

No

When did the police search that area?

Did you consent to the search of that area?

Did the police recover anything?

If yes, what was recovered?

At any point in your arrest process, did you ask to speak with an attorney?

Yes

No

When?

Did you make any statements to the police?

Yes

No

What did you say?

Did you offer your statements without solicitation, or were they in response to police questioning?

Where did you make your statements?

Were you in handcuffs when you made your statements?

Did the police provide you with a Miranda warning (you have the right to remain silent…) before your statements?

Did a witness make an identification on the scene where you were arrested?

Yes

No

Do you know whether you were identified?

Were you put in a line-up at the police precinct for a witness to make an identification?

Yes

No

Do you know whether you were identified?

Was anyone else arrested in connection with your case?

Yes

No

Provide all known information about those persons:

How many hours were you in custody before you were released?

Incident

Describe what happened during the incident for which you are charged (your version of events):

If you were not involved during the incident and were elsewhere, where were you?

Were you not present during the alleged incident (i.e., you have an alibi defense)?

Yes

No

If you have an alibi witness, provide the alibi witness’ name and contact information:

If your case involves allegations from a person/s whom you know, please describe your relationship with that person/s and provide their contact information:

If any witnesses against you have a known bias against you, have a motive to lie, or are generally untrustworthy, please provide any relevant information:

From your perspective, what are any strengths and weaknesses of your case?

Currently, what sort of outcome do you reasonably expect for your case?

Is there anything else about your case you think I should know or that you want to emphasize?

Do you have any questions for me?

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NYC criminal lawyer Cody Warner is ready to get working on a strategic and tailored defense so that you can put your case behind you.

To discuss your case and see how Cody can help you move forward, contact him today.

Cody Warner, P.C.

11 Broadway
Suite 615
New York, NY 10004

PH: 212-627-3184

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