DWI Questions on Field Sobriety tests and arres

If arrested for DWI, be prepared to answer many questions at your in office consult with an attorney.
CHARGES/TICKETS ISSUED [provide tickets, hearing notice and other important papers to front desk to be copied]
1.______________________________________ ______________
2.______________________________________ ______________
3.______________________________________ ______________
4.______________________________________ ______________
IMPORTANT INFORMATION
Date of Offense: __________________ Time: _____ (A.M./P.M.) Your Age _____
Town: ___________________________ (street/location)?____________________
What Happened: ________________________________________ ________
________________________________________ _____________________
________________________________________ ________________________________________ ________________________________________ ________________________Write additional details on the back of this page. YOU MUST FILL OUT BOTH
PAGES PRIOR TO SEEING THE ATTORNEY.Kenneth Vercammen, Esq. Confidential interview form page 2
Other Persons Arrested or Witnesses:
______________________ ____________________________
co-defendant/ Witness Name Their Address Phone No.
______________ ______________________________________
Name Address Phone No.
What did you tell the police? Provide details ____________________________
________________________________________ ________________________________________ ________________________________________ ______

Occupation: _____________ Employer: _______________ Town: ________
[Attach your business card to clipboard.]
Do you need your drivers license for work? ____ Distance driven to work: ____

Prior criminal convictions or arrests (include description of each charge, date of conviction, and place of conviction. -If none, write none): ____________
________________________________________ ________________________________________ ________________________________________ ______
Prior motor vehicle tickets, town and year (ex: speeding, drunk driving, no insurance, driving while suspended, etc. -If none, write none):____________
________________________________________ ________________________________________ ________________________________________ ________________________________________ _____________________________Prior Traffic ticket downgrades to no point tickets since 1999 [39:4-97.2]:
1. Town _______________________ Year ___________ [if none, write none]
2. Town _______________________ Year ___________
[Please note the DMV/MVC only permits 2 "no point" downgrades in 5 years.]

What questions do you have/ how can we help you and anything else important: ________________________________________ _____________
________________________________________ _______________________
________________________________________ _______________________
All paid clients receive a T-shirt, water bottle & Can Koozie upon request. Please ask upon paying the retainer. Please help yourself to all brochures in the reception area. If you have a business card, please attach it to the clipboard.
For additional information, visit www.benotguilty.com and www.njlaws.com