CRIMINAL INTAKE
CLIENT: _________________________________________________ DATE:__________________
ADDRESS: ___________________________________________ PHONE:____________________
_____________________________________________________ _____________________
_____________________________________________________ _____________________
LICENSE # AND STATE: ________________________________ SS#______________________
AGE______ DOB:_________ COURT AND COURT DATE_______________________________
DATE OF ARREST_________________ POLICE DEPARTMENT___________________________
PRIOR CONVICTIONS______________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
PROBATION OR PAROLE: _________________________________________________________
ANY OTHER CASES PENDING IN ANY OTHER COURT OR STATE:________________________
________________________________________________________________________________
________________________________________________________________________________
IMMIGRATION STATUS: ____________________________________________________________
NOTES:__________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
The Law Office of Pamala J. Favreau is located in Vernon, Connecticut and provides criminal defense to individuals throughout Northern Connecticut and Eastern Connecticut in cities such as Vernon, Danielson, Enfield, Manchester, New London, Norwich, Rockville, Willimantic and Windsor and in Tolland County, Hartford County, New London County and Windham County.
